All you need to know about hernia repair

A hernia occurs when an organ or internal tissue breaks through a hole in the muscles. Hernia repair surgery or herniorrhaphy involves returning the displaced tissues to their proper position.

Hernioplasty is a type of hernia repair surgery where a mesh patch is sewn over the weakened region of tissue.

Hernia repair surgery is one of the most common surgeries to be performed. According to a 2014 study by the Association of VA Surgeons, more than 350,000 ventral hernias or those in the abdominal region are repaired annually in the United States alone.

Contents of this article:

1. When is surgery necessary?
2. Types of hernia repair
3. What is the recovery process?
4. Complications
5. When to see a doctor
6. Risk factors

Fast facts on hernia repair:

• Small hernias may not cause any symptoms
• In general, hernia surgeries are classified as herniorrhaphy or hernioplasty.
• Hernia repairs are day surgeries, so people go home a few hours afterward.
• Hernia surgeries are considered fairly safe and effective.

When is surgery necessary?

Hernia repair surgery may be necessary if the hernia causes long-term pain and discomfort, or the pain worsens.

It often takes 1 to 2 years before hernias begin to cause noticeable, irritating, or painful symptoms. Some people may only notice hernia symptoms when doing activities, such as strenuous exercise, for example.

Hernia symptoms and factors that indicate surgery may be necessary include:

• long-term hernia pain or discomfort
• pain or discomfort that interferes with everyday activities
• pain or discomfort intensifying or worsening over time
• large hernias
• fast-growing hernias
• hernias in places where they might worsening or enlarging, such as the groin
• sharp abdominal pain and vomiting
• hernias that put pressure on nerves to cause irritation and numbness

In some cases, hernias never end up causing enough symptoms to warrant medical intervention. But hernias cannot resolve or heal without surgery, so when negative symptoms occur surgery is necessary.

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Types of hernia repair

The different types of hernia surgery include:

Herniorrhaphy (tissue repair)

Different types of hernias will require different types of surgery. An overnight hospital stay may be required.

Herniorrhaphy is the oldest type of hernia surgery and is still being used. It involves a surgeon making a long incision directly over the hernia then using surgical tools to open the cut enough to access it.

Tissues or a displaced organ are then returned to their original location, and the hernia sac is removed.

The surgeon stitches the sides of the muscle opening or hole through which the hernia protruded. Once the wound has been sterilized, it is stitched shut.

Hernioplasty (mesh repair)

In hernioplasty, instead of stitching the muscle opening shut, the surgeon covers it with a flat, sterile mesh, usually made of flexible plastics, such as polypropylene, or animal tissue.

The surgeon makes small cuts around the hole in the shape of the mesh and then stitches the patch into the healthy, intact surrounding tissues.

Damaged or weak tissues surrounding the hernia will use the mesh, as a supportive, strengthening scaffold as they regrow.

Hernioplasty is better-known as tension-free hernia repair.

Types of hernia

The type of repair may depend on the nature of the hernia. Three types of hernias are most common, including:

• Reducible hernia: When the hernia can be pushed back into the opening it came through.
• Irreducible or incarcerated hernia: When the organ or abdominal tissues have filled the hernia sac, and it cannot be pushed back through the hole it came through.
• Strangulated hernia: When part of an organ or tissue becomes stuck inside the hernia with its blood supply often cut off.

Both hernia surgery techniques can either be done through a large incision or laparoscopically, which involves accessing the misplaced tissues through three or four small cuts made adjacent to the hernia.

Laparoscopic surgeries are done with a lighted fiber-optic cable called a laparoscope that acts like a video camera. By inserting the laparoscope through the small cuts, the surgeons can see what they are doing inside someone's body.

What is the recovery process?

Before a person is discharged from hospital, their surgeon will explain what activities should be avoided and for how long.

It usually takes 3 to 6 weeks for a full recovery after hernia surgeries. Usually, it will take 1 to 2 weeks before a person can go back to everyday activities and work.

