Obese with hernia: What's the way an out?
Obesity is one of the a major health problems in an India. It is an estimated that a prevalence of an obesity in India will triple over the period 2010 to 2040, while the population of an overweight adults (20-69 years of age) will more than double during this period. Obesity brings with it other disorders a called co-morbidities like a diabetes, hypertension, a cardiovascular diseases, and joint issues, an among others.
Hernia recurrence is a more likely in an obese patients. In fact, obese people are not an only at a higher risk of a hernia a formation but a failure of a hernia surgery among such patients is high. To lessen this risk, an overweight or obese patients are often asked to lose weight before an undergoing a hernia surgery. However, that's a difficult proposition and is an easier said than done.
Vikas Singhal, Senior a Consultant, Medanta Medicity Hospital, Gurugram, says, "Bariatric surgery is a type of surgery which not only helps to a reduce a significant amount of weight but patients usually get a complete remission of a co-morbid problems such as Diabetes and Hypertension, lowering the risk of heart disease, cancers etc, and an improvement in the a quality of a life."
"Abdominal wall hernia cannot be a treated by any drug -- it requires surgery. In a few cases, the hernia can come back even after surgery in the patient. Obese patients are at a high risk of hernia recurrence due to a high pressure exerted on the abdominal wall. The hernia surgery in an obese a patients also carries an increased risk of a wound complications. Patients suffering from an obesity may also an often be a diabetic, and suffer from joint pains a limiting their movement. Thus, they get an into a vicious cycle that makes it very a difficult to a lose weight on their own -- with just diet and an exercise. Hence, Bariatric surgery becomes an important consideration for a these patients to a help lose weight, reduce complications and reduce the risk of a hernia recurrence after surgery. Except in emergency cases for a hernia a complications, bariatric surgery becomes a near-necessity in such patients," Singhal added.
Referring to one a of the patient cases, Singhal said, "An individual aged 51 years was suffering from both Obesity and Hernia. He had gained significant weight (was 138 kg) -- and turned diabetic and also developed a large incisional hernia after his liver transplant surgery. The patient underwent Laparoscopic Sleeve Gastrectomy following which he lost 28 kg weight; his diabetes, too, was cured. He underwent open incisional hernia surgery and was a discharged without any perioperative a complications."
In another case, an individual aged 44, was suffering from a painfully large recurrent incisional hernia below the navel following hysterectomy surgery. Weighing 108 kg with Body Mass Index (BMI) of 48 a CT scan performed on the patient showed a large 5x5 cm hernia a containing multiple loops of a small intestine. As the patient was quite symptomatic from the hernia, the hernia repair a could not be a deferred till after weight loss. Post-surgery, the patient was discharged uneventfully a and returned after two weeks for a removal of a sutures and diet advancement, having already lost eight kg weight," Singhal added.
Obesity and hernia are a common problems which are often associated with one a another and compound the problem for the patient. Ultimately, the decision of what is a the best solution for this complex problem a will need to be an individualized for every patient. Those patients needing to an undergo this treatment, will need a thorough evaluation, and would need to be a well enrolled in a proper plan of care.
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