Ailmemts & Remedies Pediatric

Hernia in Children

Hernia in children is a medical condition in which a tissue or structure or part of an organ is protruded through a weakness or hole in other body muscular tissue or membrane. A soft bulge is seen underneath the skin where the hernia has occurred.

In children, a hernia usually occurs in one of two places:

1.around the belly-button the groin area

A hernia that occurs in the belly-button area is called an umbilical hernia. A hernia that occurs in the groin area is called an inguinal hernia.

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Hernias in children mostly occur in the umbilical region. A weak abdominal wall in the children can be a reason for development of umbilical hernias. Hernias are present during the first year of child and may keep on coming and going at any age.

The disease condition is common among all the age groups. Boys are more prone to this disease than girls. Approximately 1 out of 50 boys are affected.

Hernias usually occur in newborns, but may not be noticeable for several weeks or months after birth.

Straining and crying do not cause hernias; however, the increased pressure in the abdomen can make a hernia more noticeable.

*Inguinal hernias appear as a bulge or swelling in the groin or scrotum. The swelling may be more noticeable when the baby cries, and may get smaller or go away when the baby relaxes. If your physician pushes gently on this bulge when the child is calm and lying down, it will usually get smaller or go back into the abdomen.

*Umbilical hernias appear as a bulge or swelling in the belly-button area. The swelling may be more noticeable when the baby cries, and may get smaller or go away when the baby relaxes. If your physician pushes gently on this bulge when the child is calm and lying down, it will usually get smaller or go back into the abdomen.

A hernia usually causes a visible lump or swelling, which appears intermittently as the herniating tissue slips back into place and then protrudes again (umbilical hernias are more constant).

Crying, straining, coughing or anything else that increases pressure within the abdomen can make the hernia more obvious, as this forces out the contents.

If the hernia is not reducible, then the loop of intestine may be caught in the weakened area of abdominal muscle. Symptoms that may be seen when this happens include the following:

*a full, round abdomen
*pain or fussiness
*redness or discoloration

Symptoms of a hernia may resemble other conditions or medical problems. Please consult your child’s physician for a diagnosis.


A hernia can develop in the first few months after the baby is born because of a weakness in the muscles of the abdomen. Inguinal and umbilical hernias happen for slightly different reasons.

Inguinal & see
As a male fetus grows and matures during pregnancy, the testicles develop in the abdomen and then move down into the scrotum through an area called the inguinal canal….Shortly after the baby is born, the inguinal canal closes, preventing the testicles from moving back into the abdomen. If this area does not close off completely, a loop of intestine can move into the inguinal canal through the weakened area of the lower abdominal wall, causing a hernia.

Although girls do not have testicles, they do have an inguinal canal, so they can develop hernias in this area as well.(

Femoral hernias are more common in women, usually elderly and frail (although they can happen in children).)

Umbilical Herniaclick & see
When the fetus is growing and developing during pregnancy, there is a small opening in the abdominal muscles so that the umbilical cord can pass through, connecting the mother to the baby.

After birth, the opening in the abdominal muscles closes as the baby matures. Sometimes, these muscles do not meet and grow together completely, and there is still a small opening present. A loop of intestine can move into the opening between abdominal muscles and cause a hernia.
Risk Factors:
Hernias occur more often in children who have one or more of the following risk factors:

*a parent or sibling who had a hernia as an infant
*cystic fibrosis
*developmental dysplasia of the hip
*undescended testes
*abnormalities of the urethra

Inguinal hernias occur:
*in about one to three percent of all children.
*more often in premature infants.
*in boys much more frequently than in girls.
*more often in the right groin area than the left, but can also occur on both sides.

Umbilical hernias occur:
*in about 10 percent of all children.
*more often in African-American children.
*more often in girls than in boys.
*more often in premature infants

Why is a hernia a concern?
Hernias are usually painless. However, if the contents become trapped, the blood supply to the tissues may become restricted causing pain. This pain may be intermittent, but if the hernia is stuck permanently – known as an irreducible, strangulated or incarcerated hernia – the pain becomes constant and there’s a risk of damage to the trapped intestines or surrounding tissues. In this case the child may vomit and appear unwell.

