Medical News Today: Chinese restaurant syndrome: What you need to know

Some people experience symptoms, such as headaches and sweating, after eating in Chinese restaurants. The medical community once called this group of symptoms Chinese restaurant syndrome. Doctors now call it MSG symptom complex.

Monosodium glutamate (MSG) is a food additive that enhances flavor. It is commonly used in restaurants and pre-packaged foods.

While there are many anecdotal reports of MSG-induced symptoms, scientific research into the syndrome is limited.

As a result, the use of MSG remains controversial. Some Chinese restaurants advertise as being MSG-free.

Read on to learn more about MSG symptom complex and the health effects of this additive.

What is Chinese restaurant syndrome?

Selection of Chinese food that may cause Chinese restaurant syndrome
Chinese restaurant syndrome is now known as MSG symptom complex.

The term Chinese restaurant syndrome is no longer in professional use, though some people may still use the phrase to explain their symptoms.

Reported symptoms include:

  • breathing difficulties
  • chest pain
  • facial flushing
  • a headache
  • numbness or burning pain in the mouth
  • a rapid heart rate
  • sweating
  • swelling of the face

Sometimes, symptoms can be severe. A case report published in the Indian Journal of Critical Care Medicine described a 23-year-old man who experienced severe swelling in the mouth after eating Chinese food. He was unable to speak and had serious difficulty swallowing saliva.


While MSG symptom complex is likely related to MSG intake, researchers are still not entirely sure what causes the symptoms.

While MSG may not affect everyone, it appears that some people are extremely sensitive to it or other food additives.

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What to know about MSG

MSG on a table which can cause Chinese restaurant syndrome
MSG is a flavor enhancer commonly added to processed meats.

MSG is made from glutamate, which is one form of glutamic acid, an amino acid that is naturally present in many foods.

The human body also produces glutamate and requires it for several functions, including learning and memory.

MSG is used to enhance flavor, and it is commonly added to Chinese food, processed meats, and canned goods.

The United States Food and Drug Administration (FDA) consider MSG to be “generally recognized as safe.”

However, because the FDA have received many reports of negative reactions to MSG, the administration requires manufacturers to feature added MSG on food labels.


Relatively few studies have investigated the effects of MSG, especially in recent years.

A study from 2000 included 130 people who self-reported as being sensitive to MSG. They were administered MSG or a placebo.

Of those participants, 38.5 percent reacted to MSG only, 13.1 percent reacted to the placebo only, and 14.6 percent reacted to MSG and the placebo.

The reactions were typically mild. An increased dose of MSG without the presence of food was most likely to cause a reaction.

However, the researchers were unable to replicate the results when they repeated the test with the same of participants. This suggests that outside factors, such as food intake, may have caused the reactions.

In 2016, a review of studies concluded that eating MSG with food had no significant influence on the occurrence of headaches.

However, one study included in the review reported a significant link between the consumption of MSG and headaches in female participants.

The authors concluded that, overall, the methods used could not produce reliable, consistent results and that more research is needed.

It is important to note that an organization that promotes the use of glutamate employs one of these authors.

Researchers commonly administer MSG to mice to induce obesity. In the past decade, some people have wondered whether MSG intake is also linked to extra weight in humans.

One study from 2011 found that MSG was associated with an increase in weight in healthy Chinese adults. However, there have been conflicting results.

More research is needed to determine the effect of MSG on the body.

Side effects

People report various health issues that they associate with MSG. According to a Korean study from 2014, the most common complaints were:

  • thirstiness (84.5 percent)
  • drowsiness (55.7 percent)
  • weakness (34.5 percent)
  • nausea (30.2 percent)
  • a headache (14.7 percent)

MSG symptom complex may also cause:

  • excessive sweating
  • flushing of the skin
  • a tingling sensation in the skin
  • numbness or burning in the mouth

Severe and life-threatening symptoms are rare. They resemble the symptoms of an allergic reaction and include:

  • chest pain
  • difficulty breathing
  • an irregular or rapid heartbeat
  • swelling in the throat or face

People who experience severe symptoms should seek emergency medical attention.


The treatment for MSG symptom complex varies, depending on the symptoms and their severity.

Mild symptoms

Mild symptoms typically clear up without treatment. A person with these symptoms may benefit from:

  • drinking water to stay hydrated
  • resting
  • drinking ginger or peppermint tea to reduce nausea
  • taking over-the-counter (OTC) pain relievers, if a person has a headache

Severe symptoms

A doctor may recommend OTC or prescription medications to relieve these symptoms. Treatments include:

ïantihistamine medications for breathing problems, facial swelling, or an abnormal heartbeat

ïa shot of epinephrine (adrenaline) for life-threatening reactions

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group of people at home drinking and eating popcorn and crisps out of bowls
MSG is usually present in potato chips.

The only way to completely prevent MSG syndrome complex is to stop eating foods that contain the additive.

People with very mild symptoms may be able to prevent them by only eating small amounts of foods that contain MSG.

Anyone with a sensitivity to MSG should check whether it is included on food labels. Remember to also check for the full name: monosodium glutamate.

The additive is usually present in:

  • packaged and processed meats, such as hot dogs
  • meat extracts, such as pork extract
  • bouillon
  • canned vegetables
  • potato chips
  • soups and stocks

MSG is also known as:

  • E621
  • hydrolyzed protein
  • maltodextrin
  • modified food starch

Some people prefer to eat at Chinese restaurants that are MSG-free. Other kinds of restaurants also use MSG, so it is essential to ask before ordering food.

Avoiding natural glutamate

People who are very sensitive to MSG may also need to avoid foods that contain high amounts of natural glutamate.

