enterocele

A hernia happens when part of an internal organ or tissue bulges through a weak area of muscle. Most hernias are in the abdomen.

There are several types of hernias, including:

• Inguinal, in the groin. This is the the most common type.
• Umbilical, around the belly button
• Incisional, through a scar
• Hiatal, a small opening in the diaphragm that allows the upper part of the stomach to move up into the chest.
• Congenital diaphragmatic, a birth defect that needs surgery

Hernias are common. They can affect men, women, and children. A combination of muscle weakness and straining, such as with heavy lifting, might contribute. Some people are born with weak abdominal muscles and may be more likely to get a hernia.

Treatment is usually surgery to repair the opening in the muscle wall. Untreated hernias can cause pain and health problems.

The pelvic floor is a group of muscles and other tissues that form a sling or hammock across the pelvis. In women, it holds the uterus, bladder, bowel, and other pelvic organs in place so that they can work properly. The pelvic floor can become weak or be injured. The main causes are pregnancy and childbirth. Other causes include being overweight, radiation treatment, surgery, and getting older.

Common symptoms include:

• Feeling heaviness, fullness, pulling, or aching in the vagina. It gets worse by the end of the day or during a bowel movement.
• Seeing or feeling a "bulge" or "something coming out" of the vagina
• Having a hard time starting to urinate or emptying the bladder completely
• Having frequent urinary tract infections
• Leaking urine when you cough, laugh, or exercise
• Feeling an urgent or frequent need to urinate
• Feeling pain while urinating
• Leaking stool or having a hard time controlling gas
• Being constipated
• Having a hard time making it to the bathroom in time

Your health care provider diagnoses the problem with a physical exam, a pelvic exam, or special tests. Treatments include special pelvic muscle exercises called Kegel exercises. A mechanical support device called a pessary helps some women. Surgery and medicines are other treatments.

NIH: National Institute of Child Health and Human Development

A hiatal hernia is a condition in which the upper part of your stomach bulges through an opening in your diaphragm. Your diaphragm is the thin muscle that separates your chest from your abdomen. Your diaphragm helps keep acid from coming up into your esophagus. When you have a hiatal hernia, it's easier for the acid to come up. This leaking of acid from your stomach into your esophagus is called GERD (gastroesophageal reflux disease). GERD may cause symptoms such as :

• Heartburn
• Problems swallowing
• A dry cough
• Bad breath
• Nausea and/or vomiting
• Breathing problems
• The wearing away of your teeth

Often, the cause of a hiatal hernia is unknown. It may have to do with weakness in the surrounding muscles. Sometimes the cause is an injury or a birth defect. Your risk of getting a hiatal hernia goes up as you age; they are common in people over age 50. You are also at higher risk if you have obesity or smoke.

People usually find out that they have a hiatal hernia when they are getting tests for GERD, heartburn, chest pain, or abdominal pain. The tests may be a chest x-ray, an x-ray with a barium swallow, or an upper endoscopy.

You don't need treatment if your hiatal hernia does not cause any symptoms or problems. If you do have symptoms, some lifestyle changes may help. They include eating small meals, avoiding certain foods, not smoking or drinking alcohol, and losing weight. Your health care provider may recommend antacids or other medicines. If these don't help, you may need surgery.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of pregnancy. One out of every 33 babies in the United States is born with a birth defect.

A birth defect may affect how the body looks, works, or both. Some birth defects like cleft lip or neural tube defects are structural problems that can be easy to see. Others, like heart disease, are found using special tests. Birth defects can range from mild to severe. How a birth defect affects a child's life depends mostly on which organ or body part is involved and how severe the defect is.

