Hernia: Types, symptoms and treatment
Yeah! Hi, I’m Dr. Nitin Jha, I’m a senior consultant laparoscopic surgeon at Fortis hospital, Noida and I also have a clinic in sector 61 Noida which goes by the name of Agarwal Clinic and today we’ll be discussing about Hernia.
By Hernia we mean that there is a small gap in the muscle of the abdomen wall and through this gap there is a protrusion of the contents which are inside of the abdomen like small intestine or the, even large intestine or the omentum fat and which tries to come out of this hole and as long as they go out and then they come back it’s okay. But the day it gets stuck, you know if you have a swelling in which the swelling refuses to go in, that means it is like an emergency then you have to immediately go to the hospital and get it operated upon.
Now, what is the cause, the basic cause of any hernia is, the weakness in the muscle wall and it can be even sometimes without any cause. That is called as Idiopathic. Now, there are basically there are three types of common hernia that we all encounter. The one is the Inguinal Hernia which are present in the lower part of the abdomen on the left as well as on the right side. Then you have our Umbilical hernia which is a hernia in the umbilicus itself, so that in the umbilicus instead of being a pit it becomes a elevated out pouching and then you have something called Incisional hernia in which after any surgery in the abdomen you can have a small bulge occurring from that incision side which is called basically insicional hernia. So be it any type of hernia the treatment is always surgical only. In contents, the usually, the intestine, the small ball, the large ball or the omentum fat can be the content of the hernia.
Now, What is the problem? Why to get it operated? As long as, as I told you, as long as it comes out and then goes back in, it is okay. But the day it refuses to go back in, that means it has become a bit complicated hernia. It starts with irreducibility, matlab, it doesn’t go back inside. Then there is something called as obstruction in which the intestine gets stuck in that pouch and it causes obstruction of the intestine. That is obstruction to the flow of the contents of the intestine. In that case the abdomen becomes bloated, the patient is not able to pass gas or motion from below and he or she can have a continuous vomiting from up. So, and obviously if the time goes on like this because of a decrease in blood supply of the intestine, the intestine can sometimes become strangulated. In that case it is an emergency and we have to immediately go to the surgeon and get it operated upon because if we give it more time the intestines can lose its blood supply and then we have to do a proper, major, big surgery. In which we have to cut the caught part of the intestine and rejoin the normal part. So, obviously we should definitely avoid this kind of circumstances which increases the cost also and plus it increases the morbidity, the trouble to the patient also.
Talking about surgery we initially had only open surgery, in which a small cut almost of this size used to be given whether it was inguinal or umbilical or incisional, but it had its own problems. The issue was, with open surgery, was you had to have a big incision on the belly. Then the bigger the incision the more the pain. The bigger the incision the more the chances of infection. But usually now we don’t do it by open surgery. We do it by something called laparoscopic surgery, in which there are almost two or three small, small holes of the size of around 5 millimeter or 1 centimeter and through, without cutting open the abdomen, through these small, small holes only the whole surgery is done. So the advantage is the patient becomes alright much faster. He needs to stay in the hospital for lesser number of time. He can be back to his work probably in three to four days. But as the thing is you know is any good thing is costly. Similarly the laparoscopic surgery is costly because the mess and the things which are required to fix the mess to the abdominal wall are costly. But if you compare between these two methods, laparoscopic surgery is far, far, far better than open surgery.
My specialty is doing the same surgery which is usually done by all other laparoscopic surgeons by three or four small, small cuts, I do it by only one single cut. So, especially with a uncomplicated simple hernia of the anteroapical wall, be it incisional or be it umbilical or super umbilical hernias which is commonly referred as ventral hernia. They are done by single incision only. That means I just put a small cut almost of this size around 1 to 1.5 centimeters size in the left part of the abdomen and through this same incision we conduct the whole surgery. So, the patient has not three small cuts but only one small cut. That’s the advantage of single incision laparoscopic surgery. So, you can consult me at my clinic in
So, you can consult me at my clinic in sector 61 Noida, Agarwal Clinic C122 and, otherwise you can also meet me in Fortis hospital Noida. Plus you can take an appointment via Lybrate and we’ll be glad to discuss your problems, thank you.read more
Hi, I’m Dr Nitin Shah. I’m a senior consultant at Fortis hospital, Noida. I’m a laparoscopic surgeon. I do all sorts of abdomen surgeries. Today we are going to be talking about the gallbladder disease, in which there are stones formed in the gallbladder. We need to understand that patients can initially be absolutely asymptomatic. The patient can have no pain or any discomfort. Many times it is detected by routine health examinations when the patient undergoes an ultra sound of the abdomen.
The initial stages after asymptomatic, the patient starts having little bloating in the abdomen which is commonly referred as gas and acidity. So people have a tendency of neglecting it and keep on taking some antacid or pantocid or Digene and this kind of stuff to suppress the symptoms. So after dyspepsia, the patient starts having pain in the abdomen. This pain can initially very simple pain. It can even progress into severe pain. It starts usually in the pre-gastric region, upper abdomen and goes to the back. This is very typical of a bilicuric and increases after any fatty meal like any extra oily friend. This kind of stuff when we eat, the patient has more pain and then depending on the severity of the inflammation, even patients are known to have pus in the gallbladder, thereby, increasing the mobility of the disease.
