Natural History of Hernia
History of Hernia
Hernias are a relatively common condition and can occur in men and women of all ages and can take place at different sites of abdominal wall. Hernias most commonly occur in the groin (‘inguinal hernias’), around the belly button (‘umbilical hernias’), and near the site of a previous surgical operation (‘incisional hernias’). The prevalence of groin hernia is estimated to be three to four percent in the population with the lifetime incidence for males estimated at five to ten percent. Women have 4 to 17 percent the risk of men . It is estimated that 700,000 hernia repair are performed yearly in the U.S.
Hernias may be present from birth, or develop over a period of time. If the defect is large enough, abdominal contents such as the bowel, may protrude through the defect causing a lump or bulge felt by the patient. This can happen during standing, walking, physical activity or straining. Majority of hernias have no symptoms but they could be associated with pain and discomfort. Hernias are termed reducible if their contents can be pushed back into the abdominal cavity. They are termed incarcerated if they cannot be pushed back . An incarcerated hernia may entrap bowel and cause bowel obstruction, or it may become strangulated if the contents of the hernia sac become ischemic. Both of these conditions carry a relatively high mortality and warrant emergency surgery.
Most groin hernias progress through an asymptomatic stage when the defect may be detectable by a physician but the patient is unaware of it. The natural history of groin hernia is of gradual enlargement until repaired. Femoral hernias are typically smaller than inguinal hernias, are more often asymptomatic, and present with strangulation more frequently (5-20% vs. 1.3-3% for inguinal hernias). Femoral hernias make up more than 30 percent of groin hernias in women, but only three percent of groin hernias overall.
The natural history of the evolution of an individual hernia is unpredictable. They never resolve on their own or get smaller. Some individuals live with their hernia for decades without any problems. Many people describe a long history of a painless hernia and some experience symptoms and emergencies even in cases of a newly diagnosed hernia.
There is a cure for a hernia?
There is no medical or rehabilitative cure for a hernia. Hernia repair is essential, since even a small hernia will not cure itself and will grow larger and possibly more serious over time.
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