Hernia Trivia Quiz

Answer: Any organ protruding through its wall

A hernia is a universal term referring to anywhere in the body where the organ pushes through its containing wall. This can be on the surface, where whatever is underneath (usually the intestines) can be seen poking through, or internal, where they will be found from known symptoms or discovery via an investigation such as an endoscopy.

The causes and treatments are covered throughout the remainder of the quiz.

Answer: True

Although this does not apply to many, there are two main types of hernia which will heal naturally, congenital umbilical hernias, and spinal disc hernias. Babies born with umbilical hernias, where the gut pokes through the area around the navel, are left for a while to see if they gradually reduce and then disappear altogether before undertaking surgery for the remainder.

Herniated discs will usually recover naturally after a few weeks with only the worst ultimately requiring surgery. But nearly all other hernias which develop after birth are a physical injury which the body is unable to repair naturally.

Answer: Strangulation

Strangulation is a form of blockage, but a very specific one, caused by a twisting of the gut or other affected organ which cuts off the blood supply, much like the similar problem with a placenta. Gangrene is the result of an untreated strangulation (which normally cause severe pain so patients would receive emergency surgery if medical assistance is available) as once the blood has been cut off for too long, necrosis will set in and begin killing off the tissue causing gangrene.

Many hernias can easily be diagnosed as serious so would normally have surgery long before they reach this stage, but sometimes they can remain undetected or the patient has not reported them, in which case it is more likely to happen.

Answer: Mesh patching

Deep suturing was the standard form of operation until the 1990s or so, and as well as being an invasive surgery with the associated long recovery period, the stitching did not always last and the weakness caused could allow the hernia to recur. The patch is a form of inert plastic mesh, which becomes part of the muscle wall and as such provides a framework to strengthen it, as well as only needing a relatively minor surgery. It can often be done using laparoscopy/keyhole surgery, with the patient able to return to normal life within a few days.

Resection is for repairing the gut itself while there is no known laser treatment for hernias. An ostomy is an intestinal bypass of the rectum and anus at various points above such as the ileum or colon, requiring an external pouch, and either a temporary method after resection to allow healing or a permanent alternative where there is no longer enough healthy bowel at the lower end.

Answer: Yes

Unfortunately once a hernia has burst through a surface it creates a permanent weakness, often building on one already present, and any sudden stress on the area can cause it to pop through again. The modern mesh method however has greatly improved the chances of preventing them compared to before.

But as hernias are more likely in people prone to them this means they are both more likely to suffer a relapse as well as subsequent ones elsewhere.

Answer: Hiatus

A hiatus hernia is a breach in the wall of the oesophagus, where the stomach can bulge into the oesophagus. It can be fairly innocent and cause few if any symptoms, only requiring monitoring in case it deteriorates, or a more sinister 'rolling' type where the stomach can get caught in a pinching formation and cut off the blood supply. Normally standard hiatus hernias only need treatment when there are symptoms, where rolling ones are safer being repaired with surgery. Discomfort and gastric reflux are the commonest symptoms of both, which can be treated with standard medicines and diet. Surgery is only recommended for the most persistent and troublesome ones.

Answer: Over 50s

Hiatus hernias affect the elderly the most, although being overweight is the second biggest cause, but more so in the older people. They are possible at any age but may be caused by long term stress such as chronic coughing or straining from constipation (which affects all hernias).

Other sudden strains can also cause them, as for all hernias, and also the long term pressure from pregnancy.

Answer: Inguinal

Inguinal hernias are where the gut passes through its wall and into the groin. Although this occurs in men and women it is far more likely in men, and if untreated you can see photos where they reach the ground, especially in the undeveloped world where medical treatment is not freely available.

They can all be treated though as the intestines are simply introduced back into the body cavity before the space they have escaped from is patched up. In the past, trusses were often used for smaller inguinal hernias, protecting them from any further extrusion, which due to gravity will tend to happen eventually in many cases.

Answer: False

It is possible to have minor hernias which cause no symptoms which the doctors prefer to leave alone, and simply monitor from time to time to check they have not grown any bigger. Hiatus hernias need the least treatment if the common type, and can be managed by diet and simple care measures such as not bending after a meal to avoid any discomfort. Reaching a healthy weight is recommended for all types of hernia, as it relieves many symptoms and makes surgery easier if required. Vertebral disc hernias are sudden and acute, and if minor are given pain and anti-inflammatory treatment and normally heal in a few weeks on their own. For all vertebral disc hernias surgery is only used as a last resort.

Answer: Genetic tendency

These are the main causes of hernias listed, but unless you are already prone to them the other causes besides a severe physical strain they are far less likely to cause a hernia, as they are based on actual weakness in the diaphragm or gut wall, which is then exploited by outside conditions. That is why some people have a few hernias in their lifetime while others will have none.