Beware of Heavy Lifting

Wellness

By SeeFoon Chan-Koppen

A hernia occurs when an organ or part of an organ pushes through an opening in the muscle or tissue that holds it in its containing compartment.  Hernias are most common in the abdomen, but they can also appear in the other areas of the body.

According to Dr. Basel Ebernesan, General Surgeon at KPJ Ipoh Specialist Hospital, Inguinal hernias are the most common type of hernia,  when the intestines push through a weak spot or tear in the lower abdominal wall, often in the inguinal canal, in the groin.

In men, it’s the area where the spermatic cord passes from the abdomen to the scrotum. This cord holds up the testicles. In women, the inguinal canal contains a ligament that helps hold the uterus in place. This type of hernia is more common in men than women.

When asked on the cause of inguinal hernias, Dr. Basel said that people who do a lot of heavy lifting and straining like those in the construction industry or gym enthusiasts lifting heavy weights, or women carrying heavy children or even heavy pots and pans, are prone to develope hernias.

The first sign of a hernia is a bulge in the groin area both for males and females. In some men, the swelling may extend to the scrotum and may hurt. If the bulge is tender and does not go in when recumbent, this would require immediate attention. Another sign which requires immediate attention is vomiting.

“We do come across congenital inguinal hernias too. These are mainly evident in babies and young children. These are usually due to failure of closure of abdominal wall openings at birth. In adult, hernias are brought on by weakening of the muscles through the aging process and constant pressure on these weakened areas.” said Dr. Basel.

“Anyone with even a small weakness in the abdominal wall must avoid exacerbating it with lifting and strain. Supports are only temporary and may even weaken the muscles further. Certainly massage is not recommended especially when the hernia is tender and the swelling has not reduced, as the bowels which lie below the abdominal wall may be injured or even break open, which then becomes a serious emergency requiring immediate surgical attention. ”

A number of patients may prefer to seek alternative treatments, however Dr. Basel advises against it.

“ Surgery is the best option. Surgery will close the defect and we also strengthen the weakness with mesh which is placed over the defect either through an open incision or laparoscopically through a small ‘keyhole’. Sometimes if the hernia is a small one and the patient comes early enough, surgery either open or laparoscopy can even be done as a day intervention without the need for overnight hospitalisation. And the earlier the surgery the quicker the recovery”

“Needless to say, the larger and more complex the hernia the duration of hospitalisation and recovery will be longer.” he added.

After surgery patients are advised not to do any heavy lifting for up to 6 to 8 weeks so women who have small children will have to be especially careful in this regard. In fact any strain that will cause strain on the abdominal muscles are to be avoided. Nor are patients allowed to go to the gym or attend any strenuous aerobics classes. Brisk walking is encouraged.

While inguinal hernia is the most common type of hernia treated by Dr. Basel, there are many other different types of hernia that require surgical attention. These include Incisional Hernia where a previous surgery develops into a hernia along the old incision scar; Hiatal hernia where a portion of the stomach slips out into the chest cavity which is usually controlled with medication with occasional cases requiring surgery; and a variety of internal hernias which have to be diagnosed through clinical examination and investigations such as CT scans.

Although a relative ‘new kid on the block’ at KPJ Ipoh Specialist, having been there for under a year, Dr. Basel is no newcomer to the medical community in Ipoh, having worked in Hospital Raja Permaisuri Bainun for a total of 15 years, part of it as a General Surgeon. Receiving his medical degree from Belfast in Northern Ireland, and after working there for a few years, Dr. Basel returned to Malaysia in 1999,  further trained in General Surgery, attaining the Masters of Surgery from University Kebangsaan Malaysia. He has an interest in Laparoscopic Surgery in which he developed and trained in Hospital Raja Permaisuri Bainun, Ipoh. He joined KPJ Ipoh Specialist Hospital at the end of 2016.