Natural glutamate is present in the following:

  • mature cheeses
  • cured meats
  • braised meats
  • bone broths
  • fish and shellfish
  • fish sauce and oyster sauce
  • soy protein
  • soy sauce
  • mushrooms
  • ripe tomatoes and tomato juice
  • grape juice
  • yeast extract
  • malted barley, which is used in beer and bread
  • walnuts

Avoiding natural glutamates may be challenging, but a doctor or dietitian can provide guidance and develop a low-glutamate meal plan.

When to see a doctor

A person should see a doctor if symptoms are severe or persistent.

Anyone with breathing difficulties, chest pain, or swelling of the throat should seek emergency medical care.

To assess a person’s symptoms, a doctor may ask:

  • when the person last ate Chinese food
  • if the person has recently eaten any foods that contained MSG

Depending on the symptoms, the doctor may also:

  • check the heart rate
  • examine the airways for blockages
  • perform an electrocardiogram to check for an abnormal heart rhythm


The effects of MSG syndrome complex usually pass quickly. People often feel better within a few hours.

In the meantime, home remedies can alleviate discomfort.

However, anyone with a life-threatening reaction to MSG should carry an epinephrine shot, such as those sold under the brand names Adrenaclick or EpiPen. Be very careful when eating out or buying packaged or processed foods.

A dietitian can help to determine which foods are safe.

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Medical News Today: Is having vaginal pressure during pregnancy normal?

During pregnancy, many women feel pressure, or heaviness, around the vagina. This is normal and can happen in the first, second, or third trimester.

A pregnant woman’s uterus will expand from the size of an orange to the size of a watermelon or larger. Her body will not only need to provide space and nutrients for a new person to develop but will have to produce an entirely new organ in the form of a placenta.

With so many changes happening, it is not surprising that many women notice sudden and unusual shifts in how their bodies feel. Vaginal, pelvic, or lower abdomen pressure is common in all three trimesters of pregnancy.

Read on to learn about the causes and symptoms of vaginal pressure during each stage of pregnancy, as well as treatment options and possible complications.

Causes of vaginal and pelvic pressure during pregnancy

Pregnant woman sat on bed holding bump experiencing vaginal pain
Vaginal pressure is a common experience in pregnancy.

Women will have different experiences of vaginal pressure during pregnancy.

Some may feel an intense pressure in the vagina, while others will have a dull ache throughout the pelvis, or feel like a weight is bearing down on their entire lower body.

Late in pregnancy, this pressure is often due to the baby’s weight pressing down on the pelvic floor, but many other factors can cause pelvic pressure during pregnancy.

Below, we discuss the different causes of vaginal pressure according to the trimester a woman is in:

First trimester

For most women, the first trimester is too early in pregnancy for weight gain to cause vaginal pressure.

Instead, the hormone relaxin is often responsible. This hormone helps relax the muscles, making it easier for the baby to pass through the pelvic area during birth. However, relaxin levels are at their highest in early pregnancy. High levels of this hormone may help the fertilized egg to implant in the lining of the uterus.

For some women, relaxin can cause muscle pain or tension, including in or around the vagina.

According to studies in animal models, relaxin may also weaken the ligaments that support the pelvis. This can lead to a feeling of pressure, as though something is pushing down on the vagina.

Second and third trimesters

In the second and third trimesters, the combination of a weakening pelvic floor and increased weight putting pressure on the pelvis can cause vaginal pressure.

The pelvic floor resembles a sling made of muscle. It supports the organs of the pelvis, including the uterus, vagina, urethra, and bladder. Pregnancy can weaken the pelvic floor.

Women who have given birth previously may have damage to their pelvic floor, which could cause it to weaken further with a subsequent pregnancy.

The extra weight of pregnancy often becomes more noticeable in the second trimester. As pregnancy progresses, the uterus puts more and more pressure on the lower body.

As the pelvic floor weakens, this pressure can cause a feeling of fullness in the vagina or generalized pain and pressure in the hips and pelvis.

For some women in the later stages of pregnancy, a pressure in the pelvis may be an early sign of labor. If cramping in the stomach also occurs or they feel a sensation of something pressing down on the uterus, it could mean that they are about to give birth.

Common problems in all trimesters

Worried pregnant woman sitting on sofa.
A number of conditions can cause vaginal pressure.

Some factors can cause a feeling of vaginal or pelvic pressure in all stages of pregnancy. These include:


Many women struggle with constipation throughout their pregnancy. Constipation can cause a feeling of fullness or pressure in the vagina, especially when the stool is hard or several days have passed since a bowel movement.

Drinking plenty of water and eating fruit and other high-fiber foods may help with constipation.

Bladder infections

For some women, pressure or pain can signify a bladder infection. Women are more likely to develop a bladder infection during pregnancy.

If the vaginal or pelvic pressure occurs alongside difficulty going to the bathroom, pain when urinating, or fever, it is essential to see a doctor.

Bladder infections are easy to treat, but, without treatment, they can worsen and increase the risk of health issues during pregnancy.

Pelvic organ prolapse (POP)

When vaginal pressure is intense, it could be a sign of POP. POP happens when organs in or near the pelvis move down, sometimes into the vagina or rectum.

POP is treatable but can cause incontinence, intense pain, and severe complications.

Women who suddenly feel intense pressure, have difficulty controlling their bowel or bladder, or notice that something seems to be pushing down into their vagina, should consult a doctor.

A weak cervix

Some women have a weak cervix, which is sometimes called cervical incompetence or cervical insufficiency.

Some women with this condition may have a miscarriage or go into premature labor because the cervix is not strong enough to support the uterus. In most cases, a weak cervix is treatable with early intervention.

Women who feel unexplained vaginal pressure, especially early in pregnancy, could ask a doctor to check their cervix. A previous cervical procedure or injury, including those resulting from childbirth, may increase the risk of a weak cervix.

