A hernia is an internal organ that sticks out through a gap in the abdominal wall due to weak abdominal muscles in certain parts. In general, the most effective way to treat a hernia is surgery. This solution is the main option recommended by the medical body. If you have a hernia, this article describes some things to do yourself before and after surgery.
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Part 1 of 3: Diagnosing a Hernia
Step 1. Know your risk factors for a hernia
So far, hernia sufferers generally experience inguinal hernias, but hernias can occur after surgery. An inguinal hernia is caused by weak abdominal muscles in certain parts so that internal organs protrude through the gaps in the abdominal wall. Hernias can affect anyone, but certain groups are more at risk of developing hernias.
- Men are 9 times more likely to have a hernia than women.
- Men aged 40-59 years are more at risk of having a hernia.
- People who practice lifting weights regularly, such as weight lifters and manual workers, are at high risk of developing hernias.
Step 2. Know the risk factors in women
Although women are less at risk for hernias, women in certain categories have hernias more often.
- A woman whose height is above average
- Women with chronic cough
- Pregnancy or obesity puts women at greater risk of developing an umbilical hernia (navel)
- Straining due to constipation often triggers a femoral hernia in women.
Step 3. Be aware of common misconceptions about hernia risk factors
Men who are obese and weigh above normal are not at risk of developing an inguinal hernia. This is influenced by a sedentary lifestyle and not lifting heavy objects. Tobacco and alcohol do not cause inguinal hernias.
Step 4. Know the symptoms of an inguinal hernia
An inguinal hernia occurs when a bulge appears in the groin that gets worse when lifting heavy objects or straining. Certain activities often make the bulge enlarged or painful, such as straining, lifting heavy objects, giving birth normally, coughing, or sneezing. This bulge occurs due to organs in the body protruding through weak muscle tissue. Usually, the hernia can be inserted back into the abdomen with pressure. Problems occur when the hernia cannot be removed or inserted back into the abdomen. In addition, hernia symptoms are characterized by the following:
- Pain that can be described in terms of stretching, squeezing, or stinging. This complaint gets worse after exercising.
- The pain goes away when lying on your back because the protruding organ goes back into its original place.
- A bubbling sound in the stomach when defecating.
- Solid protrusion. If the bulge cannot be pushed into the stomach, there is a possibility that the intestine is pinched or incarcerated. Incarcerated hernia is an emergency condition that must be treated by a doctor immediately.
Step 5. See a doctor for a check-up
When making a diagnosis, the doctor will check for a golf ball-sized bulge in the groin near the hip bone. Previously, he asked you to lie on your back to make sure the bulge is still there or deflated on its own. If the bulge doesn't go away, he may take action by pressing the hernia into the abdomen. If the bowel is causing the hernia, he can confirm it by listening for a bubbling sound with a stethoscope.
Step 6. Perform a hernia examination through the scrotum
When examining a male patient, the doctor needs to confirm the presence or absence of a hernia by pressing on the testicles. He will press on the sagging skin of the scrotum with his gloved fingers, then ask the patient to cough or strain as if he wants to defecate. If the patient has a hernia, the doctor can feel the bulge pressing against his finger. Next, he will examine both sides of the testicles in order to give the correct diagnosis.
Step 7. Carry out an ultrasound examination if necessary
In many cases, the doctor is able to diagnose a hernia simply by examining the patient's body, but sometimes it is difficult to make a diagnosis this way. To be sure, he will find out if there is a hernia using ultrasound as a visual means. This examination is relatively inexpensive and does not cause injury.
Step 8. Ask your doctor about how to treat a hernia
Usually, your doctor will let you go home if you have an asymptomatic small hernia after explaining how to monitor the hernia condition. In most cases, hernias go away on their own without surgery, but if symptoms get worse, you may need surgery. Patients are advised to undergo surgery if the hernia is large with few symptoms or the hernia reappears after the first surgery. Women who are pregnant or have given birth vaginally are more at risk of having a hernia.
Incarcerated hernia is an emergency condition that must be treated immediately with surgery because it causes the intestine to become blocked and strangulate so that blood does not flow
Part 2 of 3: Undergoing Hernia Surgery
Step 1. Learn about open surgery for hernias
In general, hernia surgery is open surgery. When performing surgery, doctors begin by separating the hernia from the surrounding tissue. Then, he will cut the hernia sac or insert the intestine through the gap in the abdominal wall. Weak abdominal muscles are tightened with strong sutures.
