Gastric Bypass Surgery: How To Recognize And Treat An Internal Hernia

Gastric bypass surgery is a procedure in which your stomach is stapled so it can hold less food. This surgery also causes your small intestine to separate from your stomach and shorten. You might not know this, but Gastric bypass surgery can cause you to develop an internal hernia. The incisions made during the procedure are the most common direct cause of pain under left rib cage after gastric bypass. An internal hernia is the most common reason for abdominal pain after Gastric bypass surgery.

Gastric Bypass Surgery: How To Recognize And Treat An Internal Hernia
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An Internal Hernia Can Occur After Gastric Bypass Surgery

Internal hernias occur when part of an organ or tissue pushes through the abdomen wall. This happens when the muscle wall weakens and creates a hole in the abdominal wall, allowing an organ to protrude. The most common internal hernia occurs at the surgery site, where the surgeon's incision creates a weakness. There are many internal hernias, but they can be broadly categorized into two groups: direct and indirect.

A direct hernia is one in which a hole in the abdominal wall allows something to push through. An indirect hernia occurs when fat or other soft tissue pushes through, but there is no hole in the abdominal wall; instead, an inguinal canal (a passageway between abdominal muscles) allows this soft tissue to protrude outwards into an external bulge called an umbilical hernia (or "belly button").

During gastric bypass surgery, a tiny pouch is made at the top of the stomach using staples or stitches; this helps you feel full more quickly after eating small meals. It also reduces how much food you can eat at one time without feeling uncomfortable or nauseated. This surgery treats obesity and can also help treat diabetes and heart disease. Gastric bypass surgery is not intended for people who are simply overweight; it is only performed on those with a body mass index (BMI) of 40 or higher, as well as other conditions that can benefit from weight loss.

Signs and Symptoms of an Internal Hernia

Internal hernias can cause a variety of signs and symptoms. Many of these relate to pressure on nerves, blood vessels, and other structures in the abdomen.

Pain in the Groin

You can experience a dull aching or severe pain in your groin, often caused by stretching and straining the abdominal wall. This pain can be worse with activity such as coughing or sneezing. The pain is usually worse when you cough or strain if you have a hernia. The pain may worsen during exercise and get better after you stop. You may feel soreness in your groin for several days after straining yourself.

Pain With Bowel Movements

In some cases, internal hernias cause pain during bowel movements. This pain may be associated with cramping, bloating, and a feeling that you need to have a bowel movement even though nothing is coming out of your bowels (rectum).

Pain That Increases When You Cough, Sneeze, or Lift Something Heavy

If an internal hernia is large enough, it can put pressure on nerves or blood vessels in the abdominal cavity that supply these muscles and cause pain when you cough or sneeze — even if there's no injury to the tissue itself. The same can happen if you lift something heavy that strains your abdominal muscles. There is usually pain under the left rib cage after gastric bypass. It can be mild or severe.

Nausea Or Vomiting

The stomach can move through the opening in the abdominal wall and into the chest cavity, causing nausea and vomiting. This could be a symptom that the hernia is progressing. If nausea and vomiting occur with coughing or sneezing, it's likely due to irritation of the nerves that supply these muscles.

Loss Of Appetite

An internal hernia's most typical symptom is loss of appetite. This is due to a feeling of fullness or pressure from the stomach outside its normal position. Abdominal pain and other symptoms may affect your appetite. This can lead to weight loss and malnutrition.

Inability To Pass Gas (Flatulence)

A blockage in your intestines causes this as they push through the weak spot in your abdominal wall. This can also cause bloating, a feeling of fullness in your stomach. Gas pain may occur when the gas builds up inside the weakened area of your abdominal wall and causes discomfort or pain. 

Methods for Diagnosing an Internal Hernia

Hernias are internal herniation of an organ or part of a muscle through the cavity wall in which they usually reside. This can lead to abdominal pain and sometimes discomfort. The three most common methods for diagnosing an internal hernia are as follows:


This method generates images of the body's interior using sound waves. The doctor will utilize this to look for signs that you have an internal hernia. Ultrasound is a painless and non-invasive procedure. The doctor will rub a small gel on your stomach, which helps the ultrasound waves pass through your skin. Then, while moving around with a handheld instrument, photograph your abdomen's sound waves.

CT Scan 

A CT scan also uses sound waves—but it's much more detailed than an ultrasound. It can help your doctor see your internal hernia's size, location, and severity. The doctor will inject you with a dye that shows your blood vessels clearly on the scan. They will then move you into a large machine called a CT scanner, which takes pictures of your stomach and intestines. 


A colonoscopy is another test that can diagnose internal hernias; however, it's not always effective since there may be other problems with your bowels or intestinal system that make it difficult for doctors to see exactly what's causing your symptoms. A small tube with a light on the end will be inserted into your rectum by the doctor, who will then move it through your colon. This allows them to see abnormalities in your intestines and take tissue samples if needed. 

Final Thoughts

It's essential to observe a patient's behavior. Surgery may be necessary if the individual is describing discomfort and they report that food seems stuck. While it can be difficult to treat, anyone with the patience to work through the process will find it possible to treat an internal hernia after gastric bypass surgery.

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