Dr Bryan Betty: Abdominal Hernias

What exactly is an abdominal hernia?  

- It’s where an internal part of body pushes through weak part of your abdominal wall muscle, creating a lump that often you can feel.  
- It’s very common, more common in men but can occur in any age from babies to the elderly.  
- There’s several different types:  

- Inguinal: occurs in the groin and can sometimes cause lump in the scrotum.  
- Femoral: occurs where abdomen joins leg.  
- Umbilical: the front of the stomach often around the tummy button.  
- Hiatus: where stomach pushes up into the chest.  
- Incisional: over a surgery scar  

What causes hernias?  

- Lots of different things: being overweight, coughing or sneezing, constipation, pregnancy.  
- Some people have weaker abdominal walls, and hernias can occur more easily.  
- Occasionally caused by injury from lifting – in which case can be covered by ACC  

What should you look out for and are they serious?  

- Most people notice a bulging lump in their stomach or groin.  
- You may occasionally notice discomfort when bending over or lifting things.  
- Generally they are small, and if they pop out they can be easily pushed back in. 
- Over time they can become bigger and cause more discomfort and pain.  
- Occasionally the bowel can twist and not be able to be pushed back in and become strangulated. This is serious and requires urgent medical help.    

What do about them?  

- Your GP will take a history and examine you to diagnose a hernia, they may order a U/S if unsure.  
- If it’s minor and not causing problems, just watch and wait.  
- However, if it’s causing pain and discomfort, they may recommend surgery.  
- An operation to fix the abdominal wall with stitches or what is called mesh, it’s often a keyhole surgery.  
- You can try to avoid them by eating food with fibre so you don’t become constipated, not putting on weight, and careful lifting with your knees instead of your back. 

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Episode Transcript

Speaker 1 (00:07):
You're listening to the Saturday Morning with Jack Team podcast
from News Talks AB.

Speaker 2 (00:13):
It's this time on Saturdays that we catch up with
doctor Brian Betty to talk health. In this morning, we
are looking at abdominal hernias. Go to Brian. Good to
have you with us.

Speaker 3 (00:23):
Oh cure, Jack gave to be here.

Speaker 2 (00:25):
Yeah, let's start off with the basics. So what exactly
is an abdominal hernia.

Speaker 3 (00:31):
Yeah, Look, it's where the abdominal cavity, which is where
the stomach or the tummy sits. It's an internal part
of the body which pushes through a weak part of
your abdominal muscle wall. So usually in a bit of
the intestine just pokes through where the muscle wall at
the front of your stomach becomes a bit weak. Now,
this creates a lump that you can often feel. Now,

(00:54):
they're really really common, very common in men. We think
up to twenty to twenty five percent a minute at
some point in their lives may have one. And they
can occur at any age, from sort of baby to
our adults and elderly. Now, there's several different kinds. There's
ones that are at the lower part of the abdomen.
They poke into the groin. So then testine pokes into
the groin and we call that an angwine or hernia,

(01:16):
and sometimes that actually pokes into the scrotum and it
can cause a lump. They can poke into the top
of the leg. We call that ephemeral or the front
of the abdomen or the stomach, and around the umbilical
umbilical or the belly button in particular, and we call
that a ventral hernia. So you will find a little
lump that starts to poke out there. So they really

(01:38):
really common occur around the abdomen and they cause these
little lumps of people start to.

Speaker 2 (01:43):
Notice, Yeah, they sound really uncomfortable. Unfortunately, not of experience.
Fun I know plenty of people who have over the years.
What causes them?

