Prevention and Wellness

Answers to Common General Surgery Questions

Premier Health Specialists’ doctors answer frequently asked questions about general surgery.

What is a hernia?

Dr. de Caestecker discusses what a hernia is. Click play to watch the video or read the transcript.

 

A hernia happens when part of an internal organ or some tissue creates a bulge through weakened muscle, according to the National Institutes of HealthOff Site Icon (NIH).

Hernias are common and most frequently occur in the abdomen, according to the NIH. Various types of hernias include:

  • congenital diaphragmatic hernia – a birth defect that needs surgery to repair
  • femoral hernia – a bulge in the upper thigh just below the groin
  • hiatal hernia – a small opening in the diaphragm allowing the upper part of the stomach to move into the chest
  • incisional hernia – occurs through a scar
  • inguinal hernia – the most common type, occurs in the groin, more common in men than in women
  • umbilical hernia – happens around the belly button

Men, women, and children all can have hernias, though some people are born with weak abdomens and can be more likely than others to get hernias, according to the NIH.

Having muscle weakness and doing an activity that causes strain, such as heavy lifting, might be a contributing factor for causing hernias, according to the NIH.

Talk to your doctor for more information about hernias.

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What are the symptoms of a hernia?

Dr. de Caestecker discusses symptoms of a hernia. Click play to watch the video or read the transcript.

 

Hernias often have no symptoms, according to the National Institutes of HealthOff Site Icon (NIH).

For people who do have hernia symptoms, according to the NIH, those symptoms could include:

  • discomfort that gets worse when standing, straining, or lifting heavy objects
  • pain
  • sore, growing bump

If a hernia continues to grow without treatment, it can get stuck inside the hole in the weakened muscle it tore through, according to the NIH. If that happens, it can cause strangulation, which is a loss in the blood supply.

The NIH lists strangulation symptoms as:

  • nausea
  • problems having bowel movements
  • problems passing gas
  • vomiting

Contact your doctor if you have any of the strangulation symptoms because surgery could be needed right away, according to the NIH.

Talk to your doctor for more information about hernia symptoms.

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Can symptoms of a hernia be mistaken for another health issue, particularly in women?

Dr. de Caestecker discusses hernia symptoms and what they might be mistaken for. Click play to watch the video or read the transcript.

 

Because hernias are more common in men than in women, they can sometimes be an overlooked source of pain for women, according to the Society of Laparoendoscopic SurgeonsOff Site Icon (SLS).

Hernias can go misdiagnosed in women, and can instead be thought to be ovarian cysts, fibroids, endometriosis, or other abdominal issues, according to the SLS.

Women’s hernias can be small and internal. They might not be a bulge that can be felt in an exam or be visible outside the body, according to the SLS.

If a woman is experiencing ongoing abdominal or groin pain – especially while bending, lifting, coughing, laughing, walking stairs, during sexual intercourse, or during her menstrual period – but her medical care team cannot find the source of the problem, a hidden hernia could be the issue, according to the SLS.

To learn more about hernia symptoms being mistaken for other issues in women, talk with your doctor.

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What is the gallbladder, and what role does it play in a person’s health?

Dr. Taylor discusses what the gallbladder is and the role it plays. Click play to watch the video or read the transcript.

 

The gallbladder is a pear-shaped organ under the liver, according to the National Institutes of HealthOff Site Icon (NIH). It stores bile, which is a fluid made by the liver and used to digest fat.

When the stomach and intestines digest food, the gallbladder releases bile into the small intestine, according to the NIH.

Talk to your doctor for more information about the gallbladder and what role it plays in your health.

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What is gallbladder disease?

Dr. Taylor discusses gallbladder disease. Click play to watch the video or read the transcript.

 

Gallbladder disease is a term used for a variety of conditions that can affect the gallbladder.

Usually, gallbladder disease happens when gallstones block the exit of the gallbladder, according to Premier Health Specialists’ (PHS) physicians.

If the gallbladder is blocked and has trouble draining, over time, the bile that sits inside will cause the gallbladder to swell, become inflamed, and cause pain, according to PHS physicians.

A person also can have gallbladder disease without gallstones, according to PHS physicians. This occurs when the gallbladder doesn’t empty at least about 35 percent when a meal is being digested.

For more information about gallbladder disease, talk with your doctor.

When should a person have their gallbladder removed?

Dr. Taylor discusses when someone should have their gallbladder removed. Click play to watch the video or read the transcript.