Complications

As with all surgeries, there are some side effects associated with hernia repair surgeries.

The incision site or wound will probably appear noticeably swollen and red. It will also usually be painful, especially to the touch.

Over-the-counter pain or anti-inflammatory medications may help reduce inflammation and its associated symptoms. Inflammation can also be reduced more immediately by applying ice to the area for 10-minute intervals once every hour.

Less common, but possible complications and risks associated with hernia repair surgeries include:

• infection
• organ or tissue damage
• recurrence or return of the hernia
• seroma or a fluid-filled sac under the surface of the skin
• nerve damage and neuralgia or nerve pain that causes tingling or numbness
• constipation or slow bowel movements
• inability or difficulty urinating
• incontinence or urine leakage
• hemorrhage or internal bleeding and hematoma or pooling of blood at the wound
• extensive scaring or adhesions
• incisional hernia that develops through a surgical cut
• fistula or an abnormal opening between two organs
• urinary tract infection
• blood clot
• pneumonia, lung infection, or breathing difficulties
• kidney complications or failure
• mesh pain

What is DNA?

DNA is perhaps the most famous biological molecule present in all forms of life on earth. But what is DNA or deoxyribonucleic acid? Here, we cover the essentials.

Virtually every cell in your body contains DNA or the genetic code that makes you you. DNA carries the instructions for the development, growth, reproduction, and functioning of all life.

Differences in the genetic code are the reason why one person has blue eyes rather than brown, why some people are susceptible to certain diseases, why birds only have two wings, and why giraffes have long necks.

Amazingly, if all of the DNA in the human body was unraveled, it would reach to the sun and back more than 300 times.

In this article, we break down the basics of DNA, what it is made of, and how it works.

Contents of this article:

1. What is DNA?
2. The structure of DNA
3. Packaging DNA
4. What is a gene?
5. Creating proteins
6. What is a telomere?

What is DNA?

In short, DNA is a long molecule that contains each person's unique genetic code. It holds the instructions for building the proteins that are essential for our bodies to function.

DNA instructions are passed from parent to child, with roughly half of a child's DNA originating from the father and half from the mother.

The structure of DNA

DNA's double helix.

DNA is a two-stranded molecule that appears twisted, giving it a unique shape referred to as the double helix.

Each of the two strands is a long sequence of nucleotides or individual units made of:

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• a phosphate molecule
• a sugar molecule called deoxyribose, containing five carbons
• a nitrogen-containing region

There are four types of nitrogen-containing regions called bases:

• adenine (A)
• cytosine (C)
• guanine (G)
• thymine (T)

The order of these four bases forms the genetic code, which is our instructions for life. 

The bases of the two strands of DNA are stuck together to create a ladder-like shape. Within the ladder, A always sticks to T, and G always sticks to C to create the "rungs." The length of the ladder is formed by the sugar and phosphate groups.

Packaging DNA: Chromatin and chromosomes

The complete set of chromosomes in a human male.
Image credit: National Human Genome Research Institute

Most DNA lives in the nuclei of cells and some is found in mitochondria, which are the powerhouses of the cells.

Because we have so much DNA (2 meters in each cell) and our nuclei are so small, DNA has to be packaged incredibly neatly.

Strands of DNA are looped, coiled and wrapped around proteins called histones. In this coiled state, it is called chromatin.

Chromatin is further condensed, through a process called supercoiling, and it is then packaged into structures called chromosomes. These chromosomes form the familiar "X" shape as seen in the image above.

Each chromosome contains one DNA molecule. Humans have 23 pairs of chromosomes or 46 chromosomes in total.

Chromosome 1 is the largest and contains around 8,000 genes. The smallest is chromosome 21 with around 3,000 genes.

What is a gene?

Each length of DNA that codes for a specific protein is called a gene. For instance, one gene codes for the protein insulin, the hormone that helps control levels of sugar in the blood. Humans have around 20,000–30,000 genes, although estimates vary.