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How to relieve vaginal pain and pressure

As vaginal pressure is often due to weak muscles and pressure on the pelvis, gentle stretches may help. Try stretching the back and hips to relieve pain and pressure.

A pregnancy yoga or gentle stretching class can help with finding comfortable and safe stretches.

Using a foam roller can help loosen tense muscles. If the pain is intense, applying a heating pad to the sore area may help. Keep the heat low, and remove the pad after a maximum of 10 minutes.

Other strategies may not offer immediate relief, but can reduce the risk of certain conditions that cause vaginal pressure. These strategies include:

  • Doing Kegel pelvic floor exercises. Tense the pelvic floor muscles as though trying to avoid urinating, hold for 10 seconds, then release. Repeat 10 times at least twice a day. This can also strengthen the muscles that the body uses to push out the baby.
  • Remaining active during pregnancy. Even low-intensity exercises such as walking can help strengthen the muscles and promote good posture. This may relieve pain and pressure and keep the pelvic muscles strong.
  • Drinking plenty of water. Stay hydrated, especially after exercising and in hot weather. This can help prevent constipation, which could otherwise lead to pressure.


Pregnant woman having checkup with doctor.
A doctor will prescribe treatment if an infection is causing the vaginal pressure.

In most cases, vaginal pressure is just an unpleasant pregnancy side effect resulting from weakened pelvic muscles and weight gain.

However, sometimes a more severe cause will need treating so that it does not harm the woman and baby. An untreated infection, for example, can spread throughout the body and put the baby in danger. It might even cause premature labor.

Very weak pelvic muscles can lead to POP. This painful condition can cause incontinence, pain during sex, and changes in the appearance of the genitals.

Some women experience muscle injuries during pregnancy or when giving birth. The hormone relaxin may increase the risk of muscle injuries. So it is important to remain physically active to keep the muscles strong. Always lift with the legs rather than the back, and see a doctor for unexplained muscle pain.

Any injury that a woman experiences during pregnancy can make childbirth more difficult. Pregnancy-related complications may also make the postpartum period more difficult, slowing recovery and potentially harming mental health.

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When to see a doctor

Women should see their doctors or midwives routinely during pregnancy. It is vital to use these visits to discuss all symptoms, even if they seem minor.

Early in pregnancy, women may only see a doctor every few weeks. If they are experiencing intense pressure or pain or have other symptoms, such as fever, painful urination, bleeding, or a change in the baby’s movements, it is important that they seek medical care immediately.

If it is after hours, they should go to the emergency room. Prompt treatment of pregnancy conditions can save both the woman and the baby.


Vaginal pressure during pregnancy is just one of the many symptoms women may experience while pregnant. It should not usually be cause for concern and can be a good sign that the body is releasing the right hormones, and the uterus is growing as expected.

A bit of caution in pregnancy can help to detect problems before they become emergencies. Never hesitate to see a doctor, even if the issue seems minor. It is unlikely that there is a severe problem, but reassurance can make pregnancy easier. If something is wrong, it is best to catch the issue as early on as possible.

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Medical News Today: How a red wine compound may prevent cancer

Previous studies have suggested that resveratrol — the chemical compound found in grapes and red wine — may have anticancer properties. But now, a new study shows how the compound can stop a mutated protein, which is present in more than half of all breast cancer cases, from aggregating.
grapes and red wine glass
Resveratrol, which can be found in grapes and red wine, may restore our body’s natural ability to fight off cancer.

Resveratrol is a bioactive compound that can be found in the skin of grapes, red wine, peanuts, blueberries, and cranberries, among others.

Recently, research has been paying increasing attention to this fascinating compound, as its unexpected health benefits are becoming evident.

Slowing down aging of the brain, lowering the brain inflammation in those with dementia, and staving off cancer are only some of the alleged health benefits of the substance.

When it comes to resveratrol’s anticancer properties, previous studies have pointed to a link with a protein called p53. Mutant aggregates of this protein are found in over 50 percent of cancer tumors.

But until now, no study had yet shown that resveratrol actively stops mutant versions of this protein from aggregating, or that it stops cancer cells from multiplying and migrating to other parts of the body.

However, researchers at the Federal University of Rio de Janeiro and the State University of Rio de Janeiro, both in Brazil, have been able to demonstrate the above for the first time in the laboratory.

Danielly C. Ferraz da Costa is the first author of the paper, which has now been published in the journal Oncotarget.

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Resveratrol stops mutated p53 aggregating

p53 has been dubbed the “guardian of the genome” because its natural role is to suppress tumors by killing off cancer cells and preserving healthy cells.

But, when mutated, p53 loses this ability and instead “gains” some harmful “powers.” In its mutant form, it aggregates into amyloid “clumps,” which led researchers to believe that “p53 aggregation may participate in some cancers through a mechanism similar to amyloid diseases.”

In this new study, da Costa and colleagues applied a technique called fluorescence spectroscopy to examine, in vitro, the impact of resveratrol on mutant forms of p53.

Also, the researchers carried out immunofluorescence colocalization assays to test the efficacy of resveratrol on breast cancer cell lines that had different p53 mutations and on breast cancer cells with normal p53.

The team also implanted breast cancer cells into mice and tested the effect of resveratrol on the resulting tumors.

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The laboratory tests revealed that resveratrol inhibited the aggregation of p53 in both human breast cancer cells and in the rodents’ tumors.

Also, “Resveratrol significantly reduced the proliferative and migratory capabilities of these cells,” write the authors.

“The findings,” says da Costa, “bring scientists closer to the development of a drug capable of acting directly on the amyloid aggregation of the mutant p53.”

