Probably one of the most widely used medical words by the non-medical public, and most misunderstood ones, is the word “hernia”.
“We had to take Ma up tu th’emergency room t’other day with chest pain. Turns out it was jist her dad-blamed hiatal HERNIA. Pa said he didn’t unnerstan’. He had one of them HERNIAS, too, but it gave him pain “down there” and he had to have a operation. Auntie said she’s had some kinda HERNIA, too, only hers happened after some whippersnapper hit her from behind at a red light. Hurt down her arm somethin’ powerful for a long time. Man, that HERNIA thang really gits around!”
So, what is a “hernia”?
It’s actually more something that a “thing” does rather than the thing itself. Briefly, a hernia is when one “thing” or structure in the body moves, slides, bulges, protrudes, or otherwise escapes its normal anatomical confines and encroaches on another space.
The inguinal “hernia”, is that bulging in the groin on one or both sides of the pubic bone. It occurs when a small opening in the lower abdominal wall becomes a bigger opening, and the contents of the abdominal cavity begin to bulge downward (sometimes all the way into the scrotum of a male, and, less commonly in women, downward into the crotch area).
An “umbilical” hernia looks like a bulging balloon around the belly button. Same principle as the inguinal hernia, only right in the middle. A “ventral hernia” is usually larger, vertically oriented along the midline of the abdomen where the joining of both sides of the abdominal muscles becomes thinned out or splits so that the contents of the abdomen want to push outward. Sometimes abdominal hernias can occur along old surgical incisions if they thin or pull apart underneath the skin.
The “herniated” disc referred to in a previous blog is when the jelly-doughnut-like cushion between spinal vertebrae escapes its normal boundaries and bulges outward (imagine a “smooshed” jelly doughnut), sometimes pushing on nerve roots coming from the spinal cord and causing a lot of pain.
And finally, the “hiatal” hernia. This one is a little confusing. First, the thing that “herniates” is the stomach. The structure that it herniates through is the diaphragm. The diaphragm separates the abdominal cavity from the chest cavity. Because the diaphragm constitutes a wall or “break” between these two areas of the body, it is, therefore, a “hiatus”… a “break”. (Like “Summer Break” or a “break in the action” is often called a “hiatus”.) The top of the stomach can sometimes slide up into the chest cavity, perhaps causing chest pain, reflux symptoms, or no symptoms whatsoever.
There are many other structures in the body that can be involved in a hernia of one sort or another. But, I won’t bore you with too many details.
Hope you get the point.
“Hey, Ma! Boy, I feel better now…. That hernia thang ain’t contagious after all!”