The list of treatments mentioned in various sources for Hernia includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.
Possibly curable types of Hernia may include:
The following are some of the latest treatments for Hernia:
These medical statistics relate to hospitals, hospitalization and Hernia:
The following medical news items are relevant to treatment of Hernia:
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The primary goals of treatment are to relieve symptoms by minimizing or correcting the incompetent cardia and to manage and prevent complications. Medical therapy is used first because symptoms usually respond to it and because hiatal hernia tends to recur after surgery. Such therapy attempts to modify or reduce reflux by changing the quantity or quality of refluxed gastric contents, by strengthening the LES muscle pharmacologically, or by decreasing the amount of reflux through gravity. These measures include restricting any activity that raises intra-abdominal pressure (coughing, straining, or bending), giving antiemetics, avoiding constrictive clothing, modifying diet, giving stool softeners or laxatives to prevent straining at stool, and discouraging smoking because it stimulates gastric acid production.
Modifying the diet means eating small, frequent, bland meals at least 2 hours before lying down (no bedtime snack), eating slowly, and avoiding spicy foods, fruit juices, alcoholic beverages, and coffee. Antacids also modify the fluid refluxed into the esophagus and are probably the best treatment for intermittent reflux.
To reduce the amount of reflux, the overweight patient should lose weight to decrease intra-abdominal pressure. Elevating the head of the bed 6" (15 cm) reduces gastric reflux by gravity.
Drug therapy to strengthen cardiac sphincter tone may include a cholinergic agent or a GI stimulant to enhance smooth-muscle contraction, increase cardiac sphincter tone, and decrease reflux after eating.
Surgical repair is necessary when symptoms can’t be controlled medically or with the onset of complications, such as stricture, bleeding, pulmonary aspiration, strangulation, or incarceration. Surgery typically involves creating an artificial closing mechanism at the gastroesophageal junction to strengthen the LES’s barrier function. The surgeon may use an abdominal or a thoracic approach or he may repair the hernia by laparoscopic surgery, which allows for less dependence on a nasogastric (NG) tube and a shorter hospital stay.
Source: Professional Guide to Diseases (Eighth Edition), 2005
If the hernia is reducible, the pain may be temporarily relieved by pushing the hernia back into place. A truss may keep the abdominal contents from protruding into the hernial sac; however, this won’t cure the hernia. This device is especially beneficial for an elderly or debilitated patient for whom surgery might be hazardous.
For infants, adults, and otherwise healthy elderly patients, herniorrhaphy is the treatment of choice. Herniorrhaphy replaces the contents of the hernial sac into the abdominal cavity and closes the opening. In many cases, this procedure is performed under local anesthesia in a short-term unit or as a single-day admission. Another effective surgical procedure for repairing hernia is hernioplasty, which reinforces the weakened area with steel mesh, fascia, or wire.
A strangulated or necrotic hernia necessitates bowel resection. Rarely, an extensive resection may require temporary colostomy. In either case, bowel resection lengthens postoperative recovery and requires antibiotics, parenteral fluids, and electrolyte replacement.
Source: Professional Guide to Diseases (Eighth Edition), 2005
The primary goals of treatment are to relieve symptoms by minimizing or correcting the incompetent cardia and to manage and prevent complications. Medical therapy is used initially because symptoms usually respond to it and hiatal hernia may recur after surgery.
Medical therapy attempts to modify or reduce reflux by changing the quantity or quality of refluxed gastric contents, strengthening the LES muscle pharmacologically, or decreasing the amount of reflux through gravity.
Specific measures include restricting any activity that increases intra-abdominal pressure (coughing, straining, bending), avoiding constrictive clothing, modifying diet, and discouraging smoking because it stimulates gastric acid production.
Modifying the diet means eating small, frequent meals at least 2 hours before lying down (no bedtime snacks); eating slowly; and avoiding irritating foods, alcoholic beverages, and coffee. Antacids also modify the fluid refluxed into the esophagus and are probably the best treatment for intermittent reflux.
To reduce the amount of reflux, the overweight patient should lose weight to decrease intra-abdominal pressure. Elevating the head of the bed about 6" (15 cm) reduces gastric reflux by gravity.
Drug therapy to strengthen cardiac sphincter tone may include a cholinergic agent such as bethanechol. Metoclopramide has also been used to stimulate smooth-muscle contraction, increase LES tone, and decrease reflux after eating.
Failure to control symptoms medically or the onset of such complications as stricture, bleeding, pulmonary aspiration, strangulation, or incarceration necessitates an antireflux surgical repair.
Surgery creates an artificial closing mechanism at the gastroesophageal junction to strengthen the LES’s barrier function. A transabdominal fundoplication is performed by wrapping the fundus of the stomach around the lower esophagus to prevent reflux of stomach contents. An abdominal or a thoracic approach may be used. Laparoscopic surgery to repair the hernia is now commonplace. A newer treatment involves thoroscopic surgery, with the hernia repaired microscopically.
Source: Handbook of Diseases, 2003
If the hernia is reducible, the pain may be temporarily relieved by pushing the hernia back into place. A truss may keep the abdominal contents from protruding into the hernial sac, although it won’t cure the hernia. This device is especially beneficial for an elderly or a debilitated patient for whom surgery is potentially hazardous.
Clinical tip Don’t try to reduce an incarcerated hernia because this may induce bowel perforation. If severe intestinal obstruction arises because of hernial strangulation, a nasogastric tube may be inserted promptly to empty the stomach and relieve pressure on the hernial sac.
Herniorrhaphy, the treatment of choice, returns the contents of the hernial sac to the abdominal cavity and closes the opening. This procedure is commonly performed laparoscopically under local anesthesia as an outpatient procedure.
Another effective surgical procedure is hernioplasty, which reinforces the weakened area with steel mesh, fascia, or wire. Complications include urine retention, wound infection, hydrocele formation, and scrotal edema.
A strangulated or necrotic hernia necessitates bowel resection. Rarely, an extensive resection may require temporary colostomy. In either case, resection lengthens postoperative recovery and requires an antibiotic, parenteral fluid, and electrolyte replacement.
Source: Handbook of Diseases, 2003
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