Da Costa and her colleagues conclude:

This study provides evidence that resveratrol directly modulates p53 and enhances our understanding of the mechanisms involved in p53 aggregation as a therapeutic strategy for cancer treatment. Our data indicate that resveratrol is a highly promising lead compound targeted against mutant p53 aggregation.”

Next, the researchers are planning to determine which molecules derived from resveratrol are required for designing drugs that can target cancers with p53 mutations.

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Medical News Today: Why does it hurt when I swallow?

Swallowing involves many muscles and nerves in the mouth, throat, and food pipe. Many people will experience pain when swallowing at least once in their lives. The medical term for painful swallowing is odynophagia.

It is often possible to identify the cause of pain when swallowing by looking at the specific symptoms.

Depending on the cause, these may include sharp or dull pain in the jaw, throat, chest, or food pipe. The pain may only affect one side of the throat and can change when a person breathes deeply.

In this article, we take a closer look at the causes and symptoms of painful swallowing. We also look at how to relieve the pain.

Causes of pain when swallowing

Several illnesses and conditions that lead to infection, inflammation, and obstruction of the throat, mouth, or food pipe can cause discomfort swallowing.

Depending on the cause, additional symptoms are often present. The following causes can lead to painful swallowing:

Strep throat

Woman drinking water and having pain when swallowing
Strep throat, epiglottitis, and esophagitis are some possible causes of pain when swallowing.

Throat infections are one of the most common causes of pain when swallowing. These include strep throat, which is an infection with Streptococcal bacteria.

People with strep throat may also notice:

  • swollen, tender lymph nodes on one or both sides of the neck
  • pain in the soft palate
  • red spots on the soft palate
  • fever
  • white patches on the tonsils


Tonsillitis is an infection and inflammation of the tonsils, which are two lymph nodes at the back of the throat. Tonsillitis is a common cause of painful swallowing.

Tonsillitis is a contagious condition. Viruses or bacterial infections, including strep throat, can cause tonsillitis.

If the pain when swallowing is due to tonsillitis, people may also notice:

  • swollen tonsils
  • white or yellow spots on the tonsils
  • bad breath
  • tender jaw or neck
  • fever


Epiglottitis is a throat infection that causes inflammation of the epiglottis, which is the flap in the back of the throat that prevents food from going down the windpipe.

In addition to pain when swallowing, typical symptoms of epiglottitis include:

  • difficulty swallowing, known as dysphagia
  • a high fever
  • drooling
  • a preference for sitting leaning forward

A yeast infection

Yeast infections in the mouth, throat, or food pipe can also lead to discomfort swallowing. Yeast is a type of fungus that can grow out of control if the conditions inside the body change in a way that promotes yeast growth.

A bacteria called Candida is a common cause of yeast infections.

Additional symptoms might include:

  • loss of taste
  • white patches on the tongue
  • redness in the corners of the mouth


The food pipe, also called the esophagus, is the pipe that carries food and liquid from the mouth to the stomach. Esophagitis is inflammation of the esophagus.

The most common cause of esophagitis is gastric reflux disease, which is a condition that allows stomach acid to flow back up the food pipe.

Certain medications and allergic reactions can also cause esophagitis.

Esophagitis can cause the following symptoms alongside painful swallowing:

  • chest pain
  • stomach pain
  • a hoarse voice
  • coughing
  • heartburn
  • nausea

Throat injury

Although less common than other causes, an injury to the throat can also lead to pain when swallowing.

Eating or drinking something that is too hot can burn the inside of the throat or food pipe. People can also scratch or cut the back of their throat when eating a cracker or chip that has a sharp edge.

Depending on the location and extent of the injury, there may only be pain on one side of the throat or further down in the food pipe.

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differential blood test paperwork from lab being filled out by gloved hand next to blood sample vials
A doctor may use a blood test to diagnose pain when swallowing.

An accurate diagnosis is vital to treat pain when swallowing. Doctors may recommend various tests to make a diagnosis. After reviewing a person’s medical history and carrying out a physical examination, they may perform the following diagnostic tests:

  • Throat culture. During a throat culture, the doctor removes a sample of mucus from the throat with a cotton swab. They test this mucus to determine whether or not it contains any organisms that might be causing an infection.
  • Blood tests. Blood tests, including a white blood cell count, help the doctor determine if an infection is present.
  • Barium swallow. A barium swallow is a special type of X-ray of the food pipe. Before taking the X-ray, the doctor will ask the individual to drink a liquid containing barium. The barium will reveal the pathway that the food takes from the mouth to the stomach.
  • CT scan. Doctors use CT scans to create images of the throat. These help the doctor identify any abnormalities, such as tumors, in the throat or food pipe that might cause painful swallowing.


Treatment for pain when swallowing generally depends on the cause.

Medication is the standard treatment for certain types of infection. Doctors usually recommend antifungal medications to treat yeast infections and antibiotics to treat bacterial infections, including strep throat.

When people have recurring tonsillitis, or it does not respond well to medication, a doctor may recommend removing the tonsils in a procedure called a tonsillectomy.

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Home remedies

lady drinking hot drink
Sipping warm drinks can provide short-term relief.

People can use the following home remedies for short-term relief from painful swallowing:

  • Taking anti-inflammatories. Nonsteroidal anti-inflammatory medications (NSAIDs) can reduce swelling and inflammation in the mouth, throat, and food pipe, making it easier and less painful to swallow.
  • Taking antacids. Over-the-counter (OTC) antacids are effective for reducing pain that results from acid reflux.
  • Using throat sprays. Throat sprays can numb the throat and make swallowing easier and less painful. These are available OTC or online.
  • Gargling with salt water. Salt water may decrease inflammation and make swallowing less painful. Mix 8 ounces (oz) of warm water with 1 teaspoon (tsp) of salt and gargle this solution several times a day.
  • Sipping warm drinks. Warm drinks, such as herbal tea, may help decrease pain. Avoid making the liquid too hot, or it can burn the throat.
  • Taking a hot shower. The steam from a hot shower may help to decrease any inflammation responsible for painful swallowing.
  • Avoiding alcohol and tobacco. Substances in alcohol and tobacco can irritate the soft tissue of the mouth, throat, and food pipe.