Our genes only account for around 3 percent of our DNA, the remaining 97 percent is less well understood. The outstanding DNA is thought to be involved in regulating transcription and translation.

How does DNA create proteins?

For genes to create a protein, there are two main steps:

Transcription: The DNA code is copied to create messenger RNA (mRNA). RNA is a copy of DNA, but it is normally single-stranded. Another difference is that RNA does not contain the base thymine (T), which is replaced by uracil (U).

Translation: The mRNA is translated into amino acids by transfer RNA (tRNA).

mRNA is read in three-letter sections called codons. Each codon codes for a specific amino acid or building block of a protein. For instance, the codon GUG codes for the amino acid valine.

There are 20 possible amino acids.

What is a telomere?

Telomeres are regions of repeated nucleotides at the end of chromosomes.

They protect the ends of the chromosome from being damaged or fusing with other chromosomes. 

They have been likened to the plastic tips on shoelaces that stop them from becoming frayed.

As we age, this protective region steadily becomes smaller. Each time a cell divides and DNA is replicated, the telomere becomes shorter.

In a nutshell

Chromosomes are tightly coiled strands of DNA. Genes are sections of DNA that code individual proteins.

Put another way, DNA is the master plan for life on earth and the source of the wonderful variety we see around us.

Food addiction: What to know

Food addiction refers to when the need to eat becomes compulsive or uncontrollable. This compulsive behavior may be in response to an emotion, such as stress, sadness, or anger.

The human body needs food to function, but food addiction is when a person becomes dependent on certain types of foods. Foods that contribute to a food addiction are usually unhealthful, such as chips, candy, or white bread.

Contents of this article:

1. What is a food addiction?
2. Which foods are associated with food addiction?
3. Symptoms of food addiction
4. Treatment and management
5. When to see a doctor

What is a food addiction?

Food addiction is closely associated with eating disorders, including obesity, bulimia, and binge eating disorder. One theory suggests that individuals can develop a chemical dependency to particular foods in the same way that people develop addictions to alcohol or cigarettes.

Consuming food triggers chemicals in the brain, such as dopamine, that act as a reward and give pleasurable sensations to the individual. These chemicals can also act as a release from emotional distress.

However, other research argues that there is not enough evidence to say that food has the same addictive qualities as alcohol or cigarettes. This research states that the term 'food addiction' is misleading because it suggests that ingredients themselves are addictive.

Addiction can be split into two categories: addiction to a substance, such as a drug, or addiction to a behavior, such as eating.

Food addiction, it is argued, is an addiction to the behavior of eating.

It is estimated that around 35 percent of adults in the United States are obese. However, people who are obese equate to only about one third of those with a food addiction, even though food addiction is sometimes associated with weight gain.

So, while food addiction may contribute to obesity, it is not the only factor. One review found that up to 10 percent of people with a food addiction were underweight, at a healthy weight, or overweight rather than obese.

Which foods are associated with food addiction?

It is believed that foods rich in sugar, fat, or starch are more closely associated with food addiction.

The Yale Food Addiction Scale, which is a questionnaire designed to help diagnose food addiction, identified certain foods that appeared to be the more problematic:

• chips
• fries
• candy
• chocolate
• cookies
• white bread
• pasta
• ice cream

Symptoms of food addiction

Having obsessive cravings and being preoccupied with obtaining food are symptoms of a food addiction.

Symptoms of food addiction can be physical, emotional, and social. These symptoms include:

• having obsessive food cravings
• being preoccupied with obtaining and consuming food
• continued binge or compulsive eating
• continued attempts to stop overeating, followed by relapses
• loss of control over how much, how often, and where eating occurs
• negative impact on family life, socializing, and finances
• the need to eat food for emotional release
• eating alone to avoid attention
• eating to the point of physical discomfort or pain

After consuming large quantities of food, a person with a food addiction may also experiencenegative feelings, such as:

• shame
• guilt
• discomfort
• reduced self-worth

Food addiction can also trigger physical responses, including:

• intensive food restriction
• compulsive exercise
• self-induced vomiting

Treatment and management

Cognitive behavioral therapy may be effective in treating food addiction.

