What is the standard of care for managing a large or symptomatic abdominal hernia?

Surgical repair is considered the standard of care for managing a large or symptomatic abdominal hernia. The primary reason for this approach is that large or symptomatic hernias pose a risk of complications, such as incarceration or strangulation of the herniated tissue, which can lead to bowel obstruction or ischemia. Surgical intervention is necessary to close the defect and prevent these potentially life-threatening complications.

In addition to addressing the immediate risks, surgical repair helps alleviate symptoms such as pain and discomfort that can significantly affect a patient's quality of life. While observation may be appropriate for small, asymptomatic hernias, it is not suitable for larger or symptomatic ones, as the risks associated with delaying surgery are higher.

Medication management might be used to control pain temporarily, but it does not address the underlying issue of the hernia itself. Similarly, physical therapy might assist with muscle strengthening or rehabilitation but cannot correct the anatomical defect caused by the hernia. Therefore, surgical repair remains the definitive treatment to ensure patient safety and resolution of symptoms.