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Is It Common To Have Pain During Protrusion Of Hernia?

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Posted on Mon, 2 Mar 2015
Question: I have a reducible umbilical hernia.

A friend of mine also has a reducible hernia, and he says the pain increases when the hernia is protruding - to the point of putting him in ER - but when he reduces the hernia, the pain goes away. Is it common for pain to occur with protrusion of hernia, for it to disappear when the hernia is reduced?
doctor
Answered by Dr. Deepak Kishore Kaltari (8 minutes later)
Brief Answer:
Pain is seen commonly in umbilical hernia

Detailed Answer:
Hi
Welcome to Healthcaremagic
Greetings of the day

Dear Sir

The hernia protrudes through a small defect in the anterior abdominal wall in the region of umbilicus. So when the contents that is intestine and omentum (fat laden structure ) squeeze their way out through the defect , there is constricting force which partially reduces the blood supply to omentum and intestine. This reduction in the blood supply is the cause for pain. The pain subsides on reducing the contents back to normal location.
Pain when the hernia is protruding out and subsiding of pain pm reduction is quite commonly seen. Surgical repair should be done at the earliest.


Take care


Best regards
Dr Deepak Kaltari
Consultant Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Deepak Kishore Kaltari (55 minutes later)
Thank you very much Dr. Kaltari. I appreciate your feedback a lot. During the period of time leading up to surgery, if the hernia patient manually reduces the hernia himself to mitigate pain, is there any significant risk of incarceration or strangulation in doing this? That is to say, can manual reduction potentially worsen hernia by inadvertently causing incarceration or strangulation?
doctor
Answered by Dr. Deepak Kishore Kaltari (32 minutes later)
Brief Answer:
Manual reduction does not predispose to strangulation

Detailed Answer:
Dear Sir

Hernia which gets manually reduced without much difficulty is a good sign. Such hernias are unlikely less undergo strangulation or incarceration as compared to hernia which are reducible with difficulty or not reducible.
So do not be worried ,manual reduction foes not predispose to these complications.


Wishing you and your family a very happy and healthy life.


Take care

Best regards
Dr Deepak
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Deepak Kishore Kaltari (20 hours later)
Thank you Dr. Deepak! My father read your responses to me, and when he read about you wishing us a healthy and happy life, he said, “What a nice man. I like this guy.” I am scheduling an elective surgery appointment as you suggest. Meanwhile, I am wondering at what point the pain necessitates emergent care? I was in ER in the summer for pain from the hernia, and discharge instructions said to return to ER if abdominal pain increases. The pain has been increasing over time, which I ‘ve read can be indicative of incarceration. It can regularly feel like I have been punched in the stomach, and can keep me up at night. I have no traditional strangulation markers – localized tenderness, discoloration, nausea/vomiting, bowel movement difficulties, rapid heart rate, or fever – the exception being sudden intensifying pain, which I can get and which can be as high as a 10 on a 1-10 scale. That said, my physician was able to reduce it to a totally flattened state in a matter of minutes, and I can reduce it myself, albeit it takes me significantly longer to do so. I have read trapped fat can be especially painful, and an ultrasound in October found a “supraumbilical anterior abdominal wall hernia containing fat with the abdominal wall defect measuring approximately 6 mm.” My father and I wish you and your loved ones an exceedingly happy and healthy life as well.
doctor
Answered by Dr. Deepak Kishore Kaltari (2 hours later)
Brief Answer:
Pain is due to Omental Ischaemia

Detailed Answer:
Dear Sir,

Thanks for all the wishes, I am very grateful to you for all the wishes.

Pain in hernia is not an indicator for incarceration, it just implies ischaemia(reduced blood supply) to Omentum(fat laden structure). As long as the hernia is reducible manually, there is no risk for incarceration/strangulation. Pain is also present when there is mechanical obstruction to herniated contents, so that is the reason Surgeons advise to seek the opinion of ER if pain increases. Reducible hernia do not get obstructed. Its easier for physician to reduce the hernia as compared to others, so do not be worried about it. The cause of your high grade pain is likely to be omental ischaemia and fat nibbling. As you have scheduled the Surgery that good indeed, the things will definitely settle down.

Wishing you safe and uneventful Surgery.

Take care Bro

Regards
Deepak

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Deepak Kishore Kaltari (47 hours later)
You're welcome and thank you and you take good care too Dr. XXXXXXX I appreciate your medically insightful information so much, and my father says you are on his God bless you list.
doctor
Answered by Dr. Deepak Kishore Kaltari (2 hours later)
Brief Answer:
Take Care

Detailed Answer:
Dear Sir,

Thanks a lot for all the wishes.
God bless you all.

Regards
Deepak
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Deepak Kishore Kaltari

General Surgeon

Practicing since :2002

Answered : 3194 Questions

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Is It Common To Have Pain During Protrusion Of Hernia?

Brief Answer: Pain is seen commonly in umbilical hernia Detailed Answer: Hi Welcome to Healthcaremagic Greetings of the day Dear Sir The hernia protrudes through a small defect in the anterior abdominal wall in the region of umbilicus. So when the contents that is intestine and omentum (fat laden structure ) squeeze their way out through the defect , there is constricting force which partially reduces the blood supply to omentum and intestine. This reduction in the blood supply is the cause for pain. The pain subsides on reducing the contents back to normal location. Pain when the hernia is protruding out and subsiding of pain pm reduction is quite commonly seen. Surgical repair should be done at the earliest. Take care Best regards Dr Deepak Kaltari Consultant Surgeon