Hernia

　　The formation of hernia is closely related to the patient's constitution. It is often caused by factors such as coughing, sneezing, overexertion, abdominal obesity, strenuous defecation, pregnancy in women, excessive crying in infants, and degenerative changes in the abdominal wall in the elderly. These factors lead to negative pressure within the abdominal cavity, causing an increase in intra-abdominal pressure, forcing free abdominal organs such as the small intestine, cecum, omentum, bladder, ovary, fallopian tube, and others to pass through any available opening, normal or abnormal, or through weak points or gaps to enter another location.

　　Western medicine believes that the causes of hernia are related to two factors: the weakened strength of the abdominal wall at the affected area and the excessive abdominal pressure. The weakened strength of the abdominal wall is divided into congenital and acquired types. Congenital deficiencies include conditions such as incomplete closure of the peritoneal processus, incomplete closure of the umbilical ring, defects in the linea alba, or wide inguinal triangles. Acquired causes include surgical incisions, trauma, inflammation, and infection. There are many factors that can increase abdominal pressure, such as chronic cough, constipation, difficulty in urination, ascites, pregnancy, and infants often crying loudly.

　　Traditional Chinese medicine believes that the causes of hernia onset are related to the following factors:

　　1. Stagnation of liver qi: due to worry, anger, emotional discomfort, poor flow of qi, qi wandering in the lower abdomen and leading to the onset of the disease.

　　2. Internal retention of cold and dampness: due to sitting in a cold and damp place for a long time, or being rained on and catching a cold; causing the evil of cold and dampness to invade the liver meridian and lead to the onset of the disease.

　　3. Sinking of middle qi: due to excessive exertion, overwork in sexual life, injury to healthy qi, leading to qi deficiency and sinking in the lower abdomen, or due to insufficient endowment from birth in children: or due to kidney and liver deficiency in the elderly, loose tendons, or due to weak spleen and stomach, sinking of middle qi, and failure to rise and lift, leading to the onset of the disease.

　　Small intestine hernia is a type of hernia disease, and its incidence rate is also very high. However, some people think that hernia will not cause serious harm to the body and delay treatment, which eventually causes small intestine hernia to threaten the health of the body, leading to a series of complications:

　　1. Small intestine hernia can cause strangulated hernia: when incarcerated hernia cannot be relieved in time, it leads to circulatory disorders and even necrosis of the hernia contents, which is called strangulated hernia.

　　2. Small intestine hernia can cause irreducible hernia: refers to the condition where the hernia contents cannot be completely returned to the abdominal cavity, but do not cause serious clinical symptoms.

　　3. Small intestine hernia can cause incarcerated hernia: when the hernia ring is small and the abdominal pressure suddenly increases, the hernia contents are forcibly expanded into the hernia sac through the neck, and then due to the shrinkage of the neck, the hernia contents are tightly caught, preventing them from being returned.

　　4. Small intestine hernia can cause reducible hernia: refers to the condition where the hernia contents can be easily and completely returned to the abdominal cavity. It herniates when the intra-abdominal pressure suddenly increases temporarily, and it can be returned to the abdominal cavity naturally or by gently pushing with the hand.

　　If small intestine hernia is not treated in time and effectively after onset, it can cause a series of complications in the body, causing greater harm to the patient's body. Therefore, if people suffer from small intestine hernia, they must be diagnosed and treated early to avoid the occurrence of other harms.

　　Hernia is divided into pediatric hernia, adult hernia, and elderly hernia according to the age of onset, and its clinical manifestations are as follows:

　　1. Children with hernia usually have a protruding lump in the inguinal region during crying, vigorous exercise, or constipation, which may extend to the scrotum or labia; it will disappear spontaneously when lying flat or pressing with the hand. Children with hernia may also affect the digestive system, leading to symptoms such as a feeling of lower abdominal坠胀, bloating, abdominal pain, constipation, poor absorption, fatigue, and decreased physical fitness. Children with hernia may also have symptoms such as constipation, loss of appetite, vomiting, and some may become easily crying or restless. Most are found between two to three months, and some may not be discovered until one to two years old. Moreover, since the inguinal region is adjacent to the urinary and reproductive systems, it can affect the normal development of the child's reproductive system due to the compression of the hernia.

　　2. Adult hernia mainly manifests as a mass in the inguinal region, which can be seen or felt. It appears when standing, exerting force, or coughing, and can disappear when lying flat. When the mass protrudes, gently pushing it upwards will feel slight resistance, which will quickly disappear. Sometimes, gurgling sounds can also be heard. In addition, when the mass protrudes, patients may feel a sinking sensation, accompanied by distension or pulling abdominal pain. Due to the proximity of the inguinal region to the urinary and reproductive systems, patients with adult hernia are prone to sexual dysfunction.

