Ask Your Doctor 196 (17.03.2017)

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1. J R., Kuwait

*I am 49 years of age. My weight is 89 kgs, and due to excess weight my belly is big and I have very bad shape. To reduce, the doctor suggested me to walk daily and also use staircase instead of lift. I can not walk daily because of my work schedule and weather condition, but I can use staircase instead of lift at my work place. My office situated at 7th floor, can I use staircase to reach my office daily climbing 7 floors ? Is there any damage on my knee or legs for climbing 7 floors daily? Will this exercise reduce my weight and stay fit.

** To reduce the belly, you have to reduce  your body weight. Aerobic exercises like walking or swimming are the best for overall health as well as to lose body weight. Along with this you also have to cut down calories, that is reduce the quantity of food gradually and regularly. To reduce the body weight you have to reduce the quantity of the calories you intake.  The amount of food intake has to be reduced and the food should be such that it produces less of calories. The food items like cheese, ghee, oil, meat and meat products are to be reduced. The diet should contain more of vegetables. The overall quantity of food intake has to be reduced gradually. Sudden reduction in the quantity of food is not good, moreover it is not feasible.

Climbing the staircase is not at all a good exercise. It can lead to wearing of the cartilage of the knee joints and you may soon become a patient of osteoarthrosis.  The doctor must have suggested this as you might have insisted on having no time for exercise. Each one of us have enough time for exercises, but we lack determination. If you make up of your mind to walk regularly for a minimum of 30 minutes everyday (at the beginning) you get time. Walking on level ground with proper shoes is the best exercise. Initially you may walk for about 30 minutes per day and gradually increase it to 60 minutes per day. Exercises should be part of our daily routine.  You may walk at any time of the day.

2. . Z.Z., Sirsi

*I am 38 years of age. I want to increase my sperm quantity. I feel it is thin like water.

**Semen is a white or grey liquid  when emitted from the urethra on ejaculation. Usually, each milliliter of semen contains millions of spermatozoa (sperm), but the majority of the volume consists of secretions of the glands in the male reproductive organs. The purpose of semen is purely for reproduction, as a vehicle to carry the spermatozoa into the female reproductive tract. Semen clots almost immediately after ejaculation, forming a sticky, jelly-like liquid. It will liquefy again in 5 to 40 minutes. It is quite normal for semen to form jelly-like globules and this does not indicate any health or fertility problem. Failure of clotting and subsequent liquefaction can cause fertility problems.

The average volume of semen produced at ejaculation is 2 to 5ml. Lower volumes may occur after very frequent ejaculation and higher volumes are seen after prolonged abstinence. The thickness again depends on the frequency of ejaculation and thin semen does not indicate any abnormality.

If a man is not able to father a baby when his partner is healthy, semen analysis is the only way to find the adequacy of sperms. The quantity or consistency of the semen does not indicate its adequacy.

The World Health Organisation provides a definition of a 'normal' sperm count:

• the concentration of spermatozoa should be at least 20 million per ml
• the total volume of semen should be at least 2ml
• the total number of spermatozoa in the ejaculate should be at least 40 million
• at least 75 per cent of the spermatozoa should be alive (it is normal for up to 25 per cent to be dead)
• at least 30 per cent of the spermatozoa should be of normal shape and form
• at least 25 per cent of the spermatozoa should be swimming with rapid forward movement
• at least 50 per cent of the spermatozoa should be swimming forward, even if only sluggishly.

3. F.R., Mangalore

*I am 31 years of age. From the past 2 years I have issue of urine drop. I cannot control this  and for the last 2 to 3 months when I pass urine I feel it is incomplete, I wait for long so that it comes out completely but it does not come out. Some time comes out little little after waiting for long.

** The symptoms appear to be related to urinary tract infection. Urinary tract infection is not common in men, compared to women. When there are symptoms, they require thorough assessment. You may consult an urologist for evaluation and treatment.

4.J.D., Bangalore

*I am 43 years old married and have 2 kids of 15 years old (Twins). My periods are usually regular. Last month it started a week early with just spotting for initial few days and later it became normal on its day and continued for 3-4 days and stopped. After the periods, I noticed rashes on both the sides of my thighs (bikini line) filled with water and some with puss and and were itching very badly. However, the rashes were healed in a week (applied some normal cream and talcum powder and stopped wearing inner in the night) but itching continued for some more time. This has happened to me for the first time. No rashes were found any where else on my body though. Is there any health issue with this?

