Hernia Solution - David Albin M.D., Michael Albin M.D.

Hernia Solution (eBook)

The Most Comprehensive, Up-to-date Advice and Information Regarding Hernias

David Albin M.D., Michael Albin M.D. (Autoren)

eBook Download: EPUB

2022 | 1. Auflage
216 Seiten
Bookbaby (Verlag)
978-1-0983-9726-5 (ISBN)

As you read The Hernia Solution, Doctor David and Michael Albin, the Hernia Specialists, will put your mind at ease with the latest information and a rundown of the most cutting-edge surgical techniques available to help you decide what is best for you. Drs. David and Michael Albin have performed over 20,000 hernia surgeries. This book will help inform you when hernia surgery is absolutely necessary, when you can wait, and when you may not need surgery at all. Plus you'll find invaluable post-op care that will reduce pain while getting you back to work and your favorite sport ASAP! This book is a compilation of important facts, findings, and questions that have arisen during my interviewing, diagnosing, and treatment of patients. Well, I am here to dispel the myths and get you to the truth about hernias. If it should happen to you or someone you care about, let this book be your guide to quell your fears and bring you peace of mind. It is my intention that after reading The Hernia Solution, you will have a complete understanding and be able to make a fully informed decision on how to best treat your particular hernia.

As you read The Hernia Solution, Doctor David and Michael Albin, the Hernia Specialists, will put your mind at ease with the latest information and a rundown of the most cutting-edge surgical techniques available to help you decide what is best for you. Drs. David and Michael Albin have performed over 20,000 hernia surgeries. This book will help inform you when hernia surgery is absolutely necessary, when you can wait, and when you may not need surgery at all. Plus you'll find invaluable post-op care that will reduce pain while getting you back to work and your favorite sport ASAP!This book is a compilation of important facts, findings, and questions that have arisen during my interviewing, diagnosing, and treatment of patients. Well, I am here to dispel the myths and get you to the truth about hernias. If it should happen to you or someone you care about, let this book be your guide to quell your fears and bring you peace of mind. It is my intention that after reading The Hernia Solution, you will have a complete understanding and be able to make a fully informed decision on how to best treat your particular hernia.

CHAPTER 3:

Interviewing the Hernia Patient

THE SYMPTOMS OF A HERNIA

Individuals will experience different symptoms depending on the type of hernia as well as the person’s health and well-being. In order to properly diagnose a hernia, your doctor will perform a physical exam and review your symptoms to first determine whether or not there is a hernia present.

The symptoms of a hernia are the presence of a bulge located on the abdominal wall that may or may not be painful. Less common symptoms are urinary disturbances associated with frequent urination or urinary infections. This occurs when the hernia contains the urinary bladder. Rare symptoms are constipation, nausea and vomiting. These occur when the intestines are involved, and the hernia is becoming incarcerated.

A BULGE IS THE MOST COMMON SYMPTOM

The most common symptom is a swelling or a bulge that presents underneath the skin. The hernia is a small sac that protrudes through a hole or a defect in muscles of the abdominal wall. The hernia sac may contain some of the contents of the abdominal cavity, mainly the intestines or fatty tissue. The bulge may initially have a squishy feeling when pressed and may even temporarily disappear. This bulge is known to appear while you are standing and disappear while you are lying down, because of gravity. Imagine a glass of water open at the top. The open glass represents the neck of the hernia. Upright the contents remain in the glass but when the glass tips over the contents spill outside. In a similar fashion the hernia contents disappear when you lie down and protrude in a standing or sitting position.

A bulge or a swelling occurs because of a hole or defect in the abdominal wall muscle. When this happens, the abdominal contents, usually fat within the abdominal cavity or even intestinal contents protrude outwards. This bulge or swelling is known as a hernia. The intestinal contents are contained within a sac. The sac, called peritoneum, is also referred to as the hernia sac.

While performing certain strenuous activities there is an increase in abdominal pressure. Over time, these strenuous activities such as lifting, straining or coughing tend to cause an increase in abdominal pressure. Eventually, the muscle fibers give way, tear slightly, and the internal pressure forces a small portion of the peritoneum through the small hole in the abdominal wall. The resulting bulge is the hernia.

PAIN ASSOCIATED WITH HERNIAS

Pain is best explained with the rule of thirds. One-third of hernia patients have no pain. One-third have a slightly uncomfortable feeling that is mildly annoying. One-third have serious pain. Pain or discomfort occurs in the immediate area of the bulge or throughout the abdomen.

Of the approximately one-third of patients who have a bulge that is not at all painful or discomforting, it is “just there.” Some patients who experience no pain describe it rather as a “funny feeling,” or a “bulge in the groin that wasn’t there before.” A person who is very physically active, such as an athlete, or a worker who performs arduous labor is more likely to develop a hernia without feeling any pain. But it is unwise to ignore a bulge of any size, even if it is not painful. You should always have it examined by a physician, regardless.

Of the approximately one-third of hernia patients who have either a mildly painful or discomforting bulge, it is often described as an “uncomfortable feeling,” or a feeling that “something is always there.” That is, a bulge that was not present before, but is now noticeable with intermittent pain.

