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Back behind the wheel: Hernias: Do you have one?

Do have an unexplained bulge in your abdomen area or near your groin? Does it hurt to cough or lift heavy things? Do you have chronic acid reflux (heartburn)? If you have answered yes to any of these...

Do have an unexplained bulge in your abdomen area or near your groin? Does it hurt to cough or lift heavy things? Do you have chronic acid reflux (heartburn)? If you have answered yes to any of these questions, you may have a hernia.

A hernia is a protrusion of an organ or tissue trough an abnormal opening in the body. Most hernias occur when a portion of the intestines slips through a weak point in the abdominal wall. For the majority of hernias (excluding hiatus hernias) when this occurs, there is a visible bulge that’s seen in the abdomen. Typical areas for hernias are in the groin area and just below the ribs.

Hiatus, inguinal and abdominal hernias are the three most common types of hernias.

Of the three, the hiatus hernia is unique from the other two. A hiatus is a hole in an organ, which allows another organ to pass through it. When a hiatus hernia occurs, part of the intestines bulges through the diaphragm muscle. The diaphragm has a hiatus in it, to allow the esophagus to pass through. The hiatus in the diaphragm is usually tight and snug around the esophagus. Sometimes, the diaphragm becomes weak and the hiatus enlarges and allows the intestines to pass through it, the end result is a hiatus hernia. Since the diaphragm is a thin sheet-like muscle that separates your lungs from your abdomen, when a hiatus hernia occurs, it cannot be seen. This makes diagnosing it a little more difficult. A diagnosis is usually made through an upper gastrointestinal barium X-ray.

In most patients a hiatus hernia does not cause any symptoms. Some patients however may experience chronic acid reflux (heartburn).

Treatment for a hiatus hernia involves limiting the foods that increase stomach acid secretion (i.e. nicotine, caffeine, fatty foods, alcohol, peppermint and chocolate). Try to eat smaller, more frequent meals, make sure you do not eat two to three hours before bedtime. Avoid bending, stooping, abdominal exercises, tight belts and anything that can possibly increase pressure of the abdominal cavity. If you are overweight, try and lose some weight because the excess weight will also increase pressure in the abdomen. Finally, try and elevate your head about eight to 10 inches by using a pillow under your mattress. Gravity will help keep the stomach acid from entering the esophagus.

Surgery is not usually done unless it is a medical emergency. Most hiatus hernia are treated with lifestyle modifications and medications.

The abdominal and inguinal hernias are two types of hernias that most people are aware of. These two hernia occur when there is a weakness in the abdomen wall, resulting in the intestines pushing through. When this occurs there is a visible bulge in your abdominal or inguinal (groin) area.

Unfortunately, it is hard to predict who will have a hernia. A hernia can be present at birth or may develop over time. If you are constantly straining or increasing the pressure of the abdominal wall (i.e. coughing, lifting heavy objects) along with being obese, your risk of having a hernia is higher.

With an abdominal hernia it is important to get it examined by your doctor. If the abdominal hernia is a reducible type hernia (can be pushed back in) there is no serious health related issues. If it is non-reducible, it is a medical emergency. With this type of abdominal hernia, blood flow can be decreased to the intestines leading to cellular death. Strangulation of the intestines may occur, making it difficult for digestion and causing extreme pain.

Surgery is the usual treatment for these two types of hernias, depending on severity. For more information contact the Shouldice clinic in Thornhill, Ont., which is world-renowned for performing hernia repairs.

Until next month, take care and drive safely.

– Dr. Jerry Singh, B. Kin., D.C., runs Trans Canada Chiropractic at 230 Truck Stop in Woodstock, Ont. He can be reached at 888-252-7327, or email

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