** It appears to be some infection in the skin. If the problem repeats, you may consult either a skin specialist or a gynecologist.

5. H.R., Mangalore

*I am 38 years of age. I am always suffering from pain, discomfort, or burning when urinating after sexual intercourse. Burning stops after urinating 4 or 5 times [After intercourse]. Is there any problem or do I have any medicine to cure this problem?

** Prostatitis, the inflammation of prostate gland  is one of the common cause sexual pain in men. This can include pain in the penis, testis, or pelvis area that occurs during sex, while ejaculating, or after sex. It could arise from a variety of  other causes. Chronic prostatitis, also can cause sexual pain for some men; this non-bacterial pain can be irritating for a long duration. You may consult an urologist for treatment.

6.L.P., Mangalore

*My daughter aged 37 years has B12 problem for the past 2 years, but very lately we came to know about it, but now she has to take B12 injection every month. Are these injections to be taken for life? Is there any cure? She always complains about weakness and gastric problem.

** Like majority of the vitamins, vitamin B12 is available in our diet and not synthesized in our body. Vitamin B12 deficiency is more common in older people and affects around one in 10 over 75s. and is very rare at your daughter’s age. The most common cause of vitamin B12 deficiency is pernicious anaemia. It is  an auto-immune condition that affects around one in 10,000 people. Pernicious anaemia is caused by a lack of a protein called intrinsic factor that’s needed to absorb vitamin B12 from food into the body from the gastro-intestinal tract. This condition is more common in people over 60, in women, in people with a family history of pernicious anaemia. People who take strict vegetarian diet are more prone for vitamin B 12 deficiency. There are certain other conditions which may result in Vitamin B12 deficiency. I presume, your daughter is evaluated for the cause of Vitamin B12 deficiency. If it is due to pernicious anemia, she may have to take Vitamin B12 as per physician’s advice.

7. A. .M., Mumbai

*I am aged 33 years. I got married in January and I had physical union with my wife. But she has not conceived. Why is this? I have heard once male sperm goes in the partner she gets pregnant. Then why she is not getting pregnant.

**Woman can conceive only on certain days in her menstrual cycle. These days are termed as ‘window of fertility’.  In general, a woman’s fertile window is the day of ovulation (usually 12 to 16 days before the menstrual period begins) and the five days preceding it. For the average woman that occurs somewhere between days 10 and 17. But the problem is that few women are average. As the  duration of cycles vary, it is difficult to predict the exact window of fertility. There are several methods to identify the window of fertility; the most accurate may be mucus method. More information about this may be got from the gynecologist.

8.J.R., Kuwait

*I am 49 years of age.  I have the habit of sleeping at 3 pm once I come home after my office work, I normally sleep for 3 to 4 hours in the afternoon. After getting up from sleep, I feel burning sensation in my stomach  and in the  upper position near the chest, my mouth is tasting very bitter and very bad smell. I brush my teeth and drink two glasses of water but burning sensation in my stomach, bitterness and bad smell on my mouth will still continue for 2 to 3 hours. How I can avoid my burning sensation, bitterness and bad smell ?

**You seem to be having a condition called gastro-esophageal reflux disease, in which acid juice from the stomach returns into the esophagus and then to mouth. This may lead to a harsh, burning sensation in the upper abdomen, moving through the chest, throat and to the neck.

The esophagus or the food pipe has a small ring of muscle called the lower esophageal sphincter (LES). This acts as a valve, opening during swallowing and closing immediately to prevent moving back of the contents from the stomach to the esophagus. When however, this valve fails to close adequately, the stomach acids may reflux back into the esophagus.

A reflux problem is treated in 3 steps:

• Lifestyle changes:

-Avoiding alcohol and eating less fatty foods may help. It is also advisable to lose weight, reduce smoking and alter eating and sleeping patterns

-Taking small, frequent meals rather than large, heavy meals is recommended.

• Drug therapy:

Taking certain medicines may reduce the frequency and severity of attacks. Now there are effective medicineswhich reduce the amount of acid production. These are available on prescribed. Drugs to strengthen the esophageal sphincter or relieve the symptoms may also help.

• Surgery: Patients who do not respond well to drug therapy, may need to undergo a surgical procedure called anti-reflux surgery. This operation may be done by an open procedure or by a laparoscope.

Even after the operation, it is advised to maintain a lifestyle with regular, balanced meals, avoidance of alcohol and smoking and maintenance of ideal body weight.

