By –Dr Rajeev Premnath, General Laparoscopic Surgeon and Endoscopist, Minimally Invasive Proctology Department at Ramakrishna Hospital, Bengaluru.
The sedentary lifestyle prevalent in modern India has undeniably led to widespread health problems and an increased vulnerability to diseases. Today, the country is witnessing a surge in conditions like obesity and hernias. The link between obesity and hernias is particularly concerning in India, where obesity rates are steadily rising. Studies reveal that 70% of India’s urban population is categorized as obese or overweight, underscoring a profound obesity crisis within the nation. As per statistics from 2022, the obesity rate among women is 9.8%, contrasting with 5.4% among men. This suggests a potentially elevated prevalence of hernias among women when compared to men.
Understanding Hernia – Link Between Hernia & Obesity in Women
Obesity, characterized by the buildup of surplus body fat, poses significant health risks, reducing life expectancy and increasing the likelihood of health complications. Conversely, a hernia arises when an organ or its surrounding tissue protrudes through the natural cavity wall that contains it. The intimate connection between obesity and hernias stems from the strain induced by excess weight, which can weaken muscles, potentially leading to hernia formation. Furthermore, overweight individuals are more predisposed to experiencing muscle weakness, a precursor to hernias.
In women, during pivotal life phases such as pregnancy and menopause, hormonal shifts significantly contribute to weight gain and obesity. This, combined with the excessive pressure exerted on abdominal muscles due to obesity, substantially elevates the risk of developing hernias by weakening these muscles and creating potential sites for herniation. Hernias persist without resolution and are commonly misdiagnosed in women, emphasizing the critical need for early symptom recognition.
Understanding Female-Specific Risks
Certain types of hernias exhibit a higher prevalence in women compared to men. While groin-related hernias are less common in women, they face an increased risk of abdominal hernias. Hernias primarily manifest in the abdomen and groin, with inguinal hernias being most prevalent in men. However, women are susceptible to hernias in the groin and upper thigh, known as femoral hernias, which are more common due to their wider pelvis, particularly occurring after childbirth, heavy lifting, or in obesity.
In addition to groin and femoral hernias, women frequently encounter umbilical hernias near the belly button, often observed during pregnancy, especially in cases of multiple pregnancies. These hernias occur when fatty tissue or part of the bowel protrudes through the area. Furthermore, incisional hernias, developing near incision sites in the abdominal wall, are more prevalent in women who have undergone cesarean sections.
Moreover, women are also prone to pelvic floor hernias, indicating a distinct pattern of hernia manifestation compared to men.
Deciphering Female Hernias
Symptoms of hernias in women vary depending on the type, commonly presenting as a noticeable bulge, discomfort, and pressure in the affected area. In some cases, hernias may become complicated, leading to intestinal obstruction characterized by severe pain and vomiting, necessitating immediate medical attention.
Female hernias often manifest differently than those in men, typically resulting in subtle symptoms. Unlike the visible bulges commonly seen in male hernias, women may experience deeper, smaller hernias that are less apparent externally. However, they are frequently misinterpreted as gynecological issues, leading to delayed diagnosis and treatment.
Combatting Recurrent Hernias
Obesity significantly heightens the risk of recurrent hernias, especially in women, who constitute two-thirds of hernia patients. Among hernia cases, 50% are primary, 30% are incisional, and 20% are recurrent, necessitating reoperation.
Typically hernias need surgery and there is no medication to cure them.
To mitigate recurrence risk, especially in obese individuals, lifestyle changes such as a healthy diet and regular exercise to maintain a normal BMI are crucial. Additionally, avoiding heavy lifting and practicing good posture can help alleviate strain on abdominal muscles. Adhering to post-operative instructions post-hernia repair is vital in minimizing recurrence risk.
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