Treatment for food addiction needs to address the emotional, physical, and psychological needs of the individual.

Treatment will focus on breaking the destructive habit of chronic overeating. The goal is to replace dysfunctional eating habits with healthy ones and to address problems, such as depression or anxiety.

Treatments that have been found to be effective include:

• Cognitive behavioral therapy (CBT), which aims to identify and change thought patterns and create new coping mechanisms for food addiction triggers. CBT can be done individually or in a group with others.
• Medication, which may be used to relieve symptoms of depression or anxiety.
• Solution-focused therapy, which focuses on finding solutions for specific issues in a person's life that cause stress and overeating.
• Trauma therapy, which aims to deal with trauma that may be associated with or may trigger a food addiction.
• Nutritional counseling and dietary planning, which can help a person develop a healthy approach to food choices and meal planning.

There are also several lifestyle changes that may help a person manage a food addiction, including:

• replacing processed foods and sweeteners with nourishing alternatives
• avoiding caffeine
• allowing time for a food craving to subside, which can be 2-5 days or longer
• eating three balanced meals a day
• drinking plenty of water
• sitting at a table while eating, focusing on the food, and chewing slowly
• preparing and sticking to a grocery list of healthful foods when shopping
• cooking meals at home
• exercising regularly
• getting enough sleep
• reducing workplace and social stress

When to see a doctor

Anyone who feels that their eating is out of control, or who wants help getting to a healthy weight, should speak to their doctor. A doctor will be able to help suggest treatment methods and routines for healthy eating, weight loss, and regular exercise.

A therapist can also help a person develop new coping mechanisms and a more positive relationship with food.

Postnasal drip: Symptoms, causes, and home remedies

Postnasal drip is extra mucus felt in the back of the nose and throat caused by the glands in these areas. People with postnasal drip usually feel they have to clear their throat more than normal. The excess mucus can also cause some other symptoms.

There are many home remedies to treat postnasal drip, though sometimes a visit to the doctor is necessary.

Contents of this article:

1. What is postnasal drip?
2. Symptoms
3. Causes
4. Over the counter remedies
5. When to see a doctor
6. Outlook

What is postnasal drip?

The nose, throat, and sinuses are all constantly producing mucus. Mucus is a thick and slippery substance that helps to keep the airways from drying out throughout the day.

The air people breathe is full of germs, pollen, and other environmental pollutants. When the air enters the body, these particles can create problems if they are not filtered out. It is the job of mucus to trap these foreign bodies and help eliminate them.

Mucus usually goes unnoticed. It harmlessly mixes with saliva throughout the day and is swallowed or blown from the nose. However, if the body produces too much mucus, it becomes much more noticeable.

When this happens, a person may feel mucus dripping down the back of their throat. This is what is known as postnasal drip. 

Symptoms

In addition to the sensation of mucus dripping down the back of the throat, symptoms of postnasal drip include:

• sore or scratchy throat
• feelings of nausea caused by extra mucus in the stomach
• frequently clearing the throat
• excessive spitting up or swallowing mucus
• foul breath
• a cough that gets worse at night

Causes

.

Postnasal drip is usually caused by certain changes in the environment or the body.

One of the most common causes of postnasal drip is an allergy. Seasonal allergies caused by plants releasing their pollen may cause trigger postnasal drip, as the body produces extra mucus to try and eliminate the pollen spores.

Cold weather or dry air can also cause postnasal drip. Breathing cold or dry air may irritate a person's nose and throat, so their body will create mucus to humidify and warm the passages and ease this irritation.

Cold weather is also associated with viral infections, such as the flu, sinus infections, and the common cold. These infections cause many symptoms, including postnasal drip.

The body reacts to any invading germs by creating more mucus to flush them out. It may be uncomfortable, but it is actually the sign of the body working to stay healthy.

