Hernia

People tend not to mention them, but hernias are extremely common. They occur when one part of the body bulges through an opening into another part. The two most common types of hernias in adults are:

• Inguinal hernias (occurring in the lower abdominal area)
• Hiatal hernias (occurring at the esophagus-stomach junction)

Inguinal hernia

Seventy-five percent of all hernias are inguinal, and they are five times more common in men than women. Inguinal hernias may occur on one or both sides of the body and can appear at any age. If you have a family history of inguinal hernia, you may be at a higher risk for one.

Three layers protect the intestines inside the lower abdomen. The first is a thin membrane called the peritoneum. The second is made up of the abdominal muscles, and the third is your skin. An inguinal hernia forms when your intestines and the peritoneum push through weakened abdominal muscles and appear as a bulge under your skin.

Inguinal hernia can occur for a variety of reasons. Sometimes an opening between the abdominal muscles fails to completely close after birth. Other times weakness in the abdominal wall itself can cause an inguinal hernia when chronic cough, constipation, excess weight or heavy lifting forces the soft tissue to push through.

Inguinal hernias come in two types: indirect inguinal hernia and direct inguinal hernia. The former type is the most common and is a type of hernia that you may be born with. The latter, which is caused by weakening of the abdominal muscles over time, occurs only in men.

There is nothing you can do to prevent an indirect inguinal hernia. However, direct inguinal hernias may be prevented with these precautions:

• Use safe lifting techniques. You probably won't get a hernia from a single heavy-lifting effort. But if you continually lift heavy objects the wrong way, hernia may well be the eventual result.
• Avoid, and when needed, treat constipation to prevent straining when having a bowel movement.
• Exercise regularly and eat a high-fiber diet to help prevent constipation.
• Maintain a healthy weight.
• Get treatment for any persistent cough.
• If you smoke, quit. (Smoking can cause a chronic cough.)
• If you are a man with an enlarged prostate and you strain to pass urine, get treated.

Hiatal hernia

A hiatal hernia occurs when the upper part of the stomach pushes up into the chest through a small opening in the diaphragm, the muscle that separates the abdomen from the chest. This results in retention of acid and other contents since the stomach tends to get squeezed by this opening in the diaphragm. These acids and other substances can easily back up (reflux) into the esophagus. (Hiatal hernia and acid reflux disease aren’t the same, but can overlap.)

There are two types of hiatal hernias: sliding hiatal hernia, when the stomach intermittently slides up into the chest, and paraesophageal hernia, when a portion of the stomach pushes up into the chest adjacent to the esophagus.

Many people age 50 and over have small hiatal hernias, but hiatal hernias may affect people of all ages. The cause of a hiatal hernia is unknown, but possible triggers include the following:

• Coughing
• Vomiting
• Straining while having a bowel movement
• Sudden physical exertion
• Pregnancy
• Obesity