When Should You Worry About a Hernia?
Parents have been bulging into my office with lots of questions as to whether or not their child has a hernia. Well, let me help you and your child “groin and bear it” - so to speak - as I tell you a bit about hernias, which are still called that when boys get them even though you’d think they’d be called “him-nias.”
A hernia is a swelling in the scrotum if it is a boy, or in the groin or belly button area for boys or girls. It is due to the intestine pushing through a weak spot in an abdominal muscle wall and then entering a space where it doesn’t belong, making a bulge or lump we call a hernia. About 5% of children experience some kind of hernia.
What causes it? Well, it may occur at birth due to abnormal or non-closure of the abdominal muscles as we see in premature infants when that closure has not yet occurred. As a child gets older, the muscle layer can be weakened by lifting, coughing or pushing, allowing the bowel to come through. Hernias are not contagious.
Hernias in the groin usually get bigger with standing and reduce in size with sitting or lying down. Taping a quarter over the bulge is not the answer although some small hernias do heal with tincture of time as the muscle layer closes up by itself.
Hernias can feel uncomfortable and eventually will need surgical attention, which is the usual treatment for this problem. Most hernia surgeries are a one-day procedure with no overnight stay required, and you can expect a quick recuperation for your child over several weeks.
When are hernias an emergency? If your child is experiencing severe pain in the bulging area, has a fever, is vomiting, or you note redness or a dark color to the bulge and it cannot be reduced in size when you gently push on it, then seek emergency care immediately. This emergency situation may represent blood flow being cut off to the part of the bowel trapped in the bulge. Although this is a worrisome condition, the outcome remains excellent if the hernia is operated on as soon as these emergency signs are noted.
Hopefully, tips like this will cut through any concerns you have when it comes to recognizing whether or not your child has a hernia.
Lewis First, M.D., is chief of Pediatrics at Vermont Children's Hospital at Fletcher Allen Health Care and chair of the Department of Pediatrics at the University of Vermont College of Medicine. You can also catch "First with Kids" weekly on WOKO 98.9FM and WPTZ Channel 5, or visit the First with Kids video archives at http://www.FletcherAllen.org/firstwithkids