Hernia & Diving

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As this is more of a medical question than one concerning the scientific aspects of decompression, I have taken the liberty of moving it here. Dr. Deco will still see it.

The dive medicine experts of whom I am aware think that diving with an unrepaired inguinal hernia is not a prudent action, but that a repaired one usually does not preclude scuba.

The primary concern with an unrepaired inguinal hernia is that a section of small intestine will protrude through the inguinal canal & become trapped. Schlepping heavy suitcases, lifting tanks & other scuba gear, or even hauling yourself back onto the boat could cause a protrusion to occur. Then, upon ascent from a dive, gas commonly in that area of bowel could expand to the extent that the intestinal segment is no longer able to retract into the abdomen, or even bursts. With continued entrapment, very serious problems can arise that require surgery to correct.

Undergoing repair and complete healing of the inguinal hernia before returning to scuba is the best way of avoiding a potential medical crisis. Once the hernia has been successfully repaired & healing is complete, many divers seem to receive clearance to dive.

Another fairly common hernia is the sliding hiatal hernia. Here, the upper part of the stomach & esophagus slip into the chest cavity through an abnormal opening in the diaphragm. Often it causes no problems, doesn't get bigger or smaller with time & does not require surgery. Gastroesophageal reflux symptoms (e.g., heartburn/acid indigestion, a sensation that food is coming back up the throat) can occur, but are usually treatable with eating & lifestyle changes, and medications. It typically is not a contraindication to scuba. Even when surgical attention is required, following repair & healing many divers seem to receive clearance to dive.

A similar, but happily much rarer type is the paraesophageal hiatal hernia. It is rather a more worrisome condition than the inguinal or sliding hiatal types and can have very serious consequences, scuba or no. Here, the esophagus & stomach stay in their normal locations, but part of the stomach squeezes through the opening & rests up next to the esophagus. As with the uncorrected inguinal hernia, the paraesophageal hernia could become incarcerated and even rupture upon ascent. This one is an absolute contraindication to scuba until successful repair & healing.

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

Best regards.

DocVikingo
 

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