You may consult a gastro-enterologist for proper assessment.

9. H.C., Mumbai

*I am 26 years of age and I have got small swelling in my left testicle. It pains sometimes.

** You are probably having a problem known as epididymitis. It is an inflammation of the epididymis. The epididymis is a tube located at the back of the testicles that stores and carries sperm. When this tube becomes swollen, it can cause pain and swelling in the testicles. Epididymitis can affect men of all ages, but it is common in men between ages 14 and 35. It’s usually caused by a bacterial infection. The condition usually improves with antibiotics. You may consult an urologist or a surgeon.

10. K.N., Saudi Arabia

*I am 35 years. I am in Saudi Arabia for the past 3 years. In 2012 in my native I had the  problem with mosquito bite wound on my shoulder, as it was itching  very badly. I came to Saudi Arabia, now the problem still exist for 3 years. If I eat certain type of food, the itching becomes more. The skin has become darker.

** The problem appears to be not related to mosquito bite now. It is probably eczema. Eczema is a common form of dermatitis (skin inflammation) that causes the skin to become itchy, red, swollen and painful.  Symptoms can vary from a mild rash that disappears quite quickly to a more severe condition that is present for a long time. You may consult a skin specialist for proper evaluation and treatment

11.G.N., Mangalore

*I am 48 years of age. I have vitiligo in my lip area and under arm for a year now. I am applying ointment regularly even then the patch not changing the colour.

** You may discuss your problem with your doctor. Many a times vitiligo may not be cured completely and it might spread to other parts of the body. It is not a contagious disease and not due to any microorganism like bacteria or virus.

Vitiligo is a pigmentation disorder in which melanocytes (the cells that make pigment) in the skin, the mucous membranes (tissues that line the inside of the mouth and nose and genital and rectal areas), and the retina (inner layer of the eyeball) are destroyed. As a result, white patches of skin appear on different parts of the body. The hair that grows in areas affected by vitiligo usually turns white.

The cause of vitiligo is not known, but researchers have several different theories. One theory is that people develop antibodies that destroy the melanocytes in their own bodies. Another theory is that melanocytes destroy themselves. People who develop vitiligo usually first notice white patches (depigmentation) on their skin. These patches are more common in sun-exposed areas, including the hands, feet, arms, face, and lips. Other common areas for white patches to appear are the armpits and groin and around the mouth, eyes, nostrils, navel, and genitals.

The goal of treating vitiligo is to restore the function of the skin and to improve the patient's appearance. Therapy for vitiligo takes a long time--it usually must be continued for 6 to 18 months. The choice of therapy depends on the number of white patches and how widespread they are and on the patient's preference for treatment. Each patient responds differently to therapy, and a particular treatment may not work for everyone.

12. L.C. Mangalore

* I am 64 years of age. Is it necessary to operate if there enlargement of the prostrate which troubles at old age? What are the symptoms of enlargement of the prostrate?

 * The prostate is a walnut-sized gland that forms part of the male reproductive system. There are no fixed dimensions for its size. Initially it is small and as the man matures, the prostate goes through two main periods of growth. The first occurs early in puberty, when the prostate doubles in size. At around the age 25, the gland begins to grow again. Though the prostate continues to grow during most of a man's life, the enlargement doesn't usually cause problems until late in life. Prostate surrounds the urethra and as the prostate enlarges the gland presses against the urethra like a clamp on a garden hose. This condition is known as “Benign Prostatic Hyperplasia” or BPH. BPH is non-malignant condition. It is the problem of elderly men and it has certain symptoms. The symptoms of BPH vary, but the most common ones involve changes or problems with urination, such as

• a hesitant, interrupted, weak stream
• urgency and leaking or dribbling
• more frequent urination, especially at night

The size of the prostate does not always determine how severe the obstruction or the symptoms will be. Some men with greatly enlarged glands have little obstruction and few symptoms while others, whose glands are less enlarged, have more blockage and greater problems.

The type of treatment needed for prostate enlargement depends on the severity of the signs and symptoms being experienced. Bleeding from the urinary system, serious or frequent urine infections that can cause more lasting damage, discomfort or lifestyle problems may all indicate that active medical intervention is required.