When to see a doctor

Painful swallowing often resolves in a few days, especially if it occurs due to a cold. However, in some cases, professional medical help is necessary to determine the cause and provide treatment.

It is best to consider seeing a doctor if the following circumstances apply:

  • the cause of pain when swallowing is unknown
  • the pain has lasted more than a week or is getting worse
  • there is a patch of white spots in the back of the throat

It is also important to recognize when painful swallowing can be a sign of a medical emergency. A person should seek immediate medical care if pain when swallowing occurs alongside:

  • swelling of the throat
  • difficulty breathing
  • problems opening the mouth
  • unusual drooling

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Although it can be uncomfortable, pain when swallowing is typically only temporary. Depending on the cause, painful swallowing often goes away in a few days.

For example, if the pain is due to a cold, it usually resolves within a week.

If a bacterial or fungal infection is causing the pain, treatment is usually successful. In the meantime, people can use home remedies to manage their symptoms and reduce discomfort.

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Medical News Today: What is a differential blood test?

A differential blood test enables a doctor to determine how many white blood cells are in the body. There are five types of white blood cell, and the test also shows how many of each type are present.

The results provide information about the condition of a person’s immune system and how it responds to diseases and other threats.

In this article, learn more about how doctors use the differential blood test and how they interpret its results.

Who needs a differential blood test?

Differential blood test paperwork from lab being filled out by gloved hand next to blood sample vials.
A differential blood test can help diagnose a range of acute or chronic conditions.

A doctor will often order this test when trying to confirm a diagnosis.

They may be looking for signs of an acute illness, such as the flu or a urinary tract infection.

Or, they may be checking for a chronic condition, such as an autoimmune disorder or one that affects the bone marrow.

The bone marrow is responsible for producing white blood cells, so changes in white blood cell counts can indicate how well the bone marrow is functioning.

A doctor may order a differential blood test if a person has symptoms, such as:

  • body aches
  • chills
  • fever
  • a headache
  • pain, particularly in the bones

While a differential blood test can indicate problems with the white blood cells, it will not be the only test that doctors use to make a diagnosis.

To perform the test, doctors draw a blood sample from a vein in the arm or finger. When testing an infant, a doctor will draw blood from the heel.

There is no need to fast or make any special preparations for a differential blood test.

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Types of cells in a differential blood test

There are five types of white blood cell in the body:

  • Neutrophils: According to the American Association for Clinical Chemistry, neutrophils are the most common type of white blood cell. They are responsible for destroying bacteria in injured or infected tissue.
  • Monocytes: Monocytes are similar to neutrophils. They destroy bacteria, but usually those causing chronic infections. Monocytes also play a role in repairing damaged tissues.
  • Eosinophils: These are responsible for treating infections caused by parasites. Eosinophils also control the immune system’s response to allergic reactions.
  • Basophils: Basophils are the least common type of white blood cell. Their function is still unclear, but they may play a role in allergic reactions.
  • Lymphocytes: There are three types of lymphocytes. B lymphocytes produce antibodies to attack specific viruses, bacteria, and other foreign invaders. T lymphocytes help to identify cells that require an immune response. Natural killer cells, the third type, destroy cancer cells and viruses.

Each type of white blood cell plays an essential role in the immune system.

Normal ranges

When a person receives their differential blood test results, they should also get a reference range of normal values from the laboratory.

Looking at this reference range can help a person to tell if their white blood cell levels are low, normal, or high.

Overall, a higher-than-average white blood cell count may indicate the presence of an infection.

Some labs give a percentage of the cells that are present. While different labs have different ranges, the following is an example of a normal range:

  • Basophils: 0.5–1.0 percent
  • Eosinophils: 1–4 percent
  • Lymphocytes: 20–40 percent
  • Monocytes: 2–8 percent
  • Neutrophils: 40–60 percent

Other labs may give the number of each type of white blood cell present. Labs usually express these figures in the thousands.

Normal values for neutrophils are typically between 2,500 and 6,000 cells. A person with a very low neutrophil count will have fewer than 1,000 of these cells. Doctors call this neutropenia.

Normal levels also depend on gender, age, and pregnancy. For this reason, it is important to examine laboratory results carefully when determining if levels are high or low.

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Understanding the results

A doctor can explain the meaning of differential blood test results.
A doctor can explain the meaning of differential blood test results.

While the results of a differential blood test give information about all five types of white blood cell, a doctor is usually focusing on just one or two types.

Depending on the type of cell, high or low levels can indicate different issues, such as:


  • High: A basophil count can point to certain types of leukemia, including chronic myeloid leukemia. A high count can also indicate that a person has severe allergic reactions. People with inflammatory disorders, such as rheumatoid arthritis or ulcerative colitis, may also have high basophil counts.
  • Low: A low basophil count does not typically suggest a medical condition. However, stress, allergic reactions, steroid use, and hyperthyroidism can each cause a basophil count to be low.


  • High: A high eosinophil count tends to result from an allergic reaction, such as asthma, eczema or a reaction to a medication. Inflammatory disorders, such as celiac disease or inflammatory bowel disease (IBD), can also cause high eosinophil levels.
  • Low: Eosinophils are usually present in such low quantities that low readings do not tend to indicate issues. However, stress or steroid use can also cause an eosinophil count to be low.