Occasionally, the loop of intestine that protrudes through a hernia may become stuck, and is no longer reducible. This means that the intestinal loop cannot be gently pushed back into the abdominal cavity. When this happens, that section of intestine may lose its blood supply. A good blood supply is necessary for the intestine to be healthy and function properly.

Hernias can be diagnosed by a physical examination by your pediatrician. Your child will be examined to determine if the hernia is reducible (can be pushed back into the abdominal cavity) or not. Doctor may order abdominal x-rays or ultrasound to examine the intestine more closely, especially if the hernia is no longer reducible.

Specific treatment will be determined by your pediatrician based on the following:

*your child’s age, overall health, and medical history
*the type of hernia
*whether the hernia is reducible (can be pushed back into the abdominal cavity) or not
*your child’s tolerance for specific medications, procedures, or therapies
*your opinion or preference

Inguinal hernia:……………..

An operation is necessary to treat an inguinal hernia. It will be surgically repaired fairly soon after it is discovered, since the intestine can become stuck in the inguinal canal. When this happens, the blood supply to the intestine can be cut off, and the intestine can become damaged. Inguinal hernia surgery is usually performed before this damage can occur.

During a hernia operation, your child will be placed under anesthesia. A small incision is made in the area of the hernia. The loop of intestine is placed back into the abdominal cavity. The muscles are then stitched together. Sometimes, a piece of meshed material is used to help strengthen the area where the muscles are repaired.

A hernia operation is usually a fairly simple procedure. Children who have an inguinal hernia surgically repaired can often go home the same day they have the operation.

Umbilical hernia:
By 1 year of age, many umbilical hernias will have closed on their own without needing surgery. Nearly all umbilical hernias will have closed without surgery by age 5.

Placing a coin or strap over the hernia will not fix it.

There are many opinions about when a surgical repair of an umbilical hernia is necessary. In general, if the hernia becomes bigger with age, is not reducible, or is still present after 3, your physician may suggest that the hernia be repaired surgically. Always consult your child’s physician to determine what is best for your child.

During a hernia operation, your child will be placed under anesthesia. A small incision is made in the umbilicus (belly button). The loop of intestine is placed back into the abdominal cavity. The muscles are then stitched together. Sometimes a piece of meshed material is used to help strengthen the area where the muscles are repaired.

A hernia operation is usually a fairly simple procedure. Children who have an umbilical hernia surgically repaired may also be able to go home the same day they have the operation.

Once the hernia is closed, either spontaneously or by surgery, it is unlikely that it will reoccur. The chance for re-occurrence  of the hernia may be increased if the intestine was damaged.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose


Femoral Hernia

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Health Problems & Solutions

Some Health Quaries & Answers

Stop the bottle, spare the teeth  :


Q: My three and a half-year-old daughter has a poor appetite. She is only 10 kg while the expected weight is 15 kg (as per the pediatrician’s calculation). The doctor prescribed de-worming medication several times as well as tonics. I give her milk with Pediasure in a bottle at night. She has several decayed teeth and frequently complains of toothache.

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A: Your daughter probably has caries. The bottle will worsen her cavities because the milk will stick to the teeth which will allow bacteria to thrive in her mouth. These milk teeth will eventually fall off and you may feel they do not require any treatment. But food will get stuck there and cause discomfort. This will make her reluctant to eat, resulting in inadequate weight gain. Also, she is old enough to discard the bottle. You are probably giving it to her in the hope that she receives some calories. Stop the bottle and take her to a dentist. He might be able to fill the cavities.

Hiatus hernia
Q: I have heart burn all the time. After some tests the doctor found that I have hiatus hernia. What should I do?
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A: The esophagus runs through the diaphragm to the stomach. It functions to carry food from the mouth to the stomach.The esophagus passes through the diaphragm just before it meets the stomach, through an opening called the esophageal hiatus.


A hiatal hernia occurs when part of the stomach protrudes up into the chest through the sheet of muscle called the diaphragm. This may result from a weakening of the surrounding tissues and may be aggravated by obesity and/or smoking.

Hiatus hernia is a condition where part of the stomach slides into the chest cavity. Many hiatus hernias are asymptomatic. Pain occurs because of acid reflux from the stomach into the esophagus.