Because this surgery exposes the abdominal wall, some patients continue to experience abdominal muscle weakness and hernias after surgery. To prevent this, the doctor will attach a piece of medical netting to the abdominal wall, then sew it up to strengthen the abdominal muscles and prevent hernia recurrence
Step 2. Consider undergoing laparoscopic surgery
Hernia surgery using a laparoscope is only 10% of all hernia surgeries. Instead of making a large incision in the patient's abdominal wall which risks weakening the abdominal muscles, the surgeon makes 3-4 small incisions. Then, he sees the inside of the patient's body through the tiny camera on the laparoscope, which is a small, long tube-shaped instrument. The laparoscope and surgical instruments are inserted into the patient's abdomen through small incisions, but the subsequent surgical procedure is the same as for open surgery.
Step 3. Discuss with your doctor to decide on the most appropriate surgical method
Open hernia surgery is a very common medical therapy. Many surgeons choose this method because they can clearly see the tissues and organs in the patient's body being manipulated. Therefore, open surgery is recommended to treat large or severe hernias. However, laparoscopic surgery is a small incision so it is less painful and heals faster.
Step 4. Prepare for surgery
Inform your doctor about all medications (prescribed and over-the-counter) and supplements you are currently taking. Make sure you fast (food and fluids) as directed by your doctor in preparation for surgery the next day. Ask your doctor if you can go home the same day after your surgery. If needed, have a friend or family member accompany you before and after surgery.
Step 5. Prepare for hospitalization
It is possible that your doctor may ask you to stay in the hospital for a few days after surgery if the hernia or surgery has complications. In addition, the doctor will determine your diet so that you can gradually return to eating food as usual. In some cases, patients who have just undergone surgery experience intestinal paralysis because they eat food as usual.
Part 3 of 3: Recovering at Home After Surgery
Step 1. Take time to rest and recover after surgery
You will need to rest for 4-6 weeks until it is completely healed after undergoing open hernia surgery. If you have laparoscopic surgery, the recovery period is only 1-2 weeks so it is much shorter. The medical staff will provide detailed instructions on what to do until you can carry on with your normal activities. For a while, you need to rest so that the surgical wound on the abdominal muscles is not problematic.
Step 2. Take a leisurely walk the same day after surgery
You should stand up and move around once you feel ready even if you have just had surgery. In addition to speeding up recovery, body movement prevents blood clots.
Step 3. Limit strenuous activities during the recovery period
After undergoing surgery, whether open or laparoscopic, you can go about your normal daily routine after 2-3 days, but for 1-2 weeks, avoid strenuous activities or lifting objects that weigh more than 10 kg. If you have open surgery, do not lift objects that weigh more than 3 kg for 3 weeks. However, follow your doctor's advice before exercising again, especially weight training.
Step 4. Apply the daily diet gradually
Although there are no specific dietary rules for post-hernia surgery, some patients feel nauseous for several days after surgery. Avoid this by consuming water, fruit juices, smoothies, and broths/soups. As a transition before adopting a normal diet, choose soft foods, such as bananas or mashed potatoes. During the first few days, eat small meals. The portion of the meal is increased little by little until you can apply the diet as usual.
Step 5. Perform surgical wound care
After surgery, either openly or laparoscopically, the doctor closes the incision (surgical wound) with plaster or steri-strips. If the wound is covered with gauze or a band-aid, replace it with a new one as directed by your doctor. If the wound is covered with steri-strips, allow it to come off on its own.
- Make sure the surgical wound remains dry for 48 hours after surgery. Before bathing, cover the wound with a plastic sheet like the one used to wrap food. Do not let the wound come into contact with water.
- After 48 hours, wet the surgical wound with running water. Gently dry with a clean towel, then cover again with a new tape.
- Do not soak in water (in the bathroom, swimming pool, or sea) for 10-14 days after laparoscopic surgery; 4-6 weeks after open surgery.
Step 6. Make an appointment to see the surgeon
Even though you are in good physical condition and there are no complaints, you should consult a surgeon to ensure that the recovery process goes well and reduces the risk of postoperative complications.
Step 7. Take a stool softener supplement
Before the operation begins, the doctor will give an anesthetic that makes the intestine paralyzed. Anesthesia can trigger constipation for approximately 1 week after surgery. The thing to avoid after hernia surgery is straining during bowel movements because it can tear the surgical wound. To prevent this, take over-the-counter stool softeners, such as milk containing magnesium or Metamucil.
- If you don't want to take stool softening supplements, make sure you stay hydrated. Drink 2-2.5 liters of water per day.
- Drink plum and apple juice as natural ingredients that are useful for softening stools.
Step 8. Call your doctor if you experience any symptoms of complications
Hernia surgery is a very common medical therapy, but complications can occur with any surgery. Call your doctor if you have a fever above 38.6 °C, calf pain or swelling, or shortness of breath. Tell the doctor if the surgical wound is bleeding a lot of fluid and the color of the skin around the wound is abnormal. However, you should go to the ER immediately if you experience:
- Bleeding from the surgical wound
- Gag
- Changes in mental state (blurred vision, staggering, fainting)
- Hard to breathe