For some birth defects, researchers know the cause. But for many birth defects, the exact cause is unknown. Researchers think that most birth defects are caused by a complex mix of factors, which can include:

• Genetics. One or more genes might have a change or mutation that prevents them from working properly. For example, this happens in Fragile X syndrome. With some defects, a gene or part of the gene might be missing.
• Chromosomal problems. In some cases, a chromosome or part of a chromosome might be missing. This is what happens in Turner syndrome. In other cases, such as with Down syndrome, the child has an extra chromosome.
• Exposures to medicines, chemicals, or other toxic substances. For example, alcohol misuse can cause fetal alcohol spectrum disorders.
• Infections during pregnancy. For example, infection with Zika virus during pregnancy can cause a serious defect in the brain.
• Lack of certain nutrients. Not getting enough folic acid before and during pregnancy is a key factor in causing neural tube defects.

Certain factors may increase the chances of having a baby with a birth defect, such as:

• Smoking, drinking alcohol, or taking certain "street" drugs during pregnancy
• Having certain medical conditions, such as obesity or uncontrolled diabetes, before and during pregnancy
• Taking certain medicines
• Having someone in your family with a birth defect. To learn more about your risk of having a baby with a birth defect, you can talk with a genetic counselor,
• Being an older mother, typically over the age of 34 years

Health care providers can diagnose some birth defects during pregnancy, using prenatal testing. That's why it important to get regular prenatal care.

Other birth defects may not be found until after the baby is born. Providers may find them through newborn screening. Some defects, such as club foot, are obvious right away. Other times, the health care provider may not discover a defect until later in life, when the child has symptoms.

Children with birth defects often need special care and treatments. Because the symptoms and problems caused by birth defects vary, the treatments also vary. Possible treatments may include surgery, medicines, assistive devices, physical therapy, and speech therapy.

Often, children with birth defects need a variety of services and may need to see several specialists. The primary health care provider can coordinate the special care that the child needs.

Not all birth defects can be prevented. But there are things you can do before and during pregnancy to increase your chance of having a healthy baby:

• Start prenatal care as soon as you think you might be pregnant, and see your health care provider regularly during pregnancy
• Get 400 micrograms (mcg) of folic acid every day. If possible, you should start taking it at least one month before you get pregnant.
• Don't drink alcohol, smoke, or use "street" drugs
• Talk to your health care provider about any medicines you are taking or thinking about taking. This includes prescription and over-the-counter medicines, as well as dietary or herbal supplements.
• Learn how to prevent infections during pregnancy
• If you have any medical conditions, try to get them under control before you get pregnant

Centers for Disease Control and Prevention

Bowel incontinence is the inability to control your bowels. When you feel the urge to have a bowel movement, you may not be able to hold it until you get to a toilet. Millions of Americans have this problem. It affects people of all ages - children and adults. It is more common in women and older adults. It is not a normal part of aging.

Causes include:

• Constipation
• Damage to muscles or nerves of the anus and rectum
• Diarrhea
• Pelvic floor disorders

Treatments include changes in diet, medicines, bowel training, or surgery.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Endoscopy is a procedure that lets your doctor look inside your body. It uses an instrument called an endoscope, or scope for short. Scopes have a tiny camera attached to a long, thin tube. The doctor moves it through a body passageway or opening to see inside an organ. Sometimes scopes are used for surgery, such as for removing polyps from the colon.

There are many different kinds of endoscopy. Here are the names of some of them and where they look.:

• Arthroscopy: joints
• Bronchoscopy: lungs
• Colonoscopy and sigmoidoscopy: large intestine
• Cystoscopy and ureteroscopy: urinary system
• Laparoscopy: abdomen or pelvis
• Upper gastrointestinal endoscopy: esophagus and stomach

Sometimes, after eating a large meal or lying down too soon after eating, you might feel acid coming up into your throat. This is called gastroesophageal reflux (GER). It happens when the muscle at the end of your esophagus (the tube that carries food from your mouth to your stomach) doesn't close properly. Stomach contents can then move back up and irritate the esophagus.

Having reflux occasionally is common. But if you have symptoms two or more times a week or if they cause damage to the lining of your esophagus, you may have gastroesophageal reflux disease (GERD). GERD is a chronic (long-lasting) condition that can cause discomfort and, over time, lead to other health problems.

Anyone can have GERD, including infants and children.

