Is It Possible to Prevent A Hernia?
With almost 1,000,000 surgical repairs every year in the United States, hernias are an extremely common condition affecting Americans. However, hernias are only repaired when they become symptomatic, so we can extrapolate that many millions more have hernias that they don’t even know about. But, is it possible to avoid a hernia altogether?
The short answer is, in most cases, not really. But there’s a lot we can do to delay it and minimize the risk of worsening one that already exists.
Two of the biggest components of hernia risk are genetics and congenital factors. If your parents suffered from hernias in the past, there is a higher chance that you will as well. If you are born with a weak point in the abdomen (usually the belly button), your risk will be higher. These risks simply cannot be prevented and there’s not much we can do except wait and see if the hernia ever develops.
However, there are a number of different types of hernias each of which have different causes, some of which are preventable.
Inguinal hernias are those that occur in the groin. Of those million hernias repaired every year, 800,000 or 80% are inguinal hernias. Moreover, inguinal hernias disproportionately affect men – to the tune of about 90%. There are, however, risk factors that increase the chance of the formation of an inguinal hernia. Essentially, anything that puts pressure on the abdomen can cause a hernia to form.
Umbilical hernias are those that form in the umbilicus or belly button. We all have congenital weakness in the belly button due to our umbilical cord. Usually, this area closes up at around age 5 or 6, but for some, the area remains weak and eventually allows abdominal tissue to protrude. Umbilical hernias can occur spontaneously, during pregnancy or any other time significant strain is put on the umbilicus. There is not much one can do to prevent an umbilical hernia beyond staying healthy and not putting unnecessary pressure on the abdomen.
An incisional hernia is one that occurs due to a previous abdominal surgery. Anytime we cut through skin and muscle, the abdominal wall is weakened, even after it has healed. We have significantly reduced the incidence of incisional hernias over the past couple decades by performing the vast majority of surgeries using traditional laparoscopy or robotic surgery. Both of these techniques only require a few small incisions versus the single long incision of open surgery. However, some patients will require open surgery due to their anatomy or their condition. Even in laparoscopic and robotic surgery, there is a small risk of an incisional hernia.
Recurrence, when a hernia comes back after it has been repaired, can occur after previous hernia surgery. While recurrence rates are relatively low with modern tension-free mesh repairs, they are still possible. Patients should take reasonable precautions not to increase the strain on their abdomen after having a hernia surgery, especially in the first six weeks after the procedure. While a mesh hernia repair is very strong it can still fail.
Common causes and preventative measures for all hernias include:
- Losing excess weight and obesity which places additional strain on the abdomen and the structures within the abdomen.
- Prioritize hydration and fiber consumption throughout the day and ensure regular bowel movements to avoid constipation and resultant strain when on the toilet.
- Excess coughing and sneezing from a cold or allergy also put additional pressure and strain on the abdomen. While allergies can be treated, there’s not much we can do about catching a cold or the flu. Try lying down when you feel a cough coming on and brace your abdomen with a pillow to reduce pressure.
- Smoking and resultant chronic cough or obstructive pulmonary disease can lead to the worsening of an abdominal hernia. Also bear in mind that surgical risk increases dramatically in smokers versus non-smokers – another reason to quit.
Ultimately, the structural weaknesses in the abdomen that often lead to a hernia are not easily modifiable – they can occur due to genetics, congenital disorders, prior surgeries or pregnancy. Most importantly, we can reduce the risk of developing or worsening a hernia by following the guidelines above.
With that said, we do not screen for asymptomatic hernias as they typically represent very low risk. For symptomatic hernias, patients should evaluate their surgical options – surgery is the only treatment – and consult with an experienced hernia surgeon like Dr. Tsuda or Dr. Ryan. Treating hernias at their earliest stages makes for a less complicated and more successful repair. Further, it reduces the risk of serious complications of a hernia, such as strangulation or incarceration.
Hernia repair surgery is a straightforward procedure that carries relatively low risk when performed by an experienced surgeon and we encourage you to contact our office to learn more and schedule a consultation to see what is best for you.