Hernia

A hernia is referred to as the protrusion of a part of an organ or a tissue from its normal place to some other cavity. Hernia in the abdomen occurs when a piece of intestine or its lining, also called the omentum, protrudes through a weak area present in the abdominal wall. Hernias of the groin (inguinal hernia) and of the diaphragm (hiatal hernia) are some of the common hernias. Hernias may be congenital (when present at birth) or acquired (develop during the lifetime). Umbilical hernia is also a common form of hernia that occurs around the belly button. The abdominal hernias occur as a result of increased pressure in the abdominal cavity that causes stress at the weak points of the abdominal wall leading to protrusion of the abdominal contents. Pressure in the abdominal cavity may increase due to chronic cough, ascites (accumulation of fluid in the abdominal cavity) or peritoneal dialysis (a procedure used to treat kidney failure). Abdominal pressure may also increase during pregnancy and due to excess weight around the abdomen. Lifting excess weight and straining while urinating and passing stool can also increase the pressure in the abdominal cavity.

Laparoscopic Inguinal Hernia Repair

Hernias that occur in the groin are known as inguinal hernias. These are characterized by small balloon-like pouches protruding from the groin region. These form at a natural point of weakness at the intersection of abdominal muscles. The protrusions occurs when a loop of intestine or fat passes through this weak point and either enters the inguinal canal or pushes out just medial (more in the middle) to the inguinal canal. Men usually suffer from inguinal hernias developing in the groin, and may notice an ambiguous discomfort or even a bulge in the scrotum. Infants and children also suffer from inguinal hernias when a part of the lining of the abdominal cavity called the peritoneum does not close properly. This leads to a bulge in the groin because the intestine or other abdominal contents may push into the opening when the pressures inside the abdomen rise.

A hernia is a condition in which a part of an organ pushes through the opening of the organ wall made up of muscle tissue or membranous material. The most common site for hernias to develop is the abdomen. Hernias may or may not display any outward symptoms. Hernias are usually treated surgically. If the blood supply at the herniated portion is cut off then it becomes a medical emergency. Muscle weakness and straining too hard at an activity can cause hernias. A person born with weak abdominal muscles is more likely to acquire the condition, particularly if he leads a sedentary lifestyle without any form of exercise.

Nutritional Concerns after Bariatric Surgery

New behaviors take time to learn. The first few months after your operation represent a sensitive time both psychologically and physiologically. Depending on your operation, it is very important to allow any connections between the stomach and the intestine to heal. The first few months post-op are also complicated by problems with judging adequate hydration. You must be cognizant and careful that obesity and over-eating may be signs of an addiction behavior.

Paraesophageal

The hiatus is a normal opening in the muscle that separates the chest cavity from the abdomen which moves up and down with breathing. Although the hiatus is a normal opening, there are occasions when this opening enlarges and the stomach or other organs can slip up inside the chest. This occasion of an abnormally large opening of the hiatus is called a hiatal hernia. Paraesophageal hernias account for only 5% of all hiatal hernias. A paraesophageal hernia is a type of hiatal hernia where the junction of the stomach and the esophagus remains in place, but part of the stomach is squeezed up into the chest beside the esophagus.

Diaphragmatic hernia being laparoscopic sutured

Ventral Hernia Repair Combined with Abdominoplasty

While it is important to keep in mind that ventral hernia surgery and abdominoplasty are two distinct operations, they are performed in the same area (lower abdomen) and address problems that often have a common origin. While the need for an operation may be driven by the hernia repair, performing it together with abdominoplasty is usually a safe and practical combination. In addition to having a diagnosed ventral hernia from whatever cause, two conditions account for about 95% of patients interested in combining hernia surgery with abdominoplasty. One condition is associated with women who have had one or more children, which left them with stretch marks and an abdominal wall musculature permanently deformed by carrying a baby. The other is the result of massive weight loss, where the patient develops folds of overhanging skin. In either case, abdominoplasty is required to correct for substantial and unsightly tissue and skin.

Parastomal

Parastomal hernia occurs when a weakness in the muscles of the abdominal wall allows a loop of bowel or other tissue to protrude out, resulting in a bulge or swelling around the stoma. Other symptoms include discomfort at the stoma site, abdominal distention, back pain, intermittent cramping, changes in stoma function and an increase in leakage due to poor fit of stomal appliances.

Ventral Hernia

A hernia might develop at a point of weakness caused by a previous surgical incision. A small out pouching that occurs months to years at a previous incision may be a sign of a hernia. Patients may witness a small soft balloon-like sac protrusion due to slackening of the muscular wall of the abdomen or at the site of the previous operation. These balloon-like protrusions may change in size according to position and may disappear when the abdominal wall is completely relaxed such as when you are lying down. This defect in the layer surrounding the muscles of your abdominal wall is called a ventral or incisional hernia. Sometimes, internal organs or a loop of the intestine may get trapped in this sac and cause a dangerous condition heralded by severe pain and discomfort.

Acid Reflux

Acid reflux occurs when stomach contents leak out into the tube connecting the mouth to the stomach. Common symptoms include heartburn, an unpleasant taste in the mouth and difficulty swallowing. Less commonly, throat pain, nausea, coughing and increased salivation may also be observed, and frequent reflux is associated with an increased risk of tooth decay due to acid erosion. Most people will experience occasional episodes of symptomatic acid reflux, and it is usually no cause for concern.

Esophagus

From the back of the mouth (the pharynx) to the top of the stomach, the esophagus is a muscular tube for foods and liquids. It’s relatively tough and resilient as organs go, built to take most of the material human beings ingest. For the most part, it’s not a very complicated organ. Depending on the height of the person, it’s about 10 inches long (25 cm) and 1 inch in diameter (2-3 cm). The esophagus’ geography usually divides into three sections: cervical at the top, thoracic in the middle, and abdominal at the bottom.