March 19, 2009
If you have a bulge...
Experts explain why you should nip that protruding lump, otherwise known as a hernia, in the bud. JUNE CHEONG reports
Gentlemen, that bulge in your pants may not be happy news.
The soft bulge in your groin or near your belly button could be a hernia. This condition occurs when part of an organ, like the intestine, pushes through a weakened area of the abdomen's muscular wall.
Although males are the ones who usually get this problem, females and young children can get hernia too.
The most common are inguinal, umbilical and incisional hernias.
According to the Asia Pacific Hernia Society, 93 per cent of hernias are inguinal, occurring around the groin area. Men aged 40 to 60 years old are most susceptible.
Manual workers and infants under the age of two - of either sex - are also prone to the condition.
Dr Chong Chee Keong, a general surgery consultant at Changi General Hospital, explained that when you carry heavy things during manual labour, you may strain your abdomen which causes the weak part of a muscle gives way.
'It's like a balloon. You squeeze it and the weak part of the balloon gives way.'
He added that while younger people may get hernia, the condition becomes more pronounced in older people as, over time, the defect in a weakened muscle becomes more pronounced.
Umbilical hernias (inset) are most common in infants, especially premature babies and those with low birth weights.
They occur when an opening in the baby's abdominal muscles, which allows the umbilical cord to pass through during pregnancy, does not close properly. However, most umbilical hernias close by the time the baby is one year old.
Incisional hernias can appear after abdominal surgery where there is an incision. They usually occur six months or more after surgery as the abdominal muscles are weakened.
A bad wound infection or poor healing can worsen the condition, causing a hernia to develop.
The earliest symptoms of hernias are pain and discomfort. A hernia, if left untreated, can develop into a strangulated hernia.
That is when the intestine becomes trapped outside the abdominal wall, swells and blood supply to that part of the intestine is cut off. Emergency surgery is required in such a case.
People who suspect they have hernias should check for bulges in the groin or abdominal areas after coughing because this action is stressful for our bodies.
The only treatment option is open or laparoscopic (keyhole surgery where repair is done through a 1cm incision) surgery.
Changi General Hospital sees between 350 and 400 hernia patients each year.
During the hour-long operation, the surgeon plugs the defect in the patient's abdominal wall with a single-layered or double-layered mesh made of a kind of plastic.
With mesh repair, the chance of the condition recurring dips to less than 1 per cent.
One patient who emerged from hernia surgery all smiles was pilot Steven Lee (not his real name) who suffered a hernia for 10 years. Mr Lee, 33, underwent surgery last October.
He said: 'It was just a ping pong ball-sized bulge and I could push it back into my skin. It didn't seem to matter as I felt no pain.
'Then it kept protruding repeatedly.'
Mr Lee paid less than $500 from his own pocket for his operation, after deductions from Medisave.
Based on the Ministry of Health's website, hernia surgery can cost between $678 and $5,860, depending on ward class and length of hospital stay.
When asked what people can do to prevent hernias, Dr Chong said: 'Regular exercise helps. Muscle-strengthening exercises like running or swimming or building up your truncal muscles will reduce the risk.'
So instead of pushing that nagging bulge around, nip the problem in the bud and talk to your doctor about it.