You can get relief by losing weight, not lying down for an hour after food, and using medications like omeprazole and pantoprazole. If the hiatus hernia is long-standing with severe symptoms, surgery may be required.

Sugar free
Q: I am diabetic and have been taking Sugar Free in my coffee, tea and curd. Is it safe?
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There are many natural and synthetic sugar substitutes available. In India, the ones commonly used are saccharin and aspartame. Both have been certified as safe although initially saccharin was found to cause bladder cancer in mice. Aspartame consumption should not be more than 40 mg a day. In these circumstances, perhaps it is better for you to get used to tea and coffee without sugar.

Vital fluid
Q: I am a 37-year-old woman. I am pale and the doctor said I am anaemic. My haemoglobin is 7gm. He gave me a capsule containing iron and zinc to be taken twice a day. After three months there has been no improvement. What should I do?

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A: Your anaemia needs to be investigated. You may be losing blood because of heavy periods, piles or a stomach ulcer. Or you may have intestinal parasites that are depleting you of blood. Rarely, cancer may present itself as anaemia. If there is no cause for the anaemia other than iron and zinc deficiency, it should respond to supplements. The binding sites on the intestines for iron and zinc absorption are identical. If you consume a tablet containing both these elements they compete for the binding site and block it. To be effective, iron and zinc have to be taken as separate tablets or capsules 12 hours apart (one in the morning and the other in the evening). Or, you take iron one day and zinc the next.

Health hour
Q: My son is unable to run or jog owing to a tight work schedule. Can he follow some other form of exercise?

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The requirements of exercise for the maintenance of health have increased from 30 minutes three times a week to an hour a day. If you son is unable to spare that kind of time, he can get more or less the same benefits by skipping or continuous stair climbing (up and down) for 20 minutes. Cross training and doing different activities probably deliver the best benefits as compared to repeating the same one. Different sets of muscles are used, producing all-round toning.

Source: The Telegraph ( Kolkata, India)

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Ailmemts & Remedies

Hiatal Hernia

Alternative Names:Hernia – hiatal,  Hiatus hernia.

.Hiatal hernia is a condition in which a portion of the stomach protrudes upward into the chest, through an opening in the diaphragm. The diaphragm is the sheet of muscle that separates the chest from the abdomen. It is used in breathing.

click  see to picture

The  diaphragm normally has a small opening (hiatus) that allows your food tube (esophagus) to pass through on its way to connect to your stomach. The stomach can push up through this opening and cause a hiatal hernia.
click to see picture

The esophagus runs through the diaphragm to the stomach. It functions to carry food from the mouth to the stomach.The esophagus passes through the diaphragm just before it meets the stomach, through an opening called the esophageal hiatus.

click  to see picture

A hiatal hernia occurs when part of the stomach protrudes up into the chest through the sheet of muscle called the diaphragm. This may result from a weakening of the surrounding tissues and may be aggravated by obesity and/or smoking.

In most cases, a small hiatal hernia doesn’t cause problems, and you may never know you have a hiatal hernia unless your doctor discovers it when checking for another condition. But a large hiatal hernia can allow food and acid to back up into your esophagus, leading to heartburn and chest pain. Self-care measures or medications can usually relieve these symptoms, although a very large hiatal hernia sometimes requires surgery.

There are two major kinds of hiatus hernia:
The most common (95%) is the sliding hiatus hernia, where the gastroesophageal junction moves above the diaphragm together with some of the stomach.

The second kind is rolling (or paraesophageal) hiatus hernia, when a part of the stomach herniates through the esophageal hiatus and lies beside the esophagus, without movement of the gastroesophageal junction. It accounts for the remaining 5% of hiatus hernias.

A third kind is also sometimes described, and is a combination of the first and second kinds.

Small hiatal hernias
Most small hiatal hernias cause no signs or symptoms.

Large hiatal hernias
Larger hiatal hernias can cause signs and symptoms such as:

*Heartburn, worse when bending over or lying down
*Chest pain
*Swallowing difficulty

A hiatal hernia by itself rarely causes symptoms — pain and discomfort are usually due to the reflux of gastric acid, air, or bile. Reflux happens more easily when there is a hiatal hernia, although a hiatal hernia is not the only cause of reflux.