  • High: A high lymphocyte level can indicate an acute viral infection, such as chicken pox, herpes, or hepatitis. Or, a lymphocyte count may be high because of a bacterial infection, such as tuberculosis or pertussis, or a condition such as lymphocytic leukemia or lymphoma.
  • Low: A low lymphocyte level can point to an autoimmune disorder, such as lupus or rheumatoid arthritis. The presence of HIV, tuberculosis, hepatitis, or the flu can also cause a lymphocyte count to be low.


  • High: A high monocyte count can result from a chronic infection, such as tuberculosis, or a fungal infection. The presence of a condition such as endocarditis (bacterial inflammation of the heart), IBD, monocytic leukemia, juvenile myelomonocytic leukemia, scleroderma, or rheumatoid arthritis can also cause a count to be high.
  • Low: Most doctors do not consider a single low monocyte count to be significant. However, low monocyte results on several tests can indicate hairy cell leukemia or bone marrow damage.


  • High: A high neutrophil level can indicate an acute bacterial infection, inflammation, tissue death (such as after a heart attack), stress on the body, or chronic leukemia. A level may also be high because a person is in the last trimester of pregnancy.
  • Low: A neutrophil count may be low after an adverse drug reaction or chemotherapy treatments. Illnesses, such as myelodysplastic syndrome, autoimmune disorders, bone marrow cancers, and aplastic anemia can also cause low neutrophil counts.


A differential blood test is one of many lab tests that a doctor can use to confirm a diagnosis of an infection or illness.

Values can vary from lab to lab, and a person should carefully review their results with the doctor.

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Medical News Today: What to eat in your second trimester

A balanced, nutritious diet during pregnancy is vital for a healthy mother and baby. A healthful diet ensures the fetus gets the nutrients it needs to develop correctly.

Eating well also prevents pregnancy complications, including preterm birth, high blood pressure, and preeclampsia.

During pregnancy, women should ensure they are getting enough vitamins, minerals, proteins, fats, and carbohydrates to encourage healthy growth. However, the body needs slightly more calories during the second trimester.

In this article, we list the most important foods to eat during the second trimester and discuss how much weight a woman might gain.

What to eat during the second trimester

During the second trimester, people should continue eating a balanced diet. The following nutrients are the most important for someone who is pregnant:


Pregnant woman in her second trimester eating salad.
Certain nutrients become more important later in pregnancy.

Iron helps to carry oxygen around the body. During pregnancy, iron supplies oxygen to the developing baby.

If a diet is lacking in iron, it could cause anemia, which increases the risk of complications, such as premature birth and postpartum depression.

The recommended daily iron intake during pregnancy is 27 milligrams (mg).

Sources of iron include:

  • lean meat
  • cooked seafood
  • leafy green vegetables
  • nuts
  • beans and lentils
  • whole grains, including bread and oatmeal
  • fortified breakfast cereals

The body absorbs iron from animal products more efficiently than iron from plant-based sources.

So, people who do not eat meat can boost absorption rates by eating foods that contain vitamin C at the same time.

Sources of vitamin C include oranges, orange juice, strawberries, and tomatoes.

People should try to avoid eating iron-containing foods and calcium-rich foods or supplements at the same time. Calcium reduces iron absorption.


When pregnant, people should aim to eat 75 to 100 grams (g) of protein each day to help the baby’s brain, and other tissue, grow. Protein is also necessary for the growth of the mother’s uterus and breasts.

Good sources of protein include:

  • lean meats
  • nuts
  • tofu and tempeh
  • eggs
  • fish (cooked, not raw)
  • peas, beans, and lentils


The recommended dietary allowance for calcium during pregnancy is 1,000 mg. Anyone who is less than 18 years old, who is pregnant, should aim to consume 1,300 mg of calcium daily.

Calcium helps the baby’s bones and teeth form, and it plays a role in the smooth running of the muscles, nerves, and circulatory system.

Calcium-rich foods include:

  • dairy (milk, yogurt, pasteurized cheese)
  • eggs
  • tofu
  • white beans
  • almonds
  • sardines and salmon (with bones)
  • greens, such as kale, broccoli, and turnip greens
  • calcium-fortified fruit juices and breakfast cereals


Foods rich in folate or folic acid, such as broccoli, beans, nuts, lentils
Oranges, whole grains, and dark green leafy vegetables contain folate.

Folate is a B vitamin. The synthetic form of folate is called folic acid.

Folate is essential during pregnancy as it helps prevent neural tube defects, including spina bifida, and reduces the risk of premature labor.

An analysis of 18 studies also suggests that folic acid significantly decreases the risk of congenital heart defects. However, more research is still needed.

During and before pregnancy, women should consume 400 to 800 micrograms (mcg) of folate or folic acid daily. The best sources include:

  • black-eyed peas and other legumes
  • fortified cereals
  • dark green leafy vegetables, including spinach, cabbage, and collard greens
  • oranges
  • whole grains, such as rice

It is a good idea to take a folic acid supplement or prenatal vitamin before and throughout pregnancy, as there is no guarantee that a person can get enough folate from food sources to meet the daily requirements.

Vitamin D

Vitamin D helps build a developing baby’s bones and teeth. The recommended intake during pregnancy is 15 mcg a day.

The body can make vitamin D from the sun, which allows many people to meet some of their needs. However, estimates suggest that more than 40 percent of the adult population in the United States have vitamin D deficiency due to lack of sun exposure and other factors.

Vitamin D is not present in lots of natural foods, but fortified foods, such as cereal and milk, contain vitamin D.

Food sources of vitamin D include:

  • fatty fish, such as salmon, fresh tuna, and mackerel
  • fish liver oils
  • beef liver
  • cheese
  • egg yolks
  • UV-exposed mushrooms
  • fortified juices and other drinks

Vitamin D supplements are also available and can be important for people who do not live in a sunny climate.

Omega-3 fatty acids

Both mother and baby can benefit from omega-3 fats in the diet. These essential fatty acids support the heart, brain, eyes, immune system, and central nervous system. Omega-3 may prevent early delivery, lower the risk of developing preeclampsia, and decrease the likelihood of postpartum depression.

An adequate daily intake of omega-3 fats during pregnancy is 1.4 g. Omega-3 fatty acids are present in:

  • oily fish, including salmon, mackerel, fresh tuna, herring, and sardines
  • fish oil
  • flaxseeds
  • chia seeds

Seeds contain a form of omega-3 that the body needs to convert before it can use it. How well the body can do this varies from person to person.

Vegans and vegetarians may need to take an algae-based supplement to meet their omega-3 requirements during pregnancy.


Pregnant people need more water than those who are not pregnant to stay hydrated. Water helps form the placenta and the amniotic sac. Dehydration during pregnancy can contribute to complications, such as neural tube defects and reduced breast milk production.

Anyone who is pregnant should drink at least 8 to 12 glasses of water a day to prevent dehydration and its complications.

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Foods to avoid

Soft creamy cheese amongst biscuits, crackers.
Avoid soft cheeses during pregnancy.

A person should avoid the following foods throughout their pregnancy:

  • raw meat
  • raw eggs
  • raw fish
  • fish with high levels of mercury, including swordfish, shark, tilefish, and king mackerel
  • unpasteurized dairy products
  • soft cheeses, such as Brie, blue cheese, and feta
  • ready-to-eat meats and seafood

A person should avoid alcohol throughout pregnancy, as there is no known safe level. All types of alcohol can be harmful and may cause:

  • miscarriage
  • stillbirth
  • fetal alcohol spectrum disorders (FASDs)

FASDs are conditions that cause physical, behavioral, and intellectual disabilities.

Pregnant women can consume caffeine in limited amounts. Experts state that it is safe to consume 150 to 300 mg per day, although the American Pregnancy Association suggest that pregnant people avoid caffeine as much as possible.

An 8-ounce cup of coffee contains between 95 to 165 mg of caffeine, and a 6-oz serving of black tea contains approximately 45 mg. Cola drinks, chocolate, green tea, and some medications also contain caffeine.

How much weight to gain

It is perfectly natural and healthy to gain weight during pregnancy. A person’s weight increases due to a higher blood volume in the body, the presence of amniotic fluid, and the baby’s weight.

The body needs 300 extra calories each day during the second and third trimesters to manage this weight gain.

The Institute of Medicine recommend the following weight gain:

  • 25 to 35 pounds if average weight (BMI of 18.5 to 24.9)
  • 28 to 40 pounds if underweight (BMI of 18.5 or less)
  • 15 to 25 pounds if overweight (BMI of 25.0 to 29.9)
  • 11 to 20 pounds if obese (BMI of 30.0 or more)

Those who were an average weight at the beginning of their pregnancy will typically gain 1 to 2 pounds per week in the second trimester. Gaining more weight than recommended increases the risk of complications, such as high blood pressure, a larger baby, and cesarean delivery.

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The basic principles of healthful eating are similar whether a person is pregnant or not. But during pregnancy, it is vital to focus on some essential nutrients, including iron, protein, calcium, folate, and omega-3 fats.

Weight gain during pregnancy, especially the second and third trimesters, is typical and healthy. To avoid gaining more weight than recommended, people should not eat more than 300 extra calories per day.

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Medical News Today: What is the purpose of a vitamin B-12 level test?

A vitamin B-12 level test checks the amount of vitamin B-12 in the blood or urine to gauge the body’s overall vitamin B-12 stores.

Vitamin B-12 is necessary for several bodily processes, including nerve function and the production of DNA and red blood cells.

A person whose vitamin B-12 levels are outside of the normal range will require treatment. Low levels of the vitamin can cause neurological symptoms, as well as fatigue, constipation, and weight loss. High B-12 levels may indicate liver disease, diabetes, or another condition.

Read on to learn more about testing B-12 levels and what the test results mean.

Why is a vitamin B-12 level test useful?

The vitamin B-12 level test checks how much vitamin B-12 is in the body. The results can help doctors to determine if abnormal vitamin B-12 levels are causing symptoms.

A doctor may order a vitamin B-12 level test if a person has any of the following:

Suspected vitamin B-12 deficiency

woman staring out of window due to catatonic depression
Depression can be a sign of vitamin B-12 deficiency.

Researchers believe that up to 15 percent of people in the United States have vitamin B-12 deficiency. Signs and symptoms of deficiency include:

  • confusion
  • dementia
  • depression
  • difficulty maintaining balance
  • fast heartbeat
  • numbness and tingling in the hands and feet
  • poor memory
  • a sore mouth or tongue

Infants with vitamin B-12 deficiency may fail to thrive. They may experience movement problems in addition to delayed development.

Pernicious anemia

People with symptoms of pernicious anemia may also need a vitamin B-12 level test. Pernicious anemia, which causes low levels of red blood cells, results from an inability to absorb vitamin B-12.

It often affects older adults or those who are lacking intrinsic factor. Intrinsic factor is a substance in the stomach that binds to vitamin B-12 so that the body can absorb it.

Symptoms of pernicious anemia include:

  • constipation
  • fatigue
  • loss of appetite
  • pale skin
  • weakness
  • weight loss

High serum folate levels

Serum folate is the level of folic acid in the blood. High serum folate levels can mask the symptoms of vitamin B-12 deficiency and make its neurological symptoms worse.

