Early diagnosis of a hernia is very important in order to minimize the risk of serious consequences that can be the result of related complications. You can first visit your family doctor if you suspect that you have a hernia. Then, you can ask your doctor to recommend other medical professionals to help during treatment. The following medical professionals may be involved in the diagnosis, treatment or management of a hernia:
To diagnose a hernia, your doctor will most likely start with a medical history and ask you about symptoms you have experienced. You will be asked to locate the area of pain, to describe how long you've had your symptoms and whether they are worse when you stand up or strain your muscles. Some questions your doctor might ask regarding hernia include:
Generally, hernias need to be seen and felt to be diagnosed. Usually the hernia will increase in size with an increase in abdominal pressure, and doctors can test this by asking you to cough while s/he feels the area by palpation.
Diagnostic laparoscopy – A laparoscopy is a mildly invasive procedure performed under general anesthesia. A scope is placed directly into the abdominal cavity, allowing the doctor to examine the internal organs in minute detail. Typically, due to its level of invasiveness, this procedure is only utilized if other methods of evaluating the possible presence of a hernia do not yield conclusive results.
Endoscope – Doctors can pass a thin, flexible tube with a light and video camera (endoscope) down the throat and into the esophagus and stomach to check for inflammation of internal organs.
Physical exam – Your doctor should check both sides of the body for hernias. Most people don't need any more tests. In order to perform a physical exam, you'll probably need to take off some clothes and maybe underwear. While standing, the doctor will gently press and palpate the bulge or painful area. You may need to cough to confirm that a bulge appears when you strain muscles. Your doctor might also want to examine the local painful area while you lie on your back
If you're a man, your doctor may place a finger against the scrotum and press gently into an opening in your abdominal muscles (called the inguinal canal to test for a bulge when you cough. If you're a woman, your doctor may insert a finger inside the vagina to test for a bulge there.
Imaging tests – Doctors will likely recommend an ultrasound to diagnose a hernia. However, doctors can also recommend other types of scans to confirm or exclude a possible hernia. These may include:
- CT (computed tomography) scan - a type of X-ray that takes several detailed pictures of the inside of your body from different angles.
- Magnetic resonance imaging (MRI) – An MRI machine uses a magnetic field to create detailed pictures of the inside of the body. MRIs can confirm or exclude a hernia diagnosis.
- Ultrasound – An ultrasound is a reliable way to check for hernias and shows where and how big a gap is in the muscles as well as creates an image of the contents of the hernia. The doctor may recommend an ultrasound if you are experiencing soft swelling or localized pain but s/he isn't sure that it's a hernia. Ultrasounds can also be useful if there might be another problem that's causing the pain or swelling in the groin, such as an abscess.
- X-ray – X rays of the upper digestive tract can help diagnose certain type of hernias. During a barium X-ray, for example you drink a chalky liquid of barium that coats the upper digestive tract to provide a clear silhouette for identifying possible hernias.
Once your physician has diagnosed the presence of a hernia, it is possible to begin proper treatment. The actual treatment process will vary, based on a number of factors, including age, the location and size of the hernia, and the degree of discomfort the patient is currently experiencing. After diagnosis, you may also be recommended to a GI or general surgeon for a consultation, as surgery provides the only cure for some types of hernias. To learn more about common treatments for hernia, continue reading the Treating Hernia section that follows.
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