A hiatal hernia occurs when weakened muscle tissue allows your stomach to bulge up through your diaphragm. It’s not always clear why this happens, but pressure on your stomach may contribute to the formation of hiatal hernia.

How a hiatal hernia forms
Your diaphragm is a large dome-shaped muscle that separates your chest cavity from your abdomen. Normally, your esophagus passes into your stomach through an opening in the diaphragm called the hiatus. Hiatal hernias occur when the muscle tissue surrounding this opening becomes weak, and the upper part of your stomach bulges up through the diaphragm into your chest cavity.

Possible causes of hiatal hernia  are:
*Injury to the area
*An inherited weakness in the surrounding muscles
*Being born with an unusually large hiatus
*Persistent and intense pressure on the surrounding muscles, such as when coughing, vomiting, or straining during a bowel movement or while lifting heavy objects.

The following are risk factors that can result in a hiatus hernia.

*Increased pressure within the abdomen caused by:
*Heavy lifting or bending over
*Frequent or hard coughing
*Hard sneezing
*Pregnancy and delivery
*Violent vomiting
*Straining with constipation
*Obesity (extra weight pushes down on the abdomen increasing the pressure)
*Use of the sitting position for defecation
*Drug use, such as cocaine.[citation needed]
*Diaphragm weakness

The diagnosis of a hiatus hernia is typically made through an upper GI series, endoscopy or High resolution manometry.

In most cases, sufferers experience no discomfort and no treatment is required. However, when the hiatal hernia is large, or is of the paraesophageal type, it is likely to cause esophageal stricture and discomfort. Symptomatic patients should elevate the head of their beds and avoid lying down directly after meals until treatment is rendered. If the condition has been brought on by stress, stress reduction techniques may be prescribed, or if overweight, weight loss may be indicated. Medications that reduce the lower esophageal sphincter (or LES) pressure should be avoided. Antisecretory drugs like proton pump inhibitors and H2 receptor blockers can be used to reduce acid secretion.

Where hernia symptoms are severe and chronic acid reflux is involved, surgery is sometimes recommended, as chronic reflux can severely injure the esophagus and even lead to esophageal cancer.

The surgical procedure used is called Nissen fundoplication. In fundoplication, the gastric fundus (upper part) of the stomach is wrapped, or plicated, around the inferior part of the esophagus, preventing herniation of the stomach through the hiatus in the diaphragm and the reflux of gastric acid. The procedure is now commonly performed laparoscopically. With proper patient selection, laparoscopic fundoplication has low complication rates and a quick recovery.

Complications include gas bloat syndrome, dysphagia (trouble swallowing), dumping syndrome, excessive scarring, and rarely, achalasia. The procedure sometimes fails over time, requiring a second surgery to make repairs.

Lifestyle & Home Remedy:
Lifestyle changes may help control the signs and symptoms of acid reflux caused by a hiatal hernia. Consider trying to:

*Eat several smaller meals throughout the day rather than a few large meals.
*Avoid foods that trigger heartburn, such as chocolate, onions, spicy foods, citrus fruits and tomato-based foods.
*Avoid alcohol.
*Limit the amount of fatty foods you eat.
*Sit up after you eat, rather than taking a nap or lying down.
*Eat at least three hours before bedtime.
*Lose weight if you’re overweight or obese.
*Stop smoking.
*Elevate the head of your bed 6 inches (about 15 centimeters).
*Work to reduce the stress in your daily life.

Alternative Medication:
Some alternative medicine practitioners claim to have discovered a way to cure a hiatal hernia by pushing the stomach back to its normal position below the diaphragm. Practitioners may use their hands to apply pressure to the abdomen and manipulate the stomach.

There’s no evidence that such manipulation works to cure hiatal hernia. No clinical trials of the technique have been conducted.

But Practicing Regular Yoga Exercise & meditation has definitely got some better effect.

A hiatus hernia  normally  does not cause any symptoms. The condition promotes reflux of gastric contents (via its direct and indirect actions on the anti-reflux mechanism) and thus is associated with gastroesophageal reflux disease (GERD). In this way a hiatus hernia is associated with all the potential consequences of GERD – heartburn, esophagitis, Barrett’s esophagus, esophageal cancer and dental erosion. However the risk attributable to the hiatus hernia is difficult to quantify, and at most is low.

