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Say 'Aaah' | The Healthy Man

Many Men Ignore Hernia Symptoms

November 23, 1998|KRISTL I. BULURAN

You're at the gym working out, confident that you can lift more weight today than yesterday. You bend down to pick up the barbell and, as you come up, you feel a pop in the groin area. Next comes a dull pain and a queasy feeling.

Even though the pain continues after you finish your workout, you figure it's just muscle strain. But the bad news is it may be a hernia.

A hernia occurs when part of an organ within the body slips through an abnormal opening in the wall that normally contains it. There are different types of hernias, but abdominal hernias are the most common. This occurs when a part of the stomach or intestine slips through an opening or weakness in the abdominal wall.

Moreover, there are different types of abdominal hernias that can afflict both men and women. The most common type of hernia for men--the kind the turn-your-head-and-cough physical examination is intended to detect--is an inguinal hernia. This is a hernia of the lower abdomen in which a part of the bowel pushes through a weak part of the abdominal wall.

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Inguinal hernias often start out small, and you may initially feel a dull, bothersome pain in the groin area, particularly when bending forward or with increased activity. A bulge may be seen or felt right where the thigh and groin meet, doctors say.

It's as uncomfortable as it sounds.

Even so, many men will ignore the symptoms, sometimes brushing the pain off as just a pulled muscle. Other times, they may be afraid to find out because they know that a hernia diagnosis will probably require surgery.

Inguinal hernias occur most frequently in men. The inguinal canal is a passage within the layers of the lower abdominal wall through which the spermatic cord passes. It is a naturally weak area; a perfect place for the intestines to push through when pressure is placed on the abdomen, said Dr. Joe Hines, assistant professor of surgery at UCLA's Department of Surgery.

Left untreated, this type of hernia can lead to a more serious condition called strangulation, in which the blood supply to part of the intestine is cut off. By then, the pain is sharper and more intense with most movements--and may require emergency surgery.

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The only type of treatment to repair an inguinal hernia is surgery. Fortunately, there are different types of surgical techniques, each varying in its recovery period and whether the surgery can be done under local or general anesthesia. If you have a hernia, it is important to discuss with your doctor the best method of repair suited for you. "There are advantages and disadvantages to the different surgical techniques, and the best method is dependent on the patient's condition and previous medical history," says Hines.

So, how do you avoid a hernia? First, keep pressure off your abdomen by following a healthy diet and keeping your weight down, advises Hines. It also helps to avoid smoking, since coughing exacerbates the problem if you are at risk for a hernia. Hines also suggests that men either avoid lifting heavy objects or be careful to use proper form.

The general rule of thumb is: Be aware of the symptoms, and talk with your doctor. And, hopefully, when you turn your head and cough for your doctor, you won't get any bad news.

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Kristl I. Buluran has a graduate degree from the UCLA School of Public Health and is a clinical researcher in Los Angeles. She can be reached by e-mail at kbuluran@ucla.edu.

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