 

A person should take gallbladder removal into consideration if it is causing problems such as pain after eating, according to Premier Health Specialists’ (PHS) physicians.

The pain from ongoing gallbladder disease usually is felt in the mid portion of the abdomen and can also move around to the back, according to PHS physicians.

According to the National Institutes of HealthOff Site Icon (NIH), most people who have their gallbladder removed have the following symptoms:

  • Bloating
  • Epigastric pain – pain after eating that is usually in the upper right or upper middle of the belly area
  • Heartburn
  • Gas
  • Nausea
  • Vomiting

In some cases, a fever can also be a symptom, according to PHS physicians.

When these issues become a chronic, ongoing problem, it might be time to consider having the gallbladder removed.

Talk to your physician for more information about making the choice to have gallbladder surgery.

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What is appendicitis, and what are the symptoms?

The appendix is a small pouch attached to the large intestine. Appendicitis is when the appendix becomes swollen, according to the National Institutes of HealthOff Site Icon (NIH).

Symptoms of appendicitis can vary from person to person. It’s a condition that can be difficult to diagnose, especially in young children, women of childbearing age, and the elderly, according to the NIH.

Pain around the belly button is a common first symptom. It usually is a minor pain that becomes sharper and severe.

Symptoms also can include loss of appetite, nausea, vomiting, and fever, according to the NIH. Appendicitis pain also can affect the right lower part of the midsection.

If your appendix bursts – ruptures – there might be less pain for a bit, followed by much more pain. 

Symptoms of a ruptured appendix, according to the NIH, include:

  • Chills
  • Diarrhea
  • Fever 
  • Hard stools
  • Nausea
  • Shaking
  • Vomiting

The pain and symptoms can get worse with walking, coughing, and sudden movements, according to the NIH.

To learn more about appendicitis and its symptoms, talk with your doctor.

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How is appendicitis treated? Does it always involve surgery?

In many cases, appendicitis is treated by removing the appendix immediately, according to the National Institutes of HealthOff Site Icon (NIH).

The quicker the appendix is removed, the less likely it is to burst.

In some cases, the appendix will have an abscess, according to the NIH. If a CT scan shows an abscess, sometimes physicians choose to treat the abscess with antibiotics to remove the infection and swelling before doing surgery to remove the appendix.

Talk to your doctor for more information about how appendicitis is treated.

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Does the removal of the appendix require a person to change their diet?

In most cases, patients do not need to change their diet or exercise routines, or their overall lifestyle, according to the National Institutes of HealthOff Site Icon (NIH).

Depending on the type of surgery you have, your doctor might recommend that you limit physical activity for between three and 14 days to let your body recover.

Talk to your doctor for more information about 

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What are the symptoms of a hernia following a C-section?

Though hernias after a C-section aren’t common, when they do happen it is because an organ or tissue bulges through the muscles that weakened when they were split vertically during the surgery, according to Premier Physician Network (PPN) physicians.

The most common symptom of a hernia after a C-section is pain, and sometimes you’ll notice a small bulge in your abdomen.

However, other women have no symptoms, and the hernia is found during a medical exam or procedure.

For more information about symptoms of a hernia after a C-section, talk with your doctor.

How is a hernia diagnosed?

A hernia is usually diagnosed by your doctor after an exam and sometimes some additional testing, according to the American Academy of Family PhysiciansOff Site Icon (AAFP).

Tests that might be used to diagnose a hernia include:

  • Barium X-ray
  • CT scan
  • Endoscopy
  • Ultrasound

Talk to your doctor for more information about how a hernia can be diagnosed.

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What puts women at higher risk for getting a hernia after a C-section?

With most C-sections, the incision is on the lower abdomen and is made horizontally.

However, once inside, surgeons split the muscles vertically to get the baby out, according to Premier Physician Network (PPN) physicians.

A hernia happens when part of an organ or internal tissue create a bulge though a weak area of muscle. It is usually in the abdomen. Though hernias after a C-section aren’t common, when they do happen it is because an organ or tissue bulges through the muscles that weakened when they were split during the surgery.

Talk to your doctor for more information about what puts women at higher risk of getting a hernia after a C-section.

Is frailty something that is considered before an older adult has surgery?

Dr. J. Scott Wilcher discusses whether frailty is considered before an older adult has surgery. Click play to watch the video or read the transcript.