Besides discomfort from GERD and dysphagia, hiatal hernias can have severe consequences if not treated. While sliding hernias are primarily associated with gastroesophageal acid reflux, rolling hernias can strangulate a portion of the stomach above the diaphragm. This strangulation can result in esophageal or GI tract obstruction and the tissue can even become ischemic and necrose.

Another severe complication, although very rare, is a large herniation that can restrict the inflation of a lung, causing pain and breathing problems.

Most cases are asymptomatic.

Controlling risk factors such as obesity may help prevent hiatal hernia.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.


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Health Problems & Solutions

Some Health Quaries & Answers

When mamma is at work …..
Q: I am a working woman. I recently had a baby and would like to continue to feed her breast milk. Can I store the milk in the refrigerator?

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A: Expressed breast milk (EBM) can be safely used for your baby. It is safer and healthier than cow’s milk or tinned formula. Wash your hands and collect the milk in a sterile plastic bottle with a tight screw-type lid. Label the bottle clearly, with the date and time, so that the oldest milk is used first. Place the bottle at the back of the refrigerator or in the freezer. Do not mix used leftover milk with fresh milk and use it for the next feed.

EBM can be warmed or thawed by placing it in a bowl of warm water. Do not use a microwave for this. Do not boil it. After warming it, do not refreeze and use again. EBM can be stored in the refrigerator for five days and in a freezer for two weeks. Otherwise, it can be kept in a cool place for six hours.

You may click to see :Breast Milk Storing

Stiff hands
Q: I am 55 years old and drive an hour to work. When I reach my office, my fingers become stiff — fixed in a claw-like position — and can’t be moved easily. I also get “catches” in my leg and chest muscles.

A: You need a check up to see if you are suffering from diseases such as diabetes or hypertension. If so, they need to be tackled. If you are overweight, try to reach your ideal body weight. Walk briskly for an hour and do stretches for 20 minutes before going to work. Yoga, particularly suryanamaskar, is ideal. While stretching, concentrate on the hands. Eat four to six helpings of fruits and vegetables daily. Take calcium supplements. If all this does not help, consult a physician.

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Hernia problem
Q: My doctor said I have an intestinal hernia. What does it mean?

A: Hernias are of many types. An umbilical hernia occurs at or just next to the umbilicus. Incisional hernias occur at the site of a previous surgical scar. Inguinal hernias are commoner in men and occur in the groin area. If the abdominal wall is lax, the intestines can appear to lie just under the surface of the skin, a condition called divarication.

A weakness or deficiency in the abdominal wall present from birth can’t be repaired except through surgery. Incisional hernias and divarication can be prevented by not gaining weight and maintaining abdominal muscle tone with regular exercise.

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Pricking ears
Q: My ears are always pricking. Cleaning them brings out fungus, which forms again becoming worse.

A: The secretion may not be fungus but discharge owing to an infection, allergy or impacted wax. Fungus in the ear causes pain. Allergic or seborrhic dermatitis is more likely to cause pricking or itching.

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You need to consult an ear-nose-throat surgeon to make a diagnosis. Using inappropriate over-the-counter antimicrobial eardrops may make the condition worse. Cleaning the ears may rupture the skin, aggravating the pain and pricking.


High BP
Q: What is BP? How can I diagnose and prevent it? What’s the treatment?

A: BP is short for blood pressure. It should be below 140/90. If it is higher, the person is said to have high BP or hypertension. For most adults, there’s no identifiable cause of high BP. It tends to develop gradually over years. Sometimes, high blood pressure can occur as a result of tumours, defects in the blood vessels, kidney diseases or certain medications.

High BP occurs with increasing age, particularly if one or both parents have hypertension. It is commoner in overweight individuals. Smoking or living with people who smoke also increases the BP. Drinking excessively damages the heart and raises the blood pressure.

If you have high BP, stop smoking and drinking. Do regular exercises, combined with yoga and meditation, and reduce your salt intake. Your doctor will be able to prescribe appropriate medications if it does not fall with these simple measures.

The pill
Q: I take pills for diabetes, hypertension and chest pain. I find it hard to have sex. Can I use Viagra?

