A hernia occurs when a sac formed by the abdominal-cavity lining pushes through the abdominal wall.A hernia bulge may appear
suddenly, but hernias often take years to develop. They grow larger as
pressure inside the body presses the intestines or other tissues out
through a weak area of the abdominal wall. With time, these tissues can bulge out beneath the
skin.
Stages of Hernia Development
Stage 1: The wall weakens or tears: The
abdominal lining bulges out through a weak area and begins to form a
hernia sac. The sac may contain fat, intestine, or other tissues. At
this point, the hernia may or may not cause a visible bulge.
Stage 2: The intestine pushes into the sac:
As the intestine pushes further into the sac, it forms a visible bulge.
The bulge may flatten when you lie down or push against it. This can be referred to as a reducible hernia. It does not cause any immediate danger, but surgery may be performed to fix it. Stage 3: The intestine becomes trapped:
The sac containing the intestine may become trapped, or incarcerated, by your abdominal muscles. If this happens, you won’t be able to flatten the
bulge. You may also have pain. Prompt surgical treatment may be needed. Stage 4: The intestine becomes strangulated:
If the intestine is tightly trapped, it becomes strangulated. The
strangulated area loses blood supply, and without blood supply those tissues begin to die. This can cause severe
pain and block the intestine. Emergency surgery is needed.Common causes of a hernia According to the U.S. National Library of Medicine, common causes for development of a hernia include:
- Having chronic constipation, which causes a person to push too hard during a bowel movement.
- Having a chronic cough.
- Having cystic fibrosis.
- Having an enlarged prostate and pushing to urinate.
- Being overweight.
- Lifting something heavy.
- Having undescended testicles.
Tips For constipation:
- Walk frequently.
- Consume at least 64 ounces of sugar-free clear liquids daily.
- Ask your surgeon about using a mild over-the-counter stool softener (DO NOT USE enemas, laxatives or other treatments without the approval of your surgeon).
- Eat 6 small meals (as directed by your surgeon) at regular times throughout the day.
- Contact your surgeon if you have not had a bowel movement in more than 3 days and you feel uncomfortable.
- Only take pain medications when you need them. Narcotics can slow down the bowels and cause constipation.
For lifting:
- Avoid lifting anything over 10 pounds for the first 8 weeks following surgery.
- Weigh bags and purses that you carry regularly. Eliminate the extras & keep only the essentials in it. Make sure it weighs less than 10 pounds.
- Pushing or pulling over 10 pounds should also be avoided. Things like vacuuming, pulling suitcases and opening heavy doors should be done by others during the first 8 weeks after surgery.
- Do not pick up children weighing more than 10 pounds for the first 8 weeks after surgery. If you have children at home explain to them before & after the surgery that the patient will not be able to pick them up. If the child can crawl in unassisted or is placed in your lap by someone else, a child may sit in your lap - but no bouncing or horse play.
For other causes: - If you develop a cough, notify your doctor. A cough suppressant may help.
- If you have difficulty urinating, notify your doctor. Medications may help.
- Talk with your doctor if you have cystic fibrosis or undescended testes. Treatment may be available.
- Commit to regular follow-up with your surgeon. Follow your bariatric team's instructions and participate in support groups. If you do these things you are more likely to achieve your weight loss goal.
Remember, some hernias exist prior to weight loss surgery. Occasionally these hernias can be fixed at the same time as your weight loss surgery. However, many times these hernias may need to be fixed after a significant amount of weight is lost.
 
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