DR FLO: Is there a better way to deal with my hernia?

Dr Flo, I have a hernia. It bulges out and for quite a long time I have had to tie a tiny rope around my waist to keep it in. Tying it in also helps prevent the pain that starts after I eat or after sleep. I don’t like having to tie the tiny rope around my waist all the time. What’s a better way to deal with my problem? Joash

Dear Joash,

A hernia occurs when an underlying organ pushes through a weakness in the muscle or tissue that holds it in, for example, when intestines protrude through a weakness in the abdominal wall such that in that area they are lying just under the skin.

They commonly appear in the abdomen, at the umbilicus, at the inguinal region (upper thigh), the groin or at the site of a previous abdominal surgery.

Complications can arise when a part of the intestine gets trapped, causing severe pain, nausea and vomiting, or constipation. If the trapped intestine does not get blood supply, the tissue can die leading to perforation, serious infection and possibly death.

Because it happens due to a weakness or an opening in the overlying tissue, the only way to manage it permanently is through surgery to close up the weak or open area.

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Dr Flo, I have suffered very painful testes for the last 10 years. I have been put on many antibiotics, but the pain comes back after each treatment. In May and June, I had two hydrocelectomies to remove fluid and a cyst from my testes, but the pain has not abated and I am still on treatment. Please help. Kirimi

Dear Kirimi

Testicular pain that lasts for more than three months is called chronic orchialgia. In most cases, there is no identifiable cause, which, sadly, means there is no definite treatment.

In some people, it may occur due to injury; swellings like varicoceles, spermatoceles or hydroceles, infection; torsion (twisting of a part of the testicle); fibrosis (formation of fibrous tissue after injury or infection); tumours; muscle, nerve or blood vessel problems; chronic prostatitis; or even pain from elsewhere e.g. from low back pain or pain from a kidney stone.

It can also be caused by long term use of the drug amiodarone used for heart conditions. It may also be due to psychological disorders.

It is advisable to be followed up by a urologist. You might need urine tests, abdominopelvic scan, testicular scan, prostate examination, and tests for testosterone and vitamin B12 levels.

If a specific cause of pain is found, it will be addressed. This might mean a prescription for painkillers including some for nerve pain and antibiotics.

Other measures include nerve blocks or spermatic cord block (numbing the surrounding nerves and spermatic cord with an anaesthetic) scrotal elevation, using warm or cold packs, pelvic floor exercises and psychotherapy. Surgery may also be done.

Avoid caffeine, and spicy and acidic foods, and avoid prolonged sitting and constipation.

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Dr Flo, every time I have sex, I get a bloated belly, pain in my left rib and severe headaches. I haven't seen a doctor yet because I'm not sure if this is abnormal. Is it normal to feel this way after sex? If not, what might be the problem? Annita

Dear Annita,

During intercourse, the emotional reaction, the release of hormones or the muscle tension that occurs during orgasm can all lead to pain and/or intestinal problems.

Intercourse can also trigger pain due to problems that were already there like an abnormally positioned uterus, fibroids, ovarian cyst, endometriosis, pelvic inflammatory disease, urinary tract infection, intestinal issues like constipation or irritable bowel syndrome.

It is advisable for you to see a gynaecologist for proper evaluation, so that if there is an underlying problem, it can be treated.

In the meantime, painkillers and medication to relieve the bloating can be prescribed for temporary relief.

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