Hernia FAQs (cont.)
What is the treatment for a hernia?
Self-Care at Home
In general, all hernias should be repaired unless you are unable to have surgery because of other medical conditions. If surgery is not possible or delayed, a person can wear a truss or surgical belt (available at medical supply stores or some drug stores) to hold the bulge of the hernia in. This will only work for certain hernias. A truss is like tightly fitting elastic underwear that keeps the area of the hernia flat. It keeps the hernia from protruding, but a truss is not a cure.
Gently push the hernia back into your abdomen. This may be easiest while lying down. If you cannot push the hernia back into your abdomen, it may have become trapped in the abdominal wall. This is a medical emergency. Seek emergency medical care.
Practice these techniques:
- If you become constipated easily and strain for bowel movements, add fiber to your diet so you do not have to strain.
- Ask your doctor to treat coughs so you are not coughing and causing your hernia to bulge.
- Avoid any activity that could increase abdominal pressure, such as lifting heavy items.
For small hernias that cause no pain, you and your doctor may decide to watch and wait. Any hernia that seems to grow and cause pain may require surgery.
Treatment of a hernia depends on whether it is reducible or irreducible and possibly strangulated.
- In general, all hernias should be repaired to avoid the possibility of future intestinal strangulation.
- If a person has medical conditions that would make surgery unsafe, the doctor may not repair the hernia but will monitor it closely.
- Rarely, the doctor may advise against surgery because of the special condition of your hernia.
- Some hernias have or develop very large openings in the abdominal wall, and closing the opening is not possible because of its large size.
- These kinds of hernias may be treated without surgery, perhaps using abdominal binders.
- Some doctors feel that the hernias with large openings have a very low risk of strangulation and that surgery is not needed if the person is relatively symptom-free.
- All acutely irreducible hernias need emergency treatment because of the risk of strangulation.
- An attempt to reduce (push back) the hernia will generally be made, often with medicine for pain and muscle relaxation. If unsuccessful, emergency surgery is needed. If successful, treatment depends on the length of the time that the hernia was irreducible.
- If the intestinal contents of the hernia had the blood supply cut off, dead (gangrenous) bowel is possible within hours.
- In cases where the hernia has been strangulated for an extended time, surgery is performed to check whether the intestine has died and to repair the hernia.
- In cases in which the length of time that the hernia was irreducible was short and gangrenous bowel is not suspected, the person may be discharged.
- Because a hernia that becomes trapped and difficult to reduce has a dramatically increased risk of doing so again, if you have had an irreducible hernia, you should have surgery sooner rather than later.
- Occasionally, your doctor may decide that the long-term irreducible hernia is not a surgical emergency. These hernias, having passed the test of time without signs of strangulation, may be repaired by scheduled surgery.
Medically Reviewed by a Doctor on 6/5/2014
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