Other causes of postnasal drip include:

• eating overly spicy food
• pregnancy
• objects stuck in the nose
• irritating chemicals from perfumes, cleaning products, or environmental fumes
• smoke
• medications, including birth control and blood pressure medications
• chronic respiratory conditions, such as COPD

A deviated septum, which occurs when the nasal septum (the wall between the nostrils) is crooked or damaged, can make it difficult for the body to drain mucus correctly. This may cause postnasal drip.

Most cases of postnasal drip clear up on their own. However, depending on its cause, complications can arise if postnasal drip is left untreated. There is a chance for infection if germs get in and cause the excess mucus to clog up the sinuses or Eustachian tube, which is the canal that connects the throat to the middle ear.

It is best to treat postnasal drip early to avoid complications, and people should see a doctor for any symptoms that last for more than 10 days.

Over the counter remedies

There are remedies available to treat postnasal drip, including:

Drying out the mucus

Over-the-counter decongestant medications such as phenylephrine (Sudafed PE Congestion) and pseudoephedrine (Sudafed) can help dry out the mucus. This works for many people but may not be right for everyone.

These medications can dry out the mucus, and some people may find that their nose feels too dry. Others find these medications make them feel nervous or dizzy and may avoid them for this reason.

Newer drugs, such as loratadine (Claritin) and cetirizine (Zyrtec) are called non-sedating antihistamines, meaning they are less likely to cause fatigue. This is especially beneficial for people who have to work or drive while dealing with postnasal drip.

Additional over-the-counter non-sedating antihistamine options include fexofenadine (Allegra) and levocetirizine (Xyzal).

Each of these medications comes with side effects and may interact with other medicines. A person should discuss new medications with a doctor or pharmacist before trying them.

Thinning the mucus

Another home remedy for postnasal drip involves thinning the mucus out. There are over-the-counter medications for this, such as guaifenesin (Mucinex), but there are also some non-chemical options.

Increasing the moisture in the air may help make postnasal drip thinner and allow it to move smoothly through the passageways. Using humidifiers or steam vaporizers may help relieve postnasal drip, especially if it associated with clogged sinuses.

Using nasal sprays

Saline nasal sprays or irrigation pots use salt water to flush out the mucus buildup. These options may help clear blocked airways and reduce overall mucus content.

Home remedies

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A person can also try using home remedies to treat postnasal drip. These include:

Propping up the head

If the mucus buildup gets worse at night, people may find it helps to sleep with their head slightly higher than the rest of their body.

Propping a couple of pillows under the head and shoulders promotes drainage and reduces the amount of mucus a person feels in their throat and airways.

Drinking fluids

The body also loses water through a postnasal drip. Drinking plenty of liquids can help to thin mucus, keep the mucus flowing smoothly, and prevent dehydration.

Warm teas and broths may also provide relief from other symptoms, such as a sore throat, and the steam may help clear the sinuses.

When to see a doctor

A person with discolored mucus that does not clear up should see a doctor, as this can be a sign of a bacterial or viral infection. A person with a postnasal drip caused by a bacterial infection may require antibiotics. Infections caused by a virus will not be treated with antibiotics, however.

Anyone who experiences foul smelling mucus or symptoms accompanied by a significant fevershould see their doctor for a proper diagnosis. Also, people who have been experiencing symptoms of postnasal drip for 10 days or more should see a doctor for a diagnosis.

Doctors may order additional tests to check for other causes such as stomach acid reflux. They may also prescribe a steroid nasal spray for people who suffer from persistent allergies.

Outlook

Postnasal drip is a common occurrence. The best way to avoid it is to eliminate allergens or other triggers whenever possible. Most cases of postnasal drip are bothersome but clear up on their own.

Over-the-counter medications and home remedies are often successful treatments. People who experience persistent postnasal drip or postnasal drip accompanied by additional symptoms should see their doctor for diagnosis and treatment.