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Stitch in time saves nine, and, of course, hernias.

Byline: Dr Anya Heywood

THIS week I'm going to ease back from all that walking and gardening. I don't want to give myself a hernia.

I clearly recall a hernia being the problem of the very first patient I ever saw as a medical student. He was an old man up in Newcastle and had a Geordie accent so thick I honestly couldn't understand him. In the end he gave up repeating himself to me, dropped his pyjama trousers and pointed at his groin lump and said: "It's me hornia pet". Ah happy student days.

But what is a hernia? Well, all our intestines and organs are kept inside our bellies by our abdominal muscles which form a bendy stretchy wall.

The muscles stretch from our ribs down to the pelvis.

If this muscle wall develops a hole, then loops of intestine can be pushed through the muscle. This is more likely to happen if the pressure inside the belly is high, for example coughing a lot, carrying a lot of extra weight, lifting heavy objects or otherwise straining.

As you can imagine, over time the hole can get stretched bigger and bigger and more and more intestine can slide through it.

The loops of bowel on the outside of the muscle wall start to stretch the skin and there it is, your perfectly formed hernia.

Hernias tend to slide back inside the abdomen if you lie down and pop out again when you stand up.

Strangulated hernias occur when bowel gets pushed through a smallish hole and then gets stuck. This is very painful and needs urgent surgery to release it before the bowel is permanently damaged.

Hernias tend to form at points of weakness in the abdominal wall. So groins are a common hernia site (inguinal hernia) as the muscle wall is attached to a thick ligament there rather than a bone.

Equally, the tummy button is a weak spot (umbilical hernia) as are any operation scars (incisional hernia).

The hole in the muscle wall can be closed with a simple operation. To prevent the repair work coming undone and the hernia making an unwelcome reappearance, surgeons are commonly using mesh to strengthen the repair.

As hernias don't get better themselves, a stitch in time saves nine. Small hernias are much easier to fix than big ones, so don't be shy in coming to see your GP!

In the end he gave up repeating himself to me, dropped his pyjama trousers and pointed to his hernia

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Publication:Evening Gazette (Middlesbrough, England)
Date:May 15, 2017
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