There are two types of medication that help to control the symptoms of an enlarged prostate, they are alpha blockers and finasteride. The alpha blockers are effective in about 75% of men. They work by relaxing the muscles at the neck of the bladder making urination easier. Finasteride or dutasteride actually shrinks the prostate gland and is found to be most effective in men whose prostate is significantly enlarged. It can take a long time for the drug to show improvement in symptoms - up to a year for complete results. Side effects can include a reduced libido, impotence and a reduced semen release during ejaculation. Finasteride also has the side effect of hair growth and is also sometimes used for treating male pattern baldness.

Surgical intervention is now less common because of alternative effective and less invasive therapies. Surgery is often the most effective long term option for difficult to manage or more serious complications resulting from an enlarged prostate. There are a number of surgical procedures for it, transurethral resection of the prostate, transurethral incision of the prostate or open prostatectomy. All these procedures require hospital in-patient care, a general anesthetic and few days rest

13 J. B. ,Mangalore

* I have a son who is 4 years and 3 months. He is about 20 Kgs in weight, but he is slim. He has low hemoglobin count and doctor has prescribed iron drops which I give him daily. As I want him to put on some weight I try to give him daily 2 eggs in addition to normal food. His health is not very good. He gets constant cold and currently is on antibiotics. Please can you advice whether two eggs a day can cause any harm.

** Though two eggs per day may not cause harm, they are not required. About 60% of the calories in an egg come from fat; chicken egg yolks contain about 10 grams of fat.  The white of the egg consists primarily of water (87%) and protein (13%) and contains no cholesterol and little, if any, fat.  Instead of eggs you can give other food items containing protiens.

By eating eggs daily your child might soon develop aversion to eggs. Like adults children also have tastes, likes and dislikes. Some of the children might develop allergy to protein part of the egg. Have you ever informed the doctor of your child about his eating habits? The allergy to the eggs can cause repeated attacks of cold. Consult the pediatrician and find out why he gets cold frequently? Is it viral or allergic?

 Good nutrition and a balanced diet will help your child grow up healthy. You can take some steps to improve nutrition and encourage smart eating habits. Some of the best strategies are:

Have regular family meals: Family meals are a comforting ritual for both parents and kids. Children like the predictability of family meals and parents get a chance to catch up with their kids. Kids who take part in regular family meals are also more likely to eat fruits, vegetables, and grains and less likely to snack on unhealthy foods

Serve a variety of healthy foods and snacks: Work fruits and vegetables into the daily routine. Make it easy for your child to choose healthy snacks by keeping them on the dining table. Serve lean meats and other good sources of protein but limit fat intake by avoiding deep-fried foods and choosing healthier cooking methods, such as broiling, grilling, roasting, and steaming. Alsolimit sugary drinks, such as soda and fruit-flavored drinks. Serve water and milk instead.  Be a role model by eating healthy yourself.

The weight of your child seems to be alright. Some children tend to grow slim till puberty and later on they might put on weight. Overfeeding might lead to obesity which can be the foundation to many illnesses at a young age like diabetes mellitus.

 14. J.K. Abudhabi

* I am 40 years, married but I am staying away here single. I have strong sex feelings so to relieve them I masturbate two to three times per week. As a result I am feeling very weak and tired. Can you please suggest how I can control the sex feelings and there by avoid masturbation?

** Sexual feelings are normal and they indicate that you are healthy. There are no ways by which the feelings or desire for sex can be avoided in men of your age as they are related to hormones. As long as hormones are secreted the desire will persist. Some men might overcome the desire but it can not be curbed. Masturbation is a perfectly normal method of relieving sexual tension. It is estimated that over 70% of the male population masturbates. Masturbation is one of those issues that guys normally can't talk about.Most people masturbate. It doesn't matter who people are, what they do, or what they say, chances are they masturbate. In fact, many people masturbate throughout their lives regardless of whether they have a sexual partner or not.Masturbation is a common and harmless habit. Almost every man would have masturbated during youth. In a few of the men the habit persists even in marriage without affecting their marital life. Masturbation is very common in men who can not have normal physical union. Masturbation has no effect on general or sexual health.But if one worries about it then there can be psychological stress which might lead to sexual difficulties, feelings of weakness, tiredness etc. The person with such worries has to be convinced that masturbation is a common habit and every man had this habit at one or other part of his life. If he is convinced that there are no problems because of masturbation, he will be able to lead a normal sex life.

