A Primer On Hernia: Discussing One of the Most Common Health Issues in The Philippines

When I began my career as a reconstructive surgeon and eventually expanded my practice to include cosmetic surgery (both of which can be costly and out of reach for a lot of people in the Philippines), I’ve always had in mind this mission to help those in the underserved communities.

To offset the costs of procedures, I decided to set up a mobile reconstructive clinic where I could offer free surgeries to patients. While some reconstructive surgeries are life-saving procedures, others are more common in nature and provide an opportunity for people who need it most.
One of the most common procedures performed by our team in our mobile clinics is hernia surgery. In this post, I will providing an in depth discussion of what hernia (more commonly known locally as “luslos”) is.

What is Hernia?

Hernia is a common medical condition that occurs when an organ or tissue pushes through the muscle wall of the abdomen. It is a tear in the muscles or connective tissues that normally hold in your internal organs. 

It can lead to a bulge or mass of tissue that can be felt through the skin. Hernias usually occur near the bellybutton, groin, or lower abdomen.


  • A bulge in the area of your groin or bellybutton
  • Pain in the area of your groin or bellybutton
  • Pain when you cough, move around or lift something heavy

The most common symptoms of a hernia are:

What Are The Common Types of Hernia?

There are many types of hernias, which include inguinal, femoral, umbilical, and ventral.

Inguinal hernia

An inguinal hernia is a bulge of abdominal organs through the groin area. The abdominal organs include the intestines, kidneys and reproductive organs. The inguinal canal is a passageway in your lower abdomen that runs from your groin to your femoral triangle (hip area). Sometimes, a small part of the intestine can bulge through this passage due to weakness in the muscles or tissues that hold them in place. When this happens, it’s known as an inguinal hernia.

Femoral hernia

A femoral hernia occurs when an organ, such as the intestine, pushes through the femoral ring (the opening in the groin) and becomes trapped. Femoral hernias are more common in women and people who are overweight or obese. They most often occur in older adults, with symptoms appearing after age 50. Femoral hernias can be treated with surgery, which is usually successful if done quickly. If you have a femoral hernia, you should see your doctor immediately for treatment before your symptoms get worse.

Umbilical hernia

An umbilical hernia is a protrusion of the abdominal lining through the area around the belly button. It’s usually caused by a weakness in the abdominal muscles, which can be caused by straining or an injury. For example, if you’ve had a baby, your abdomen may have been stretched out and weakened during childbirth. This could make you more likely to develop an umbilical hernia later in life. Umbilical hernias can often be repaired with surgery. Hernia repair typically involves making an incision below your belly button and inserting mesh material into your abdominal cavity to reinforce weakened areas and prevent future problems with your skin bulging out through your belly button.

Incisional hernia

An incisional hernia is the protrusion of abdominal contents or organs through a surgical wound. It can occur after any type of surgery but most commonly occurs with abdominal procedures such as hysterectomy, C-section, laparoscopic surgery, and appendectomy. The hernia develops when muscles and fascia (connective tissue) of the abdominal wall are weakened by surgery. This weakness allows fat deposits and other tissues to bulge out from where they normally reside in your abdomen. These bulges are usually just under or on top of your skin and can be felt as lumps or bumps under the skin.

Incisional hernias are generally treated with surgical repair, which involves removing the protruding tissues and closing the incision site with sutures, staples or surgical glue.

Epigastric hernia

An epigastric hernia is a bulge of the abdominal wall that can be felt through the abdominal skin. It is caused by a small hole in the fascia (the fibrous tissue that surrounds your muscles). If you have an epigastric hernia, it means there’s an opening in your abdominal wall where intestine or fat can push through. The most common cause of an epigastric hernia is straining too hard at the stool. But you can also get one from having surgery on your abdomen, such as a hysterectomy or gallbladder surgery.

Hiatal hernia

Hiatal hernia is a condition that affects the stomach and esophagus. It occurs when part of the stomach protrudes up into the chest cavity. This can cause symptoms such as heartburn, regurgitation, and difficulty swallowing. It’s also possible to get a hiatal hernia without any symptoms at all! The most common cause of hiatal hernia is obesity, but it can also be caused by smoking or chronic coughing.

What Causes Hernia?

Hernias can be caused by age, obesity, pregnancy and chronic coughing.

  • Age. As we get older, our bodies change in ways that make it more likely to develop a hernia. For example, as we age, our tissues tend to become more brittle and less elastic. We also lose muscle mass as well as fat from our midsection. All these changes can lead to weakened areas in our abdominal muscles that could cause a hernia if exposed to increased pressure on them (such as heavy lifting).
  • Obesity. Hernias can also be caused by obesity because fat builds up in the abdomen and presses against the weakened walls of the abdomen, causing them to bulge outwards and create a hole in their walls where they’re weakest.
  • Pregnancy. During pregnancy, there’s an increase in the amount of blood flow to your body. This means that there is more pressure on your abdomen area and organs—including your intestines—and this can cause them to rupture through weak spots in your abdominal wall. Hernia repair surgery may be necessary during or after pregnancy if you have any symptoms like pain or discomfort around your belly button, groin area, or near scar tissue from previous surgery.
  • Chronic coughing. When a person coughs forcefully, there is increased pressure on the abdominal cavity causing it to expand rapidly which may result in a rupture within the abdomen, causing contents to leak into adjacent spaces such as between layers of muscle tissue (fascia). The injured area might also develop inflammation from infection caused by bacteria entering through an opening in your skin after surgery or wound healing process has been disrupted due to chronic coughing.

How is Hernia Treated?

There are three main types of hernia repair: open, laparoscopic, and robotic. Open surgery is done through a large incision in your abdomen, while laparoscopic hernia repair uses several small incisions to insert the instruments for the procedure. Robotic surgery uses an automated surgical robot to carry out the operation.

The type of incision needed depends on the type of hernia you have and where it is located. If your hernia is small and located near your groin area, you may be able to undergo minimally invasive surgery using a laparoscope or a mini-laparoscope (a very small version of a traditional laparoscope). The surgeon will make one or two small incisions near your navel and then insert an endoscope into one of them to see inside your abdomen while they work.

If your hernia is large or located higher up in your abdomen, then open surgery may be necessary. The surgeon will make one large incision through which they will access your abdominal cavity and perform their repairs there.

Seek Professional Medical Help if You Suspect You Have a Hernia or “Luslos”

I would like to end this article by saying that when you experience a hernia or other problem concerning your abdomen, seek out the help of a professional. Avoiding the problem and not getting a doctor’s advice when needed can be harmful and dangerous. Be sure to see a trained doctor before your condition gets worse.

To date, our team has catered to hundreds of patients that require surgical procedures to treat their hernias. For me, it’s all about helping patients regain their confidence and self-esteem through these life-changing surgeries.

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