Hernia Treatment

A hernia is a gap in the wall of muscle and tendon that holds the abdominal contents in place. Fat, or a loop of bowel, pushes through the gap and comes to sit under the skin, so a soft bulge appears at whichever point the wall is weakest.

The usual weak points are the groin, the navel and the line of an old surgical scar. Some gaps have been there since birth and only open up later in life; others come from years of coughing, lifting or straining, all of which raise the pressure inside the abdomen against a wall that is already thin.

A gap in muscle does not close by itself. It widens slowly, and the amount of tissue sitting in it grows with it, so the size at which a hernia is found is the smallest it is ever going to be.

A surgeon makes the diagnosis at the examination. They feel the area with you lying flat and again standing, and ask you to cough, since the rise in pressure pushes the contents forward and defines the edge of the gap under their fingers.

An ultrasound is used where the abdominal wall is thick or the findings are borderline. A CT scan is reserved for a hernia through an old scar, where the surgeon needs to know how wide the defect is and what is sitting inside it before planning anything.

The examination also establishes whether the contents slide back easily, and that single finding is what decides how urgently the repair is arranged.

You are up and walking the same day. Most people are back at a desk job inside a week and back to lifting at six weeks, which is the point by which the repair has taken up enough strength of its own.

The area feels tight and bruised for a fortnight and there is often more swelling than you expect, since fluid gathers in the space the contents used to occupy. It settles over a month or so.

The limits you are given for those first six weeks are the ones that matter. What happens in that window largely decides whether the repair holds for decades.