A “ventral hernia” is another way of saying you have bulge coming out of the middle of your belly. This happens when there is weakness of the muscle causing the bulge to come out with straining, coughing, or bending. The hernia can be painful- most people feel a dull ache but sometimes it can be a sharp, stabbing pain. Some patients describe it as a burning sensation over the edges of the skin. These symptoms have to do with how hernias are formed.
Normally there are several strong layers that protect the internal organs and intestines. The first layers are the skin, then there are 3 muscle layers, and one last layer, the peritoneum. The peritoneum is a sac that contains the internal organs and intestines. A weakness in the muscle layers can cause stretching and over time a hole can form. The belly button is a natural area of weakness in the abdominal wall. There was a hole here where the umbilical cord was attached. Over time this weakness in the middle of the abdomen can stretch until the other layers can bulge through. Sometimes it can be just the peritoneum, the lining of the abdominal cavity. But if the hole is big enough other abdominal organs can come through the hernia. This is why some people can have bowel obstructions because a part of the small or large bowel can get into the hernia. In rare cases the intestines can actually get stuck which is called “incarcerated.” When it is stuck for a long time the blood supply can get cut off, causing the hernia to be what is known as “strangulated. “ In either incarceration or strangulation a hernia requires urgent surgery.
If you notice a lump or bulge that gets bigger with increased activity, especially when you are trying to sit or stand up, talk to your doctor. Not all ventral hernias require surgery! It is good to discuss the size, what is in the hernia, what symptoms you may be having, and your treatment options. That way should you ever require surgery you will have a good idea what to expect.