Speaker 3 (01:51):
Right, yeah, look, so lots of different things. So, look,
if you're carrying a bit of extra weight and you're overweight,
that tends to put extra pressure on the muscles around
the abdomen and that can weaken them and cause a
hernia to call call occur. You know, if you cough
or sneeze a lot again, that puts pressure on the
abdomin and can cause a weakness to develop, constipation, interestingly

(02:14):
enough can cause it. So if you're straining to pass
bowel motions, that can cause the stomach wall weakness. And
actually pregnancy is the other one. So look, if you're
pregnanty carrying baby, that puts a lot of pressure on
the abdomen. Now, the other big, big one is actually work,
so lifting the wrong way. So you suddenly lift something,
you suddenly tear the muscle wall and the hernia develops.

(02:38):
And that's a really very common way of these occurring.
And in those cases it's actually covered by accd AT treatments.
So lifting heavy things in the wrong way can be
a real real problem with hernia's developing.

Speaker 2 (02:50):
I don't expect you to know this. This is a
random question, but I was watching have some weightlifting the
other day. You know how the weightlifters put on those
belts when they're about to lift a really heavy weight.
Is it for hernias?

Speaker 3 (03:02):
Yeah, so that's one of the reasons I do it.
So I give you extra protection around the walls things,
so that you know you're not really you're not pressuring yeah. Yeah,
otherwise it pressure builds up and can pop out, and
that's a real problem for weightlifters.

Speaker 2 (03:16):
Yeah, Okay, they're good. Sorry, little digression there, Look out,
and I mean are they serious?

Speaker 3 (03:24):
Look? Look known most of them aren't serious. And the
commonest thing I say, we see this commonly in general
practice as GPS, and people will often come in and say, look,
I've just noticed this little lump in my stomach, and
I'll point to where it is, or the other thing
they complain of is, look, I've just noticed this uncomfortable
feeling or the slight pain, especially when I bend over

(03:44):
or sort of lift things. And again people can point
to where exactly it is. And so so generally we
have a look for them. And they're very small, and
if you can feel the lump, they often pop out
and you can push them back in so they can
come out. They call reducible they come out and then
but you can feel where they actually are. Now, over
time they can become bigger, and they can call more

(04:06):
discomfort and they can cause more pain, and in those
situations we need to get them treated. And very the
one serious thing which is quite uncommon, which can occur,
the intestine pops out and you suddenly can't push it
back in, and it becomes what we call irreducible Now,
in those situations, the vowel can twist of it suddenly

(04:27):
become very painful, can develop a temperature, and very tender
to touch. And in those situations you do need to
see a doctor straight away to get urgent treatment. So
that's the one complication that we do watch out for them.

Speaker 2 (04:41):
And what do you do about Yeah.

Speaker 3 (04:44):
So, look, if someone comes in to see me the surgery, Look,
we take a history and examination, We examine the patient,
look for the hernia. Occasionally we'll order an ultrasound which
shows up the hernia. It's like a little test we
do to see that it's there. Now, Look, if it's
very small and not causing any problems, we just watch
and wait. There's no point in doing anything if it's

(05:04):
not causing problems. However, if I over time it becomes bigger,
cause a bit more discomfort, a bit more pain, we
refer you to a general surgeon to get an operation. Now,
the operations are red good these days. They're often done
through keyholes, little laparoscopes, and they put in a number
of stitches to seal the muscle wall, or they put
in what we call a mesh to go over the

(05:26):
hern your and stop it happening, So look very easy
to ficture general surgery. Day surgery. You're in and out,
the problems fixed. I suppose. The other thing is if
they are there. We often advise people things like, look,
don't become constipated. Increases your risk. Try to keep the
weight off because that increases the risk. And actually be
really really careful with lifting heavy weights like a weightlifter. Yeah, real, carefully,

(05:49):
bend with your knees, not with your back.

Speaker 2 (05:51):
Okay, Hey, thank you very much, Brian. I appreciate that,
as always, doctor Brian Betting. Jack weightlifters also use the
belt so they can embrace their abdominal muscles against something
like pushing out. You can tell that I don't do
a lot of weightlifting. I guess you've never bumped into
me on the street. There's not going to have a
huge surprise.

Speaker 1 (06:08):
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