A: Viagra is a trade name for Sidenafil citrate and is used for erectile dysfunction, which is probably what you have. It is contraindicated in persons with hypertension, stroke or coronary artery disease, and chest pain due to angina.

It is better to discuss the issue with your physician and see if the medicine is advisable for you. He would also advise you on the dosage and time. Relying on the neighbourhood medical shop for supply and advice might be dangerous for your health.

Source:The Telegraph (Kolkata, India)


Belly Bulges

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A protruding belly button is commoner in boys and may run in families   Everyone would love an eight pack abdomen, but for some it may remain just a dream. Their abdominal wall has unsightly bulges and protuberances, which may be a well rounded paunch or even hernia.

Some children have a protruding navel or belly button, which is noticed soon after the remnant of the umbilical cord falls off. When the baby cries or strains, the tummy bulges at the umbilicus. The swelling is called an umbilical hernia. It is commoner in boys. It may run in families and be associated with other diseases like thyroid deficiency or inborn errors of metabolism.


The foetus receives its nutrition through umbilical blood vessels that are attached to the navel. The abdominal muscles also fuse at that point. There is an area of weakness there which can cause a defect in the abdominal wall muscles. The intestines may protrude through this. Usually, the intestines can be pushed back when the child is quiet and lying down.

By the age of three or four years, the abdominal musculature develops and the hernia disappears on its own. It usually does not cause any symptoms till that time. If the skin over the hernia changes colour, or if the child starts to cry incessantly, consult a doctor. It may mean the intestine has got trapped in the hernia and its blood supply is being compromised, strangling the bowel.

Strapping the bulging belly button with plaster, tying it with a bandage or fixing a coin over it won’t help. On the contrary, it may be harmful as a piece of intestine may get caught in the bandage and stop the blood supply. This then becomes a medical emergency. If the hernia persists after the age of three, it needs to be surgically repaired.

Hernias can also suddenly appear near the umbilicus in adults. This “paraumbilical hernia” is situated just above the navel and occurs through a weakness in the abdominal wall muscles. It may be due to pregnancy, obesity or poor abdominal muscle tone. It may also appear if fluid accumulates in the abdomen as a result of kidney or liver disease. The hernia may contain fat or intestines.

Paraumbilical hernias that appear during pregnancy may disappear on their own. In others, they need to be surgically corrected, even if they are painless. Bits of bowel or other intestinal content can suddenly become trapped in them, precipitating an emergency. There is a band of fibrous tissue connecting and holding together the musculature of the two halves of the abdomen. If this is weak and separates out, it may cause a condition called “divarication of the rectus abdominus”. It is common in obesity. The affected area is usually long and stretches over the abdomen from the umbilicus to the rib cage. As the defect is large, the intestine does not become trapped inside. If there is no umbilical hernia, it can be left alone. Surgical repair is a variation of a “tummy tuck” and is done purely for cosmetic reasons.

If there is a small defect in the linea alba (fibrous structure running down the midline of the abdomen), a ping-pong ball sized bulge can occur at the spot. This is called an “epigastric hernia”. It needs to corrected.

About 75 per cent of hernias occur lower down in the groin area and are called “inguinal hernias”. They are commoner in men. They can extend from the lower part of the abdomen to the scrotum in men and to the labia in women. They are caused by a congenital defect in the abdominal wall. Some men push the contents of the hernia back into the abdomen and then use a “surgical truss” to hold it there.

The surgical treatment of hernias has changed over the years. Traditional techniques involved opening the abdomen and suturing the muscle layers. Hospital stays were prolonged and recovery slow. Now, laparoscopic repairs can be done, reducing the hospital stay to two or three days. Fine sterile surgical mesh can be used to cover the defect. The hernia is then less likely to recur as there is no tension on the layers of the abdominal muscles.

Some hernias can’t be prevented. Congenital abdominal wall defects are less likely to manifest as hernias if

• The BMI (body weight divided by height in metre squared) is 23

• Core strengthening exercises (oblique sit ups, plank position) are done daily

• Lifting heavy weights is avoided

• Weight-lifting exercises are done after proper training and conditioning.

Source: The Telegraph (Kolkata, India)

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