Hernia, Inguinal

What is an inguinal hernia?

An inguinal hernia occurs when part of the "sac" that lines the abdomen
pushes through a weak spot in the inguinal canal (an opening between
layers of abdominal muscle near the groin between the abdomen and inner
thigh). This abnormal bulge can typically be seen and felt, especially when
one "bears down," that is, increases abdominal pressure by holding ones
breath and pushing, coughing or sneezing.
What are the top inguinal hernia symptoms?
With an inguinal hernia, there is a soft bulge in the groin area or a swelling
in the scrotum with or without pain that is usually reducible (able to be
pushed back through the area of weakness). Hernias can often be
diagnosed on examination by simply placing a hand or finger over the area
and having the patient bear down or cough. Very small hernias usually
contain only fluid from the abdominal cavity, while a loop or part of bowel
will occasionally be pushed into the bulge of medium or large hernias and
cause discomfort. Pain can worsen with repeated heavy lifting or straining.
Nausea, vomiting, severe pain and/or absence of bowel movements may
indicate an incarcerated hernia, which occurs if the intestine cannot be
pushed back through the area of muscle. This can be a potentially lifethreatening condition that requires immediate surgical intervention to
prevent the trapped part of bowel from dying from loss of blood supply.
What are the causes of inguinal hernias?
The majority of people who get inguinal hernias are men born with a
weakness in the abdominal wall, and 90 percent of newborns diagnosed

with inguinal hernias are boys. Most often this occurs when a muscle in the
abdominal wall does not close as it should during fetal development,
therefore causing a weakness that allows tissue to protrude with abdominal
pressure. Anything that causes increased pressure on the abdominal wall
can cause a herniation (bulging) through this weakness in the muscle.
People who are overweight are much more likely to get an inguinal hernia,
especially if they smoke and have a chronic cough. Weightlifters and
people who do heavy lifting in their line of work are also at risk for inguinal
hernias. Women who are pregnant are also at greater risk due to the
abdominal pressure and weight gain associated with pregnancy, as well as
those with allergies who have chronic coughing and sneezing. Straining to
have a bowel movement or even to pass urine, as in men with enlarged
prostates, can cause enough pressure to produce this bulge in the groin as
well
What is the conventional treatment for an inguinal hernia?
Although a hernia will not "repair" itself with rest, if the symptoms are
tolerable and the bulge can be pushed back (reduced), one may choose to
simply avoid activities that aggravate it like heavy lifting or straining. A belt
can be worn for extra support to the area. If this is not an option, the
conventional treatment for an inguinal hernia is surgical repair. This can be
done laparoscopically or by an open incision in the abdominal wall.
Laparoscopic surgery is typically done on an outpatient basis, involves a
telescope-like instrument that requires small abdominal incisions for the
surgical instruments and the scope, is minimally invasive and requires a
relatively short recovery time when compared with open repair through an
incision. Some surgeons choose to reinforce the area with steel mesh or
wire, called hernioplasty, which helps prevent recurrence. If the hernia has
become incarcerated or strangulated, a bowel resection will most likely be
performed to remove the area of damaged intestine. This can usually be
done through the laparoscope. Although surgical interventions are highly
successful, there is no guarantee the hernia will not return. Recurrence

rates are higher in those who have the procedure laparoscopically and
those who do not get the steel mesh reinforcement.
What therapies does Dr. Weil recommend for an inguinal hernia?
Dietary changes: If you battle with chronic constipation, work on
getting enough fiber, drinking plenty of water, and if necessary
using bulk-agents like Metamucil and Citrucel.
Exercise: If you need to lose weight, employ both prudent caloric
intake (using the anti-inflammatory diet) and moderate physical
exercise that does not place undue stress on the abdominal wall.
Ask a physical therapist for guidance on exercises that fit your
unique condition.
Supplements: Address allergies (to avoid chronic sneezing and
coughing that can strain the abdominal wall) with natural agents
like freeze-dried stinging nettles and quercetin, or use
antihistamines and other conventional medications to control
symptoms if necessary. For constipation, Dr. Weil recommends
triphala, a mixture of three fruits from the Ayurvedic tradition of
India. It helps to regulate bowel function and is available in
capsule form at health food stores. A low dose of magnesium
glycinate may also be helpful for chronic constipation.
Also:
Obviously, the best therapy for inguinal hernias is to avoid getting
one in the first place. Because chronic pressure on a weakened
abdominal wall is the primary cause of inguinal hernias, you
should do all you can to avoid risk factors that cause this.
If you have a chronic cough due to smoking, quit!
Regarding surgical repair of a hernia, one simple adjunct that can
help ensure a good outcome is vitamin C, either in IV fluids or
taken orally. You can try to convince your surgeon to mix vitamin C
with the intravenous fluids you'll get in the operating room: ask for
20 grams of vitamin C in every 24-hour period. The body uses a
lot of vitamin C to make and repair connective tissue. A high intake

of C has been shown to help speed the healing of surgical

wounds. Your surgeon may resist, but press your case. The
results will be worth it. If you can't do this, increase oral intake of
vitamin C to 1,000 mg twice a day until and after surgery.
Be sure that your anesthesiologist is aware of all supplements and
drugs you are taking, especially blood thinners such as aspirin or
other anticoagulant drugs, including high doses of fish oil, garlic,
and vitamin E, all of which have anticoagulant effects. Dr. Weil
also suggests making a tape of healing statements to be played
while you're under anesthesia and using guided imagery tapes
both before and after surgery. You may want to look into taking the
"Prepare for Surgery" program by psychologist Peggy Huddleston
or listening to affirming tapes made by psychotherapist Belleruth
Naparstek and available via her
website: www.healthjourneys.com. More than 200 studies have
shown that guided imagery can make a huge difference to surgical
patients by decreasing pain and the need for pain medication,
reducing side effects and complications of surgery, lessening
stress and anxiety before and after procedures, reducing recovery
time, improving sleep, strengthening the immune system, and
boosting self-confidence and self-control.
Finally, you may also be able to shorten your recovery time after
surgery for an inguinal hernia by taking cordyceps, a Chinese
tonic mushroom, along with bromelain, a pineapple enzyme that
can reduce swelling and bruising; take 200-400 mg three times a
day on an empty stomach. Homeopathic arnica may help with
pain; use the 30c potency and take five tablets as directed every
two to four hours as needed for the first 48 hours after surgery.