GERD can happen when the muscle at the bottom of your esophagus becomes weak or relaxes at the wrong time. You are more likely to have GERD if you:

• Are overweight or have obesity
• Are pregnant
• Smoke or are around secondhand smoke
• Have a hiatal hernia (when part of the stomach pushes up into the chest)

Certain foods, drinks, or medicines can also make GERD worse.

The most common symptom of GERD is heartburn. This is a burning feeling in your chest or throat. You can also have GERD without having heartburn. Other symptoms may include:

• Tasting acid or food in the back of your mouth
• A dry cough or hoarse voice
• Asthma-like symptoms
• Trouble swallowing

Get medical help right away if you have chest pain with shortness of breath, or pain in your jaw or arm. These can be signs of a heart problem.

Your health care provider will ask about your symptoms and medical history. They may recommend tests such as:

• Upper GI endoscopy to look at the esophagus and stomach lining with a tiny camera.
• Biopsy to check a small tissue sample.
• X-Ray to take pictures of the upper digestive system.
• Esophageal pH test to measure how often acid backs up the esophagus and how long the acid stays there.
• Esophageal manometry to check how well your esophagus moves food when you swallow.
• Transnasal esophagoscopy to look for damage to the esophagus by using a small tube with a camera.

Most people can manage GERD with lifestyle changes and medicine. In rare cases, surgery is needed.

Lifestyle changes can include:

• Eating smaller meals and avoiding lying down for at least 2-3 hours after eating
• Avoiding foods that trigger symptoms, such as spicy foods, chocolate, caffeine, or fatty foods
• Losing weight if needed
• Raising the head of your bed
• Quitting smoking

Medicines can include:

• Over-the-counter medicines, such as antacids
• Prescription medicines

If not treated, GERD can cause problems like inflammation of the esophagus, scarring, or changes in the tissue lining (Barrett's esophagus). It can also worsen asthma or cause chronic (long-term) cough or hoarseness.

You may be able to improve symptoms of GERD by:

• Avoiding alcohol and trigger foods
• Eating smaller meals
• Not eating close to bedtime
• Wearing loose-fitting clothes
• Sleeping on your left side or raising the head of your bed
• Maintaining a healthy weight

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Does your child seem much shorter - or much taller - than other kids his or her age? It could be normal. Some children may be small for their age but still be developing normally. Some children are short or tall because their parents are.

But some children have growth disorders. Growth disorders are problems that prevent children from developing normal height, weight, sexual maturity or other features.

Very slow or very fast growth can sometimes signal a gland problem or disease.

The pituitary gland makes growth hormone, which stimulates the growth of bone and other tissues. Children who have too little of it may be very short. Treatment with growth hormone can stimulate growth.

People can also have too much growth hormone. Usually the cause is a pituitary gland tumor, which is not cancer. Too much growth hormone can cause gigantism in children, where their bones and their body grow too much. In adults, it can cause acromegaly, which makes the hands, feet and face larger than normal. Possible treatments include surgery to remove the tumor, medicines, and radiation therapy.

Metabolism is the process your body uses to get or make energy from the food you eat. Food is made up of proteins, carbohydrates, and fats. Chemicals in your digestive system break the food parts down into sugars and acids, your body's fuel. Your body can use this fuel right away, or it can store the energy in your body tissues, such as your liver, muscles, and body fat.

A metabolic disorder occurs when abnormal chemical reactions in your body disrupt this process. When this happens, you might have too much of some substances or too little of other ones that you need to stay healthy. There are different groups of disorders. Some affect the breakdown of amino acids, carbohydrates, or lipids. Another group, mitochondrial diseases, affects the parts of the cells that produce the energy.

You can develop a metabolic disorder when some organs, such as your liver or pancreas, become diseased or do not function normally. Diabetes is an example.

Gastroesophageal reflux (GER), often called reflux, occurs when food or stomach acid flows back from your child's stomach into the esophagus. The esophagus is the tube that carries food from your mouth to your stomach. This can sometimes cause irritation or a burning sensation. Occasional reflux is common and usually not a problem.