Some stones can slip from the gallbladder into the bile duct thereby obstructing the bile duct and producing something that is called obstructive jaundice. In which the patient has severe pain and has visible jaundice also. These stones not only block the bile duct but also can block the pancreas duct thereby causing something called as gall stone pancreatic. So, this is another very severe problem. As we all know, gall bladder cancer is quite common these days. In 4% of the cases, the gall stones are the causes of gallbladder cancer. So, for a simple disease like a gall bladder stone, if not treated at the immediate time this can land up into very very severe problems. now once the diagnosis is confirmed it is a simple surgery called as lap coly cystectomy in which we remove the gallbladder in very small three to four cuts that is called the laparoscopic surgery. The same surgery was previously done with a big cut that’s called the laparotomy, cutting open the whole abdomen and then removing the gall bladder. Now it is done by three or four small cuts. In fact, my specialization is getting the same surgery done by a single incision in the ablycus. In which there is one cut in the navel and no cut anywhere else in the abdomen and hence the surgical cut is hardly seen. Probably, even after two months, the surgeon will also not be able to make out whether any surgery is done on the patient or not. The scar is hardly seen and it is very cleverly hidden in the ablycus.
So, for any further information or any question that you want to ask I am available at lybrate.
You can log onto lybrate or even text me or video chat with me on lybrate and I will be more than happy to clear all your doubts regarding any surgical disease and help you in the best way I can.
Doctors in Fortis Hospital - Noida
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Hello! Doctor, I am going through extremely difficult time in my life this is because I have lost my wonder brother in 2012 of him having cancer. Since then my life has changed, I have going through severe depression and have I cannot come to terms of losing him. I cannot sleep, or eat and my health is somewhat going all over the place. I live alone, I am tired all the time, I cannot focus on anything or do anything, also I have noticed that I cannot seems to hold any items on my hand as they feel weak. I also have Asthma and it is also getting worse. I am having hair loss. I am constantly thinking of my wonderful brother. I have had counselling but it did not help. I don't wa nt to take depression tablets because they did not help. I also suffer Hypertension and cholesterol. please advise Thanks Nargis Chowdhury.
My mother is diagnosing with multiple myeloma and bone metastases. She had haemoglobin of 10.4 and m -protien spikes of 4.27 with gamma globulin of 4.47 before radiation therapy. She has gone with radiation therapy for 11 days and a dose of bisphosphonate 3 days ago. 1) Is her treatment is going in right direction? 2) which food is best for her.
Few month before I feel pain in breast week before .t menses. But from last menses (20/02). I feel regular pain nonstop. Pls help.
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Irritable bowel syndrome is a disorder of the large intestine. It may cause abdominal pain, bloating, diarrhea and constipation. The condition is not life threatening in nature and does not make you susceptible to colon disorders such as Crohn's disease, ulcerative colitis and colon cancer, however, symptoms of IBS may act as deterrents in leading a normal life.
The symptoms of irritable bowel syndrome are -
- You may experience symptoms of constipation
- Frequent episodes of diarrhea
- Abdominal cramps especially on the lower part of the abdomen
- Constant bloating
- Abnormal stool structure
- You belly might stick out
In some cases, you may experience sexual problems and urinary problems. In addition, if you also suffer from stress related disorders then it might aggravate the symptoms.
The primary cause is that the colon becomes very sensitive such that small stimulation may cause it to react. When the food passes through the colon, it tends contract strongly and leads to complications such as bloating and constipation. It may also lead to weak contractions of the colon which leads to hardened stool.
There are certain things which may symptoms of IBS, they are -
- Stress: Any type of stress tends to aggravate symptoms of irritable bowel syndrome.
- Foods: Certain foods such as chocolate, spices, cabbage, milk and carbonated beverages may trigger symptoms of IBS.
- Hormones: Hormonal changes such as the ones during menstrual cycles may aggravate symptoms of IBS.
- Illnesses: Various illnesses such as diarrhea or conditions such as overproduction of bacteria in the intestines may lead to symptoms of irritable bowel syndrome.
Women are more likely to be affected by symptoms of IBS as are people who are below 45 years of age. If someone in your family has irritable bowel syndrome, then you are also likely to develop this disorder. It may also aggravate symptoms of hemorrhoids, along with aggravating symptoms of stress.
In case you have a concern or query you can always consult an expert & get answers to your questions!
With the recent number of breast cancer cases on the rise, it is important that we should get the examination done on a regular basis as a preventive measure. Even if someone is suffering from it, it is important that we should make an effort and learn about.
If you have breast cancer then a surgery will be part of your treatment. Based on the condition, surgery will be carried out due to any of the following reasons:
1. To remove the cancerous tissues from the breast
2. To reconstruct the breast once the cancer is removed
3. To check whether the cancer has spread to the lymph nodes below the arm
4. To treat symptoms of cancer that has progressed to an advanced stage
Breast cancer surgery may be classified into two types
1. Mastectomy: Mastectomy involves removing the entire breast; tissues in the adjoining region may also be removed. A double mastectomy is a procedure where both the breasts are removed.
2. Breast-conserving surgery: In this surgery, only parts of the breast affected by cancer are removed. The area of the breast that is to be removed will depend on the severity of the cancer. Some healthy tissues may also be removed in this surgery.
Usually, if a woman is in the initial stages of cancer then she may opt for the latter as it entails removing parts of the breast. They may also undergo radiation therapy along with these surgeries.
For checking if the cancer has spread to the lymph nodes below the arm, the lymph nodes are removed from the body. Once they are removed, they are studied under a microscope to check if it has spread, if yes then the extent of their damage. This procedure is carried out along with the surgery to remove the cancer.
Once the mastectomy procedure is completed, you can opt for a breast reconstruction surgery to rebuild the area. You may opt for this procedure at the time of breast cancer removal or at a later stage. If you are considering breast reconstruction surgery then you should discuss it with your surgeon.
Surgery is sometimes not used to treat cancer, but in slowing the progression of cancer or even reducing its symptoms.It is important you talk to your surgeon before the procedure to understand the goal of the surgery.
In case you have a concern or query you can always consult an expert & get answers to your questions!