DEAR DR. DONOHUE: My doctor of 50 years retired, and I had to find a new one. I did, and he made a huge fuss about a groin hernia that I’ve had for as long as I can remember. I am 83. It’s never bothered me. My former doctor never made a big deal of it. Should I have surgery? — R.K.

ANSWER: Last week, I wrote about an umbilical hernia. Groin hernias are more common. All hernias are pretty much the same. They’re protrusions of the internal abdominal covering — the peritoneum — or an internal organ through a defect in the abdominal wall. The abdominal wall consists of abdominal muscles and ligaments. The peritoneum is a cellophanelike covering that drapes over the abdominal organs. You can get a good idea of a hernia if you picture an inner tube bulging through a tire.

Men have more groin hernias than women because the testicles begin their life within the abdomen. During fetal development, they migrate downward, pass through the abdominal wall in the groin and settle in the scrotum. Their passage through the groin remains a weak spot, one that is a potential site of a future hernia.

You have had a hernia for many years, and it hasn’t bothered you. It’s quite safe for you to do nothing for the hernia at your age.

Two rare complications of a hernia are incarceration and strangulation. “Incarceration” indicates that the hernia cannot be pushed back into the abdominal cavity. “Strangulation” means that blood supply to the hernia has been cut off. Pain lets you know if either has occurred. Surgery is done when and if they do. They’re not common occurrences.

Surgery has its own complications.

You might wonder if you should wear a truss, a padded covering with a belt. The covering is placed over the hernia to keep it in place. Since your hernia hasn’t caused you a bit of trouble, you don’t need a truss.

DEAR DR. DONOHUE: Please let me know what you think about my way of staying regular.

Every day I take a shot of mineral oil. It keeps my bowels loose. I also have hemorrhoids, and the mineral oil keeps them from acting up. It seems to coat them.

What do you think of this? — K.R.

ANSWER: Mineral oil softens the stool. That is helpful for hemorrhoid control. Straining to eliminate enlarges hemorrhoids. However, mineral oil isn’t the safest stool softener. Mineral oil poses a danger: It can drip into your airways and lungs. That produces what’s called lipid pneumonia, a serious problem. It also binds vitamins A, D, E and K, and prevents their absorption.

You can keep your stools soft in safer ways. Fiber works well. Many cereals have a high fiber content. You also can purchase psyllium-containing products like Metamucil, Fiberall and Perdiem to keep stool hydrated and soft.

Stop the mineral-oil treatments.

DEAR DR. DONOHUE: I smoked my last cigarette two days ago. I think about lighting up constantly. Smoking gave me a lot of pleasure. I liked smoking after eating and with coffee or beer.

How long do these urges last? I’m not sure I can resist them if they stay this strong. — L.F.

ANSWER: Nicotine withdrawal symptoms vary from one person to the next. You might have trouble concentrating, and you might be irritable and unable to fall asleep for two or three weeks.

The desire for a cigarette lasts longer. The brain doesn’t forget pleasurable sensations, but even these ingrained longings do disappear in time.

If you’re having a problem resisting the urge to light up, try one of the many ways of withdrawing from nicotine more slowly. Nicotine gum, nicotine skin patches or oral nicotine pave the way to total nicotine abandonment. Chantix, a prescription item, can help you through the period of denicotinization.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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