From the Editor's Desk
Dr. Saravana Bharathy. S. P
Consultant
Internal Medicine
Internal Medicine
HERNIA: THE SILENT BULGE YOU SHOULD NEVER IGNORE
What begins as a small bulge can escalate into a medical emergency.
A hernia does not resolve on its own, it only progresses with times.
Why Hernia Needs Greater Attention in India
- Hernia is one of the most common surgical conditions in India, yet one of the most neglected.
- India reports over 1.5 million hernia surgeries annually, among the highest worldwide
- Inguinal hernia accounts for nearly 75% of all abdominal wall hernias
- Lifetime risk of developing a hernia: Men - 27%, Women - 3%
- Peak incidence is seen in working-age adults (30–60 years), not just the elderly
- Despite how common it is, many patients postpone treatment due to mild or intermittent symptoms, until complications develop.
Common Types of Hernia Seen in Clinical Practice
Inguinal hernia
Groin swelling, common in men
Umbilical hernia
Near the navel, more common in women and obese patients
Incisional hernia
At previous surgical scar sites
Femoral hernia
More common in women and associated with a higher risk of strangulation
Epigastric hernia
Upper abdomen
Symptoms You Should Take Seriously
Hernias often start quietly but progress relentlessly.
- Early symptoms:
- A visible or palpable bulge that increases on coughing or straining
- Heaviness or dragging sensation in the groin or abdomen
- Discomfort after prolonged standing or lifting
- Early symptoms:
- A visible or palpable bulge that increases on coughing or straining
- Heaviness or dragging sensation in the groin or abdomen
- Discomfort after prolonged standing or lifting
When Should You Approach a Doctor Immediately?
- According to HerniaSurge & IAGES guidelines, medical evaluation is recommended if:
- A swelling persists beyond 2–4 weeks
- Pain interferes with daily activities
- The bulge enlarges progressively
- There is a history of chronic cough, constipation, or heavy lifting
- You have diabetes, obesity, or prior abdominal surgery
- Watchful waiting is not recommended once symptoms develop.
Role of Ultrasound in Hernia Screening – When clinical examination is inconclusive, imaging provides clarity
- Clinical examination remains key, but ultrasound plays a crucial role, especially in early or occult hernias.
- Ultrasound helps in:
- Confirming the diagnosis when swelling is not obvious
- Differentiating hernia from lymph nodes, lipomas, hydroceles
- Assessing hernia size, content (fat vs bowel), and reducibility
- Detecting bilateral or recurrent hernias
Symptoms You Should Take Seriously
There is no medical cure for a hernia. Surgery remains the definitive treatment.
Modern surgical options include:
Open mesh repair
- Gold standard for many uncomplicated hernias
- Safe, durable, cost-effective
Laparoscopic hernia repair (TAPP / TEP)
- Less pain, faster recovery
- Ideal for bilateral, recurrent, and working individuals
Day-care hernia surgery
- Discharge within 24 hours
- Early return to normal activity
| Common Myths That Delay Treatment | Facts |
|---|---|
|
If it doesn’t pain, it’s harmless |
Size does not predict safety |
|
A belt or truss will cure it |
Hernias only enlarge with time |
|
I’ll wait until it becomes bigger |
Delay increases both surgical risk and procedural complexity |
This Month’s Focus: Hernia Awareness & Early Detection
This month, we are placing a special focus on early hernia detection and safe surgical planning, aiming to identify hernias before they turn into emergencies.
- As part of this initiative, we are conducting a Hernia Screening Camp, which includes:
- Ultrasound screening
- Specialist surgical consultation
- Clear guidance on need, timing, and type of surgery