A person who is very physically active, such as an athlete, or a worker who performs arduous labor, may experience this intermittent discomfort. In some instances, during the phase when the abdominal wall is rupturing, resulting in a hernia, patients will complain of an ache similar to a muscle strain, instead of a sharp pain. This is a more typical complaint for patients who are constantly performing strenuous activities. They think muscle strain is a routine part of their daily routines. If they work hard some days, they are a little sorer than usual. But it’s the specific location of the soreness that may in fact be the hallmark of the development of a hernia.

Very annoying or severe pain occurs in approximately the final one-third of hernia patients. This pain may intensify as the hernia develops. This is called the acute phase and is the result of muscle tissue stretching or tearing, and impinging upon the surrounding nerves. When the tissues around the hernia are stretched or torn these tissues, which contain nerve endings, experience a painful response. For these patients, due to the intense discomfort, it is very clear that there is something wrong. The type of intense pain associated with a hernia can be described several ways: “a burning pain, a tearing pain, sharp, or point pain.”

A hernia can also cause a radiating pain which occurs away from the site of the hernia—or a generalized pain, which is a pain throughout the abdominal cavity. A hernia can also cause referred pain (sensations of pain in other areas away from the actual site of the hernia). This is because the irritated nerve travels along the nerve fibers to other regions supplied by the same nerve. For example, patients with an abdominal hernia may complain of pain in the testicle or the inner thigh. In this case, the irritated nerve at the site of the hernia has traveled along its path to the testicle or thigh. In some instances, the effected nerve may actually travel back to the abdomen resulting in pain that starts in the groin and radiates along the flank to the back. This pain is similar to the pain caused by testicular trauma because the nerve to the testicle travels backwards to the abdomen and the back. Thus, referred pain can occur anywhere along the course of the nerve from the site of origin in the groin, to the testicle and thigh, or inwards to the abdomen and back.

Inguinal hernia

The pain that occurs during the hernia development usually subsides in a week or two. If you develop a hernia, even if you no longer experience pain, it is important to remember that the hernia will not go away on its own. Even if the pain has subsided, surgery is the only treatment to correct or undo the hernia.

SEVERE PAIN SYMPTOMS

In severe cases a hernia can cause generalized pain when incarceration or strangulation occurs. The intra abdominal organs such as the intestines become pinched resulting in a diminished blood supply—which leads to an irritation of the nerves supplying the intestines, resulting in intense pain. The pain from a strangulated hernia, that starts as a stomachache, and increases in severity, may result in nausea and vomiting. If untreated, the strangulated intestines may rupture with fatal results if prompt surgery is not performed.

A physician should be immediately consulted to determine the cause of any severe pain. In some instances, the pain, while appearing to be a hernia may actually be due to a non hernia cause. A few common causes of abdominal pain are an appendicitis, cholecystitis, peptic ulcer disease, or an ovarian cyst. These should all be ruled out throughout the course of physical examination.

Constipation as a Symptom

Constipation occurs when a portion of the large intestines are within the hernia sac. The stool within the intestine becomes mechanically blocked by the hernia. At times, if the blood flow to the intestine is blocked, the stool will be unable to travel through the intestines. This will result in either constipation, or blood in the stool. When this occurs, emergency surgery is necessary.

Nausea and Vomiting

Nausea and vomiting may also occur when a hernia becomes incarcerated or strangulated. The flow of food in the intestines may become blocked by the hernia sac. The backup that results within the intestine may cause nausea or vomiting. The nausea and vomiting occur as a result of a partial or complete blockage of the intestine. In addition, loss of appetite may occur. The treatment of an intestinal blockage resulting in nausea and vomiting is considered emergency surgery.

Urinary Symptoms

Urinary disturbances may occur when the bladder is within the hernia sac. In this instance, a portion of the urinary bladder has been trapped by the hernia. The more common urinary disturbances result in frequent urination due to an inability to completely empty the bladder. A common symptom is urinating frequently during the day and several times at night.

When the bladder is chronically trapped within the hernia, a urinary infection may develop and cause a burning sensation during urination, urinary frequency, and bloody urination. Additionally, patients with prostate problems are also known to develop hernias. As the prostate enlarges, the patient tends to strain during urination, and the constant straining may result in the formation of a hernia.

Physical Examination

Examination of a hernia patient

If a physical examination of the patient by a physician reveals an abnormal bulge in the abdominal wall, it is highly likely that a hernia is present. The bulge usually is not exceptionally tender to the touch. In rare instances the bulge has become very tender. A very tender bulge may be present if the hernia is incarcerated or strangulated. The hernia bulge may or may not be reducible...

Erscheint lt. Verlag	21.3.2022
Sprache	englisch
Themenwelt	Medizin / Pharmazie ► Medizinische Fachgebiete ► Chirurgie
ISBN-10	1-0983-9726-6 / 1098397266
ISBN-13	978-1-0983-9726-5 / 9781098397265

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