　　3. Elderly hernia is more special, often caused by weak physical condition in the elderly. The organs that prolapse in elderly hernia are mostly small intestines, so they feel soft, and when they return, there may be gurgling sounds. The large intestine, appendix, omentum, and other organs may also prolapse. After the occurrence of elderly hernia, symptoms such as abdominal pain, bloating, constipation, weakened resistance, malnutrition, and poor digestion may also occur in the elderly.

　　The prevention of hernia mainly focuses on enhancing the strength of the abdominal wall muscles and avoiding sudden increases in abdominal wall pressure.

　　Exercise can strengthen the abdominal wall strength

　　Strengthening the abdominal wall muscles can reduce the occurrence of intestinal hernias. This can be achieved through appropriate exercise, such as bending over and body flexion exercises, which can be combined with Tai Chi, gymnastics, swimming, and ballroom dancing, but it is not recommended to engage in剧烈 exercise, especially sudden weight lifting. At the same time, appropriate physical exercise can maintain a healthy weight, and there are studies showing that obesity can also increase the incidence of hernia.

　　People who smoke heavily for a long time are not only prone to lung cancer, but the long-term chronic cough caused by smoking can also significantly increase abdominal pressure. Studies have also found that smoking can lead to disordered metabolism of collagen fibers in the abdominal wall, reducing the strength of the abdominal wall. Therefore, avoiding smoking, preventing coughs, and controlling asthma are also important for the elderly in preventing and treating hernia.

　　The elderly can still go shopping at the market and do other daily activities, but they should not try to carry heavy objects like gas cylinders or large water containers because the instant of lifting heavy objects can also cause a sharp increase in abdominal pressure, leading to the occurrence of hernia. Excessive force during constipation can also lead to increased abdominal pressure, which is an important factor in causing hernia.

　　Constipation in the elderly is common, and excessive force during constipation can lead to increased abdominal pressure, which is an important factor in causing hernia. Therefore, the elderly should not eat foods that are easy to cause constipation, abdominal bloating, or too cold or too hot foods. They should eat more easily digestible foods to reduce the burden on the intestines. In their daily life, they should follow the principle of 'more of this and less of that', which includes eating more fresh vegetables rich in dietary fiber (such as celery and chives), more coarse grains (such as whole wheat), and more fruits (such as bananas), and less greasy and rich meat. In addition, it is recommended to drink a cup of warm water or honey water after getting up in the morning, and develop the habit of defecating at a fixed time. If constipation occurs, take laxatives under the guidance of a doctor and treat it in a timely manner.

　　Difficulties in urination and other symptoms that increase intra-abdominal pressure can lead to hernia.

　　Among people over 60 years old, more than half of the men have varying degrees of benign prostatic hyperplasia, and this proportion can reach 83% by the age of 80. Patients are prone to symptoms such as frequent urination, urgency, and difficult urination, which increase intra-abdominal pressure. Appropriate treatment should be sought as soon as possible to avoid 'adding snow on the snow' on the fragile abdominal wall, leading to the occurrence of hernia.

　　The elderly often practice lifting their legs to prevent hernia. Direct inguinal hernia is often seen in the elderly, and the incidence of elderly hernia is high. This is mainly because the abdominal wall muscles and tendons of the elderly degenerate, the strength decreases, and factors such as obesity or long-term illness and bed rest, which are very likely to cause atrophy of the abdominal wall muscles, leading to the protrusion of the small intestine or omentum from the weak part of the abdominal wall. In severe cases, surgery may be necessary. Summary: The elderly often practice lifting their legs to prevent hernia. Therefore, the elderly should consciously strengthen abdominal muscle exercises, increase muscle strength, and avoid the occurrence of hernia.

　　Regarding hernia, it is mainly diagnosed through clinical symptoms and related examinations. The specific examinations are as follows:

　　1. Hernia examination should be done in general surgery, and an ultrasound can be used to confirm the diagnosis

　　2. For patients with umbilical hernia without complications, the examination plan mainly includes limited ECG and liver function tests;

　　3. For patients with unexplained pulmonary and abdominal diseases, the examination plan can include limited ECG, liver function tests, and blood creatinine, blood urea nitrogen (BUN), and ultrasonic examination of gastrointestinal diseases.

