A hernia occurs when an organ or tissue protrudes through an opening or weak spot in the surrounding muscle or

connective tissue. This can happen for various reasons, and the specific cause can depend on the type of hernia. The
most common types of hernias involve the abdominal wall, and here are some general causes:

Weakness in the Muscles:

Over time, the muscles of the abdominal wall may weaken, creating a vulnerability for organs or tissues to push through.
This weakening can be due to factors such as aging, genetic predisposition, or muscle strain.

Increased Pressure in the Abdomen:

Any activity or condition that increases pressure within the abdominal cavity can contribute to the development of a
hernia. This can include heavy lifting, persistent coughing, constipation, obesity, or pregnancy.

Congenital Weakness:

Some individuals may be born with a congenital weakness in the abdominal wall, making them more prone to hernias.

Aging:

As individuals age, the tissues of the body, including the muscles and connective tissue, may naturally weaken. This age-
related weakening can contribute to the development of hernias.

Previous Surgery:

Surgical incisions can create weak points in the abdominal wall. In some cases, hernias can develop at or near these
incision sites, particularly if the healing process doesn't adequately strengthen the area.

Obesity:

Excess weight and obesity can put added strain on the abdominal muscles, increasing the risk of hernia development.

Chronic Coughing or Straining:

Conditions that cause chronic coughing or straining, such as persistent cough, chronic obstructive pulmonary disease
(COPD), or constipation, can contribute to the development of hernias.

Management:
1. Avoid any activities that can increase pressure within the abdominal cavity. This includes heavy lifting and persistent
coughing.
2. Medication to control pain and bloating
- Parecoxib and Celecoxib – NSAID, reducing inflammation and pain after surgery
- Metoclopramide and Ondansetron – antiemetic medication, to prevent or treat nausea and vomiting, which can occur
after surgery or due to anesthesia
- Ampicillin-Sulbactam – antibiotic to prevent or treat infection
- Stool softeners – prevent straining during bowel movements
Surgical Procedures:

Herniorrhaphy (tissue repair)

Herniorrhaphy is the oldest type of hernia surgery and is still being used. It involves a surgeon making a long incision
directly over the hernia then using surgical tools to open the cut enough to access it. Tissues or a displaced organ are
then returned to their original location, and the hernia sac is removed. The surgeon stitches the sides of the muscle
opening or hole through which the hernia protruded. Once the wound has been sterilized, it is stitched shut.

Hernioplasty (mesh repair)

In hernioplasty, instead of stitching the muscle opening shut, the surgeon covers it with a flat, sterile mesh, usually made
of flexible plastics, such as polypropylene. The surgeon makes small cuts around the hole in the shape of the mesh and
then stitches the patch into the healthy, intact surrounding tissues. Damaged or weak tissues surrounding the hernia will
use the mesh, as a supportive, strengthening scaffold as they regrow.

Management:
1. Avoid any activities that can increase pressure within the abdominal cavity. This includes heavy lifting and persistent
coughing.
2. Medication to control pain and bloating
- Parecoxib and Celecoxib – NSAID, reducing inflammation and pain after surgery
- Metoclopramide and Ondansetron – antiemetic medication, to prevent or treat nausea and vomiting, which can occur
after surgery or due to anesthesia
- Ampicillin-Sulbactam – antibiotic to prevent or treat infection
- Stool softeners – prevent straining during bowel movements

Reference:
Medical News Today. (2017, November 30). All you need to know about hernia repair. Medical News Today.
https://www.medicalnewstoday.com/articles/319753