Gastroesophageal reflux disease (GERD) is a more serious and long-lasting type of reflux. GERD can cause repeated symptoms or damage to the lining of the esophagus. Having reflux two or more times a week may be a sign of GERD. Your child's health care provider may diagnose GERD if the reflux causes pain, feeding problems, or irritation of the esophagus.

A small muscle called the lower esophageal sphincter acts as a valve between the esophagus and stomach. When your child swallows, this muscle relaxes to let food pass from the esophagus to the stomach. This muscle normally stays closed, so the stomach contents and acid don't flow back into the esophagus. This muscle, along with the diaphragm (the large muscle between the chest and abdomen), usually prevents reflux. It's normal for children to have reflux occasionally.

In children who have GERD, the lower esophageal sphincter may be weak or relax when it shouldn't. That allows stomach contents into the esophagus. This can happen because of:

• A hiatal hernia, a condition in which the upper part of the stomach pushes up into the chest
• Increased pressure on the abdomen (belly) from being overweight or having obesity
• Certain medicines, such as some used to treat asthma, allergies, depression, or pain
• Smoking or exposure to secondhand smoke
• Previous surgery on the esophagus or upper abdomen
• Developmental delays or certain neurological conditions, such as cerebral palsy
• Lung conditions, such as cystic fibrosis

Many children have occasional reflux, especially after large meals or physical activity. GERD is less common, and most symptoms improve with time and lifestyle changes.

Symptoms may vary by age. Some children might not even notice reflux, while others may taste food or stomach acid in the back of their mouth.

In children, GERD can cause:

• Heartburn, a burning feeling in the chest or throat (more common in older children and teens)
• Bad breath
• Nausea or vomiting
• Trouble or pain when swallowing
• Cough, hoarseness, or breathing problems
• Wearing away of tooth enamel from stomach acid

Other conditions can cause similar symptoms. Talk to your child's provider if symptoms happen often or make eating, sleeping, or daily activities difficult.

In most cases, your child's provider can tell if it's reflux by learning about your child's symptoms and health history. Tests are usually needed only if symptoms don't get better with lifestyle changes or medicines, or if another health problem is suspected.

Common tests include:

• Upper GI series, which looks at the shape of your child's upper GI (gastrointestinal) tract. Your child will drink or eat a chalky-tasting liquid called barium. For young children, the barium is mixed in with a bottle or other food. Several x-rays are taken to track the barium as it goes through your child's esophagus and stomach.
• Esophageal pH and impedance monitoring, which measures the amount of acid or liquid in your child's esophagus. A thin flexible tube is placed through their nose into the stomach. The end of the tube in the esophagus measures when and how much acid comes up into the esophagus. The other end of the tube attaches to a monitor that records the measurements. Your child will wear the tube for 24 hours. They may need to stay in the hospital during the test.
• Upper gastrointestinal (GI) endoscopy and biopsy, which uses an endoscope, a long, flexible tube with a light and camera at the end of it. An endoscope is inserted down your child's esophagus, stomach, and first part of the small intestine. While looking at the pictures from the endoscope, tissue samples (biopsy) may be taken.

Simple lifestyle changes can often improve symptoms. Examples include:

• Maintaining a healthy weight.
• Eating smaller meals.
• Avoiding high-fat foods or other trigger foods that cause symptoms.
• Wearing loose-fitting clothing around the abdomen (belly).
• Staying upright for 3 hours after meals and avoiding slouching when sitting.
• Sleeping with the head of the bed raised 6 to 8 inches.

If lifestyle changes aren't enough, your provider may recommend medicine to reduce stomach acid. The medicines work by lowering the amount of acid your child's stomach makes. Some are available over-the-counter, while others need a prescription. Do not give your child any medicine unless your provider recommends it.

If symptoms don't get better or are severe, your provider may refer you to a doctor who treats stomach and digestion problems in children. In rare cases, surgery may be considered.

If GERD isn't treated, it can cause problems such as inflammation or scarring in the esophagus, changes in its lining (Barrett's esophagus), or make breathing problems, like asthma, worse.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases