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Johns Hopkins Health - Battle of the Bulge

Winter 2012
Issue No. 15

Battle of the Bulge

Date: January 12, 2012


Why should I be concerned about a hernia?
More than 4 million Americans have a hernia, which is when tissue comes through a weak area of the abdominal wall, most commonly the groin. This causes a visible bulge that enlarges over time. The herniated tissue can also twist and cut off its own blood supply, which can cause extreme pain and may lead to a surgical emergency. Some 800,000 patients undergo operations for hernias annually in the U.S., and most of these patients are men older than age 45. The occurrence of an incisional hernia, where a bulge develops below a scar line after an operation, can be as high as 20 percent.

How do I know if I am at risk?
For many people, hernias are hereditary. Any circumstance, however, that greatly increases the pressure within the abdomen for an extended period will increase this risk. These circumstances include obesity, chronic constipation, frequent heavy lifting, pregnancy and chronic coughing. Smoking also has been shown to increase the risk of developing a hernia.

When should I see a doctor?
If you have an enlarging bulge that is associated with pain or symptoms such as nausea or vomiting, then you should be evaluated by a medical professional to determine if treatment is needed. With few exceptions, hernias will continue to enlarge. As this happens, more tissue will push through and intestines can become stuck in the defect. Without adequate blood flow, the intestines may be constricted, and this can be a very serious surgical emergency.

How is treatment different at Johns Hopkins?
We have a variety of experienced hernia surgeons. Many patients are also sent to us by other physicians for repair of hernias that have recurred. (Scar tissue can form inside the abdomen and distort normal anatomy after an operation, which increases the complexity of repair for recurrent hernias.) There is an emphasis on performing minimally invasive surgery for appropriate patients. Often, we will repair these large hernias with small incisions and advanced laparoscopic techniques. This usually leads to less pain after surgery and faster recovery time. Many options exist for complex hernia repair, including component separation, which can dramatically reduce the recurrence rate for large hernias.

Want to know more about hernias and treatment options?
Hien Nguyen, M.D., Johns Hopkins minimally invasive surgeon, describes the common types of hernias (inguinal, incisional, hiatal, umbilical, ventral and sports), what causes them, how they are repaired, when to have surgery, and how to prevent them in the vide: Battle of the Bulge: Common Hernias and Their Treatment.

For more information, appointments or consultations, call 877-546-1872.

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