15. J. S. Dubai

*My husband is 39years of age. These days he is complaining of cramps/numbness in his head. Kindly let me know what can be the reason and what is the treatment? Is it due to stress, or lack of sleep? Or some other problem? ** It is difficult to opine why he gets cramps in the head. Let him consult a neurologist. The stress can lead to tension in the muscles on the scalp and can give rise to varieties of symptoms including cramps, head ache etc. 16. S.P. Mangalore*I am 29 years of age. Whether using insulin for diabetes results in erection problems? Will it affect the fertility?

** Insulin injection is not the cause for erection problems. It is been estimated that about 35-75% of men with diabetes will experience at least some degree of erectile dysfunction during their lifetime. Those who are diabetics for a long period irrespective of the status of the disease (whether in or out of control) might develop erectile dysfunction. Majority of the diabetic patients get this problem.

Men with diabetes tend to develop erectile dysfunction 10 to 15 years earlier than men without diabetes. As men with diabetes age, erectile dysfunction becomes even more common. Above the age of 50, the likelihood of having difficulties with an erection occurs in approximately 50-60% of men with diabetes. Above the age 70, there is about a 95% likelihood of having some difficulty with erectile function.

The causes of erectile dysfunction in men with diabetes are complex and involve impairments in nerve, blood vessel and muscle function. Erectile dysfunction is not due to insulin or other medication.

To get an erection, men need healthy blood vessels, nerves, male hormones, and a desire to be sexually stimulated. Diabetes can damage the blood vessels and nerves that control erection. Therefore, even with normal amounts of male hormones and the desire to have sex, men with diabetes still may not be able to achieve a firm erection.

Men with diabetes having trouble with achieving and/or maintaining an erection can take oral medicine like Sidnafil (Viagra) as per the advice of the physcian.However, because people with diabetes also tend to have problems with their heart, these medications may not be appropriate and cause dangerous interactions with the heart medicine. They have to talk to their doctor to determine what treatment is the best.

17. K R. Mangalore

* I am 40 years. Recently I went to night club and met one lady who sat next to me. After some time she kept her hand on my private parts. I had emission with my dress on. I had no other physical contact with her. Is there any possibility of me getting HIV from her, if she was infected? Is there a need for blood test?

** Mere external contact even with an AIDS patient does not transmit HIV. HIV is transmitted through sexual contact, through intravenous drug use, through infected blood donations and from mother to child during pregnancy, birth and breastfeeding. HIV is not transmitted through everyday social contact. There is no need for blood test as long as you had no casual (extra-marital) sex.

18. R.P. Kuwait

* I am 35 years of age. I am having burning of feet (underneath) for more than a month now. It burns so bad that I feel like placing my feet on ice or some cool surface. I have cracked feet too and this time it is very bad. My left heel hurts a lot especially when I walk after I rest for some time. What can be done?

** I presume you refer to burning of the whole of the sole and not the heel alone. Pain in the heels after a period of rest indicates plantar fascitis or calcaneal spur. Where as burning feet is a different problem altogether. It may be a temporary problem, such as due to athlete's foot or sensitivities to fabrics or leather dyes. But when this symptom occurs over a longer period, it can indicate a more complex disorder and should be evaluated by a doctor.

The more common causes of burning feet can be any one or more of the following:

* Many feet just ache and burn at the end of a long day, especially in those who are on their feet all day or are overweight (mechanical overload)

* Hot and sweaty feet can cause a burning foot sensation (and may be related to the mechanical overload problem)

* The neuropathy that occurs in diabetes can cause a burning feet.

* Other types of neuropathy (nerve damage) that can cause a burning foot include those that occur in chronic alcoholism, vitamin deficiencies (usually B) and heavy metal poisoning

* Blood disorders (eg thrombocytopenia, pernicious anemia) can cause burning feet

* Erythromelalgia is a rare circulatory disorder can cause burning feet

* Reflex sympathetic dystrophy or complex regional pain syndrome can follow trauma (including surgery) and cause a burning foot sensation

* Nerve entrapments, which is the compression of a nerve near the ankle joint can cause a burning sensation

* A localized burning sensation may be due to other specific problems in the forefoot only.

* It could also be due to sensitivity to chemical substances in socks and shoes (contact dermatitis)

Treatment of burning feet is directed at the underlying condition, if known. Your doctor might assess the problem and suggest a possible solution.

To help relieve discomfort, you may try these tips:

Wear socks made of cotton — which allows your feet to "breathe" — rather than synthetic fabrics.
Avoid standing for long periods.
Take a pain reliever when needed.
Bathe your feet in cool water.

