Would You Know If You Had a Hernia?: Dr. Peter Rice



My Hernia Story #1

An inguinal hernia is a weakness or separation of muscles in the abdomen that allows abdominal tissue – typically fat or intestines – to move where it shouldn’t ought to be. Sometimes the hernia can come and go without symptoms. Sometimes the hernia traps tissue causing pain and discomfort. Hernias can be a medical emergency if the intestines become trapped and the blood supply compromised.

Although physicians will often examine young men for hernias under the testicles – “turn your head and cough” – the actual inguinal hernia can occur on either side of the lower abdomen at about the level of the top of the pubic bone. The symptoms – discomfort and pain – are referred to other sites depending on how the hernia pulls on nerves and other tissues.

Symptoms of a Hernia

Symptoms of a Hernia

 


Some patients can see or feel their hernias; many cannot.

  • A hernia can present as indigestion, abdominal discomfort that might feel like bladder issues, or as testicular pain in men.
  • The hernia presentation can be an acute change that might be noticed after heavy lifting, or a slow insidious progression of symptoms that gets worse over time with little apparent cause.

I was recently diagnosed with an inguinal hernia. Looking back, it developed slowly over at least two years and caused pain, nausea and discomfort that at different times seemed (to me) to mimic a bladder infection, gastric reflux disease and testicular issues.

Like many patients I visited several healthcare providers who ruled out serious abnormalities in their specialty areas, but who did not really provide me with information that made me comfortable with the diagnosis. Like many patients, I moved on to the internet and typed in some specific symptoms to learn there were numerous causes, some of which were serious. Just as for medications, the internet contains so much information of variable quality that the problem is interpreting what is useful, true and important.

I spoke with a colleague who had his hernia present acutely (with some symptoms similar to my own) and more severely, so he had it repaired immediately. He and others described a recovery of several weeks.

“It could be a hernia, but I really can’t feel it”, from one doc. I had an ultrasound which was described as possible but small. The symptoms definitely didn’t feel small to me and continued to worsen to where I stopped biking and most activity last summer. Eventually, I spoke with a surgical nurse who really did know about hernias and explained how all the symptoms fit together. Even the “small” comment made sense, since the tighter hernias are more likely to trap tissue and cause pain.

So I found myself scheduled for surgery a short time ago. I ended up having a smaller “indirect” hernia on my right side and a larger but asymptomatic “direct” hernia on my left side. Hernia repair can be either laparoscopic or “open”. My open hernia repair involved entering the area from the outside, suturing the separated muscles together and placing a reinforcing mesh in the area to prevent future herniation.

I learned something from the experience.

  • I should have been more persistent in asking around and finding someone who could interpret my symptoms and help me.
  • In the area of diagnostics, you often have to find just the right “specialist” to help you, as though you need to know what’s up in order to find out what’s up.

And, of course, I always tend to compare experiences back to pharmacy. If you have a problem that may be related to your medications, you do not need to hunt around. Your pharmacist is the one that can help you make sense of drug information and your drug responses.

Hernia Info at MedLine Plus
https://medlineplus.gov/ency/article/000960.htm

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