I Have a Hernia: Is IBS the Cause?
When I was 23, I began to have severe, sharp pain in my low right side at certain intervals – such as when I moved or turned a certain way or bent over. On a few instances over the course of a couple of months, it became bad enough that I went to the ER, where I was subjected to ultrasounds and CAT Scans, which revealed nothing of any significance.
What is an inguinal hernia?
However, some months later, I had a laparoscopic surgery to diagnose and treat endometriosis. The doctors did indeed find and remove a lot of endo during this surgery. However, they made another surprising discovery: I had a small, inguinal hernia. A hernia is when a piece of intestines pushes through the abdominal wall. An inguinal hernia occurs in a very low portion of the intestinal tract, bordering the groin. My hernia was on my right side, and so I finally felt vindicated that in addition to my endo, this hernia might have also been a factor in those sharp, right-sided pains.
I decided at the time to not rush back into another surgery to have the hernia repaired, and I am unsure if I still have it (occasionally small hernias can resolve or heal on their own, though it's fairly rare).
Is it the hernia, IBS, or something else?
Over the years, I've occasionally had periods where I get sharp right-sided pain – but again it's difficult to discern if it's from the hernia (if I do indeed still have it), or simply a complication from IBS, endo, ovarian cysts or a combination of two or more of these. There is still a section in my low right side that if one presses down hard enough on it, it will cause pain strong and sudden enough for me to yelp. I always make doctors aware enough of my hernia to take it into consideration when examining me and trying to discern what is causing my pain. In a worst-case scenario, a hernia can actually become incarceration – that is, become trapped and that piece of the intestines can become necrotic (dying off), which is dangerous and potentially life-threatening. So far, it seems my hernia has either resolved or is still manageable and causes minimal complication.
The connection between hernia and IBS
One thing it's important for people with IBS or suspected of having IBS to know is that a hernia, especially if it is significant enough, can cause symptoms very similar to IBS. Even a small hernia can cause complications that mimic IBS. That is why some researchers on the issue have cautioned that doctors should always thoroughly evaluate patients who have IBS-like symptoms for an underlying mechanical reason like a hernia and rule it out before simply assuming IBS is the only culprit.1
It is also plausible that having IBS can actually contribute to the development of a hernia. As Mayo Clinic notes, a potential cause of an inguinal hernia is "straining during bowel movements."2 And as someone with the kind of IBS that occasionally or primarily causes constipation, this kind of straining can become routine, potentially putting those with IBS at higher risk of having hernias. Also, as I've written about before, those with Ehlers Danlos Syndrome, or EDS (which I also have), are more likely to have IBS. Yet, since EDS is characterized by weak connective tissue and hernias often push through the connective tissue of the abdominal wall because it is weak or has been weakened, those with EDS are more likely to have both IBS and hernias.3
For now, I will continue to monitor my right side and eventually might have to decide to have my hernia surgically repaired. But I am glad to be aware of it, so I can monitor it.
Do you have an intestinal hernia? Have you had it repaired and how successful was the surgery? Answer in the comments section below.
Do you think there is enough awareness of IBS?