　　If infants have the following symptoms, they should be highly regarded:

　　1. Unexplained crying and fussiness; it is necessary to consider the possibility of pediatric hernia with incarceration;

　　2. Severe vomiting and fever; it is necessary to consider the possibility of pediatric hernia with incarceration;

　　3. Intestinal obstruction; it is necessary to consider the possibility of pediatric hernia with incarceration;

　　4. Finding blood in stools; it is necessary to consider the possibility of pediatric hernia with incarceration.

　　It is necessary to carefully investigate whether there is inguinal hernia; of course, it is also necessary to consult a doctor to check for other diseases.

　　Nutritional therapy has a good auxiliary therapeutic effect on hernia, and several methods are introduced below:

　　Eggplant has multiple effects such as astringing and stopping bleeding, and invigorating the spleen and stopping leukorrhea. In folk medicine, 50 grams of eggplant are decocted into a decoction for oral administration, taken warm before meals, twice a day. It has astringent and firming effects on mild hernia and can improve the discomfort caused by hernia. Eggplant can also be eaten as a cold dish, stir-fried, or fried, which has effects on hernia.

　　According to the Compendium of Materia Medica, dolichos lablab is considered to 'warm the middle jiao, descend qi, benefit the intestines and stomach, stop hiccups, and tonify the kidneys and qi'.

　　They can be used to make porridge, with 50 grams of dolichos lablab and 50 grams of glutinous rice, taken twice a day. Alternatively, the dolichos lablab can be ground into powder and mixed with boiling water for oral administration, 5 grams each time.

　　The seeds of pomelo have the effects of regulating qi, relaxing the middle jiao, and resolving phlegm and dampness. Take 30 grams of pomelo seeds, decocted in water for oral administration, twice a day, for a month. Alternatively, 10 grams of pomelo peel can be decocted into a decoction for oral administration, twice a day. Both methods have certain effects on the pain of hernia.

　　Lychee kernel, according to the 'Explanation of the Materia Medica': 'Lychee kernel treats heartache and small intestine Qi.' The 'Compendium of Materia Medica' believes that it can 'promote the circulation of Qi, treat hernia pain, and women's blood Qi pain'. 30 grams of lychee kernel, 10 grams of Anxiang, decocted in water, twice a day. It has the effect of promoting Qi, dispersing nodules, and relieving pain.

　　Figs have the effect of regulating Qi and strengthening the spleen. Take 5 figs, 10 grams of Anxiang, decocted in water, twice a day.

　　Old loofah 250 grams (roasted dry), Chenpi 10 grams, finely ground together, taken with white wine, 3 grams each time, twice a day, for one month.

　　Juhexie 30 grams, Shanzha 30 grams, decocted in water, twice a day. It has the effect of promoting Qi, dispersing nodules, and relieving pain.

　　Western treatment of hernia is divided into conservative treatment and surgical treatment, as follows:

　　1. Surgical treatment includes traditional hernia repair surgery, tension-free hernia repair surgery (hernia patch repair surgery), hernia laparoscopic repair surgery:

　　Traditional Hernia Repair Surgery: It repairs the hernia ring opening by stripping part of the external oblique abdominal muscle, which has a relatively high recurrence rate and slightly worse postoperative comfort;

　　Tension-free Hernia Repair Surgery (Hernia Patch Repair Surgery): It uses a patch material to replace the stripped part of the external oblique abdominal muscle to repair the hernia ring opening, which is the mainstream treatment method in hospitals at or above the county level in China. The patients recover quickly after the operation, and the recurrence rate of comfort is less than one percent. (Children grow rapidly, but the size of the patch is fixed and inelastic, so it is generally not recommended to use patch repair for children's hernia, and traditional high ligation repair surgery is more commonly used)

　　Hernia Laparoscopic Repair: It is to complete the hernia repair operation or hernia patch repair operation through laparoscopy, which has relatively small trauma and relatively high technical requirements for doctors. Large hospitals or professional hernia treatment departments at or above the provincial level have been carrying out in turn. Currently, it has not been widely carried out.

　　2. Conservative treatment includes oral medication and hernia belt treatment:

　　Oral Medication: Helps to relieve the pain of hernia, relieve abdominal distension, abdominal pain, constipation caused by hernia, etc. Since it cannot make the hernia prolapse return to the hernia ring opening and heal, it can only play an auxiliary therapeutic effect;

　　Hernia Belt: Physically, the health hernia belt plays a role in preventing the prolapse of the small intestine and alleviating the condition of hernia, but it can only relieve the condition in the short term and cannot treat it, and not treating it in time may worsen the condition.