 

Frailty is a syndrome common in older adults. It has an increased risk of health issues including falls, slowed or limited recovery, and diminished strength and energy, according to the National Institutes of HealthOff Site Icon (NIH).

Frailty, more than age itself, is considered before an older adult has surgery. The frailer an older adult is, the less likely they will be able to recover from surgery.

Talk to your doctor for more information about whether frailty is considered before older adults have surgery.

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Are there steps you can take to reduce your risk of complications from surgery? 

Dr. J. Scott Wilcher discusses what you can do to reduce your risk of complications from surgery. Click play to watch the video or read the transcript.

 

A medical care team can help frail patients prepare before surgery to reduce their risk of complications after surgery, say Premier Physician Network (PPN) physicians.

Some steps that can be taken include:

  • Pre-operative physical therapy to improve strength and increase muscle mass
  • Improved nutrition to provide the body the energy it needs
  • Smoking patients need to quit at least six to eight weeks before surgery
  • Patients with diabetes need to get their condition stable

Talk to your doctor for more information about what can be done before surgery to reduce the risk of complications for a frail patient after surgery.

What are common surgical and post-surgical complications related to frailty? 

Dr. J. Scott Wilcher discusses common surgical and post-surgical complications related to frailty. Click play to watch the video or read the transcript.

 

There are a variety of surgical and post-surgical complications that are related to frailty, according to Premier Physician Network (PPN) physicians.

Frailty causes an increased risk of:

  • Bleeding
  • Blood clots in the legs
  • Wound healing complications
  • Wound infections

Talk to your doctor for more information about surgical complications related to frailty.

How is frailty diagnosed? 

Dr. J. Scott Wilcher discusses how frailty is diagnosed. Click play to watch the video or read the transcript.

 

Premier Physician Network (PPN) physicians say the best way to diagnose frailty is to observe the person.

For example, someone who is older, very thin and unsteady on their feet could be considered frail.

The “Get up and go test” is also recommended. The person doing the test starts while sitting. They stand up and are asked to walk 10 to 15 feet across the room and back. 

If it takes longer than 30 to 40 seconds, they are considered frail.

Someone who is unsteady, barely has strength to stand up, or is exhausted after the walk should also be considered for frailty, especially if they are considering a major surgery.

For more information, talk to your doctor about how frailty is diagnosed.

What is a gallbladder attack?

Dr. Steven Sutherin discusses gallbladder attacks. Click play to watch the video or read the transcript.

   

A gallbladder attack happens when liquid in your gallbladder crystalizes and forms a stone full of different substances, Premier Physician Network (PPN) physicians say. The most common substance is cholesterol.

The gallbladder is like a water balloon, and it wants to empty after you eat a meal. It squeezes and pushes to get the liquid out, but a gallstone can block the opening and keep the gallbladder from emptying. This causes a gallbladder attack.

The attack is pain that usually starts suddenly and lasts for a few hours, according to the American Academy of Family PhysiciansOff Site Icon (AAFP).

Talk to your doctor for more information about gallbladder attacks.

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What can trigger a gallbladder attack?

Dr. Steven Sutherin discusses triggers of gallbladder attacks. Click play to watch the video or read the transcript.

   

Anything we eat or drink will cause the gallbladder to squeeze to empty, Premier Physician Network (PPN) physicians say.

But fat in the stomach causes the gallbladder to squeeze harder. And foods that are fried and greasy make the gallbladder work even harder.

Having a gallstone can cause the attack to be much worse.

According to the American Academy of Family PhysiciansOff Site Icon (AAFP), you’re more likely to get gallstones if you:

  • Are a woman
  • Are of American Indian or Mexican descent
  • Are older than 60
  • Are overweight or obese
  • Are pregnant
  • Eat a high cholesterol diet
  • Eat a low-calorie diet and have recently lost weight quickly
  • Have a family history of gallstones
  • Have diabetes
  • Take birth control pills

To learn more about what causes a gallbladder attack, talk with your doctor.

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What role does overeating play in a gallbladder attack?

Dr. Steven Sutherin discusses the role of overeating in a gallbladder attack. Click play to watch the video or read the transcript.

   

Overeating can cause the gallbladder to start squeezing the same way fatty foods do, Premier Physician Network (PPN) physicians say. 

However, most of the time when we overeat, it’s while we’re eating rich, greasy foods like pizza or fried chicken. So, many times, overeating and eating fatty foods go hand-in-hand in causing a gallbladder attack.

For more about the role overeating plays in gallbladder attacks, talk to your doctor.

