DR. HOOK- Heavy lifting: All you wanted to know about hernias

Sanjaya Malakar on American Idol makes little girls cry... and the judges (especially when Paula is spaced out)... and America. He kind of reminds me of an Asian Indian version of Michael Jackson. All the girls scream and cry because "He's so sensitive and sweet!" 

I like Sanjaya. Okay, he isn't the greatest thing since Naomi Campbell had to wear an orange jump suit to clean bathrooms for community service, but he's still very entertaining. I wonder if the judges are just being harsh on him for the sake of ratings, or are they really going to have a hernia if he wins?

Hernias are when the muscle-fiber walls in the body burst open so that what was contained becomes "un-contained." Groin hernias are pretty common, like oil companies raising prices. With a groin hernia, the small intestine and/or fat pop out like a stripper in a cake. Surprise! Well, not totally, of course– the hernia remains under the skin.

Each year, 700,000 surgeries are done in the USA to fix these nasty bulges. In general, 25 percent of men and 5 percent of women have a lifetime risk of a groin hernia. Ninety percent of inguinal hernias are in men and 80 percent of femoral hernias are in women.

What is inguinal? It's where the belly and the thigh meet. Inguinal hernias occur above this ligament and femoral hernias occur below it.

Indirect inguinal hernia is usually a congenital issue. While in the womb, the boy's testicles descend from the abdomen region down into the scrotum via the inguinal canal (not to be confused with the Erie Canal– a song I used to sing in music class in Ohio). Well, the inguinal canal is supposed to close up, but if it doesn't 100 percent, an indirect inguinal hernia can develop. What a ball of fun, huh?

Direct inguinal hernia is usually a result of weakness in the inguinal canal wall. Does heavy lifting precipitate an inguinal hernia? In my experience, it seems this way, but the literature is inconclusive.

Femoral hernia occurs in the upper thigh region, just south of the inguinal ligament. For women who have borne children, this region might be weakened, so this hernia tends to pop up in older women like a Jack-in-the-Box. Mae West said, "Is that a gun in your pocket, or are you just happy to see me?" A surgeon could inappropriately say the same to someone with a groin hernia.

Not everyone with a groin hernia has an obvious protrusion in the inguinal region; it's best seen when a person is standing up or straining. Increased abdomen pressure tends to push out the hernia (now, gentlemen, you know why the doctor says, "Cough," when the finger is up near your inguinal canal). Examination only picks up a groin hernia about 75 percent of the time.

Not everyone feels pain with a groin hernia. Usually the "discomfort" is mild, and people with the hernia feel like something is dragging down there– a kind of heaviness that makes you flee from wearing Speedos. Pregnant women feel the hernia more because the big ole' uterus pushes the intestines or fat through. Standing all day has the same effect as well as heaving lifting. If the pain is severe, that can be a bad sign. The bowels can become strangulated like a victim in a bad slasher film, or vital tissue can get damaged from lack of blood flow.

Surgery is the standard treatment. I wonder if American Idol can operate without Sanjaya. Either way, I have a feeling he is going to bust out with his career.