19. S.D., Kuwait

*My son is 10 years of age. He is having pain in the heel when he plays for a long time. This summer vacation he went to India, there he was taken to an Orthopaedic surgeon; he did an x-ray and informed that there was nothing to worry about. He did not advise medication as this pain normally occurs with growing kids. He also had advised to reduce the weight and when the pain starts, to stop playing and to relax. This pain would go off as he reaches the age of 13 or 14. I want to know is there something to worry about. Does my child need some vitamins or calcium or anything else? Is this pain is due to lack of vitamins like calcium etc. Should I give sevenseas? Do I need to consult a doctor or I can give him just like that?

**Heel pain, unlike the spurs in heel, that occur in adults is uncommon in children. Of those children who do get heel pain, by far the most common cause is a disturbance to the growing area at the back of the heel bone (calcaneus) where the strong Achilles tendon attaches to it. This is known as Sever's disease or calcaneal apophysitis (inflammation of the growth plate). It is most common between the ages of 10 to 14 years of age. These are one of several different 'osteochondroses' that can occur in other parts of the body. Pain is usually felt at the back and side of the heel bone. Sometimes there may be pain at the bottom of the heel. The pain is usually relieved when the child is not active and becomes painful with sport. Squeezing the sides of the heel bone is often painful. Running and jumping make the symptoms worse. One or both heels can be affected. In more severe cases, the child may be limping.

The cause of Sever's disease is not entirely clear. It is most likely due to overuse or repeated minor trauma that happens in a lot of sporting activities - the cartilage joint between the two parts of the bone can not take all the shear stress of the activities. Some children seem to be just more prone to it for an unknown reason - combine this with sport, especially if it is on a hard surface and the risk of getting it increases. It can be almost epidemic at the start of some sports seasons, especially winter. Children who are heavier are also at greater risk for developing calcaneal apophysitis.

If your child has Sever's disease, the following is suggested:

* Cut back on sporting activities - don't stop, just reduce the amount until symptoms improve (if the condition has been present for a while, a total break from sport may be needed later)

* Avoid going barefoot

* A soft cushioning heel raise is really important (this reduces the pull from the calf muscles on the growth plate and increases the shock absorption, so the growth plate is not knocked around as much).

* Stretching the musles of calfprovided the stretch does not cause pain in the area of the growth plate)

* The use of an ice pack after activity for 20mins is often useful for calcaneal apophysitis - this should be repeated 2 to 3 times a day. As the problem is not due to deficiency of any nutrient- like calcium or vitamins its supplementation is not required. 20. N. P., Mangalore * I am 38 years of age. I have umbilical hernia. The size is now like a lemon. I want to know whether it requires surgery or can be treated by medication?

** A hernia happens when tissue or part of an organ bulges out of its normal place in the body. An umbilical hernia is when something from the abdomen (belly) slips out of place on the abdominal wall in front. This causes a lump or bulge in the area of the navel. The hernia may contain fluid, part of an organ (such as the intestine), or other tissue from the abdomen. Umbilical hernias usually happen because of a hole or a weak area in the muscles of the abdominal wall. Some may have been born with the weak area, or the area may have become weak with age. The area may have been weakened because of an injury or surgery there

Umbilical hernias can happen to people of any age. Umbilical hernias in adults happen more often in women than in men. One may be more likely to have a hernia if other family members have them. Other things that may increase the risk of having an umbilical hernia include: being overweight, having a large tumor (growth) in the abdomen, multiple pregnancies, having a very long labor when delivering the baby

Most adults with umbilical hernias will need surgery. During the surgery the sac containing the herniated tissue is opened, the contents, such as intestine are pushed back into the abdominal cavity and the opening is closed in such a way that the hernia does not recur there. If the hernia is not treated, the following serious problems may happen:

*Incarcerated hernia: An incarcerated hernia is when the hernia cannot be pushed back into the abdomen by the doctor. The tissue becomes stuck or trapped, which can cause serious problems. Umbilical hernias have a high risk of becoming incarcerated. If this happens the intestines may become blocked. It causes very bad pain in the abdomen.

*Strangulated hernia: A loop of intestine in the hernia may become pinched or strangulated. This means that the blood supply to that area of intestine is decreased or cut off. This again causes very bad pain in the abdomen. Other signs may include nausea, vomiting, or a high body temperature (fever). If the hernia is not treated right away, that part of the intestine may die. This is called gangrene and it can be life threatening.