What is an abdominal adhesion?

Overeating can stimulate the gallbladder to squeeze but so does even a small amount of fat so it's more the fats in the food than it is overeating. But usually if we're overeating it's usually something very, very rich. It's usually something greasy, pizzas, fried chicken, so they go hand-in-hand. But once again, anything can make that gallbladder squeeze down and give you a gallbladder attack.

An abdominal adhesion is a band of fibrous scar tissue that forms on organs in your abdomen, according to Harvard Medical SchoolOff Site Icon (HMS). The tissue causes organs to stick together or to stick to the walls of your abdomen.

Talk to your doctor for more information about abdominal adhesions.

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Can an abdominal adhesion be removed? If so, how?

Abdominal adhesions can be cut away during surgery. They aren’t ever completely removed. Instead, the band is cut to detach organs from each other or the abdomen wall, Premier Physician Network (PPN) physicians say.

Though some adhesions go away on their own, abdominal adhesions that cause pain or discomfort have to be removed with surgery, according to the National Institutes of HealthOff Site Icon (NIH).

For more information about removing abdominal adhesions, talk with your doctor.

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What are the symptoms of an abdominal adhesion?

Most times, abdominal adhesions don’t cause symptoms.

When there are symptoms, the most common one is chronic abdominal pain, according to the National Institutes of HealthOff Site Icon (NIH)

An abdominal adhesion that leads to a complete intestinal obstruction needs immediate medical care and can have the following symptoms:

  • Abdominal swelling
  • Bloating
  • Constipation
  • Loud bowel sounds
  • Nausea
  • Severe abdominal pain or cramping

Talk to your doctor for more information about symptoms of an abdominal adhesion.

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Can surgery be used to help fix an abdominal adhesion?

Surgery can be used to help fix an abdominal adhesion.

When an abdominal adhesion is painful, surgery can be done to cut the band of fibrous scar tissue, according to Harvard Medical SchoolOff Site Icon (HMS).

Cutting the band detaches your organs from each other or from the abdominal wall.

Talk to your doctor for more information about how surgery can help remedy an abdominal adhesion.

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Is my weight a factor when determining if I’m ready for surgery? 

Dr. Scott Wilcher discusses whether weight is a factor in determining if you’re ready for surgery. Click play to watch the video or read the transcript.

 

Your weight plays a big part in whether you’re ready to have surgery, Premier Physician Network (PPN) physicians say.

Some surgeries are best to hold off on until you’re able to lose weight. 

With an incisional hernia repair, for example, the surgery is best done when you’ve lost enough weight that your body mass index (BMI) is less than 40.

And your doctor might say you’re not ready for a hiatal hernia repair surgery unless your BMI is less than 35.

Talk to your doctor for more information about how your weight can affect you having surgery.

How can obesity affect anesthesia? 

Dr. Scott Wilcher discusses how obesity can affect anesthesia. Click play to watch the video or read the transcript.

 

Anesthesia can cause challenges with surgeries if you’re overweight, according to the American Society of AnesthesiologistsOff Site Icon (ASA).

Obesity can make veins hard to find. And, medication dosing can be difficult when you carry extra weight.

Being obese can also increase your risk for problems after surgery, including breathing problems if you already had sleep apnea and even cardio pulmonary issues, Premier Physician Network (PPN) physicians say.

Talk to your doctor for more information about anesthesia and obesity.

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Could surgery be postponed because of my weight? 

Dr. Scott Wilcher discusses whether surgery can be postponed because of weight. Click play to watch the video or read the transcript.

 

Sometimes your surgery can be postponed because of your weight, especially for hernia surgeries, Premier Physician Network (PPN) physicians say.

If your body mass index (BMI) is higher than 35 or 40, your risk of complications, including infections, is greater.

So, your surgery might be postponed for you to lose some weight first because it is a safer choice to wait awhile for surgery than to risk the complications.

For more information about whether your weight could cause a surgery to be postponed, talk to your doctor.


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Source: James deCaestecker, DO, FACS, Gem City Surgical Associates; Daniel Taylor, MD, FACS, Miami County Surgeons; L. Stewart Lowry, MD, FACS, Miami County Surgeons; Luan Tran, MD, Miami Valley Surgery Associates; J. Scott Wilcher, MD, North Dayton Surgeons; Steven Sutherin, MD, FACS, Miami Valley Surgery Associates

Content Updated: October 4, 2018

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