They can also increase the likelihood of anemia.

Symptoms of other conditions

An abnormally high vitamin B-12 status can be an early sign of liver disease, diabetes, or certain types of leukemia. A doctor may use the results of a vitamin B-12 test to help form their diagnosis.

Risk factors for low vitamin B-12 levels

vitamin b-12 level blood test
Children and older adults are more likely to experience low vitamin B-12 levels.

Certain people are more at risk of vitamin B-12 deficiency than others, especially those who have low stomach acid or other digestive issues. Stomach acid separates vitamin B-12 from food so that the body can absorb it more efficiently.

The following groups of people are more likely than others to experience low vitamin B-12 levels:

  • older adults
  • children
  • vegans and vegetarians
  • people with diabetes
  • people with conditions that reduce vitamin B-12 absorption, including celiac disease and Crohn’s disease
  • people who have had gastric bypass surgery
  • those who are breast-feeding
  • people who are taking medicines such as chloramphenicol, proton pump inhibitors, or H2 blockers

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How does the vitamin B-12 level test work?

Doctors usually use a blood test to check vitamin B-12 status, but home urine tests are also available. A doctor can check vitamin B-12 as part of a standard blood test.

Although it is not necessary to fast before a B-12 test, a person may need to if the doctor is also using the test to look at other components in the blood.

It is important that individuals tell their doctor about any medications and supplements they are taking, as some can affect the results.

Understanding the results

The results may be:

  • Normal. The normal range for vitamin B-12 in the blood is between 200 and 900 nanograms per milliliter (ng/mL). People at the lower end of this range may require follow-up testing, especially if they have symptoms.
  • Low. Levels of vitamin B-12 are low if they are below 200 ng/mL. This result suggests a vitamin B-12 deficiency, pernicious anemia, or an overactive thyroid. People with low vitamin B-12 levels often experience neurological symptoms.
  • High. An abnormally high vitamin B-12 status is anything over 900 ng/mL. This result may suggest liver or kidney problems, diabetes, or certain forms of leukemia.

The result ranges vary from one laboratory to another, so it is important to discuss the results and their meaning with a doctor.

The doctor may also check the levels of methylmalonic acid (MMA) and other substances to evaluate for vitamin B-12 deficiency. These lab values help detect a vitamin B-12 deficiency during the early stages.

Treatment for low vitamin B-12 levels

Individuals with low vitamin B-12 levels often require regular injections of the vitamin. These shots are more effective than supplements at raising vitamin B-12 levels, especially when people have medical conditions that may make it more difficult to absorb supplements.

For some people, high doses of vitamin B-12 supplements may improve B-12 status. Supplements are available in capsule or liquid form from pharmacies, supermarkets, health stores, and online. It may also be helpful to eat more foods that are rich in vitamin B-12.

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Treatment for high vitamin B-12 levels

There is no upper limit for vitamin B-12 intake because consuming high levels does not cause problems. However, having naturally high levels of vitamin B-12 in the body may be a cause for concern, as it suggests a severe underlying condition. Doctors will aim to treat the underlying medical condition, rather than the elevated levels of vitamin B-12.

Food sources of vitamin B-12

carton of eggs
Eggs are rich in vitamin B-12.

Although absorption difficulties and other medical issues often cause low vitamin B-12 levels, some people may be deficient because they do not get enough vitamin B-12 from their diet. This is especially true for vegans and long-term vegetarians.

Foods rich in vitamin B-12 include:

  • fish and seafood
  • meat
  • eggs
  • dairy products
  • fortified plant-based dairy alternatives
  • fortified breakfast cereals
  • fortified nutritional yeast

Vitamin supplements can make up for a shortfall in the diet, especially for vegans and strict vegetarians. As it can be easier for their body to absorb supplements than naturally occurring vitamin B-12, older adults should aim to meet their vitamin B-12 needs through fortified foods and vitamin supplements.

Recommended dietary allowances of vitamin B-12

Adults and adolescents over 14 years of age require 2.4 micrograms (mcg) of vitamin B-12 daily. This increases to 2.6 mcg during pregnancy, and 2.8 mcg when breast-feeding.


Vitamin B-12 is an essential nutrient that plays a vital role in overall health. A vitamin B-12 level test determines a person’s vitamin B-12 status. A doctor may recommend this test to people who have symptoms of a deficiency or who have a higher risk of low vitamin B-12 in the body.

People can avoid vitamin B-12 deficiency by eating a balanced diet and including several sources of vitamin B-12 daily or taking supplements. If they have issues absorbing vitamin B-12 from food sources, oral supplements or injections of the vitamin can help to prevent symptoms and complications.

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Medical News Today: What to know about hernias after a cesarean delivery

A hernia is a rare complication of cesarean delivery, also known as a C-section. Being aware of the signs and symptoms can help people to get proper medical treatment.

A hernia that occurs after surgery is called an incisional hernia. Cesarean delivery is a surgical procedure that can create a weakness in the abdominal wall. A hernia occurs when part of the intestines or stomach protrudes outward through this weakened area, creating a bulge.

In this article, we explain how to identify a hernia after cesarean delivery. We also cover the risk factors, treatment, and recovery.

Symptoms of a hernia after cesarean delivery

woman in pain on her bed due to hernia after C-section
A slowly intensifying pain in the stomach can be a symptom of a strangulated hernia.

The primary symptom of an incisional hernia is an unusual bulge near or attached to the site of the surgical incision. The bulge can be as small as a grape in size, or it can be very large. A hernia may change position or grow over time.

Sometimes a person can only feel a hernia, but it is often possible to see a visible bulge when looking at the stomach. The bulge is usually the same color as the skin.

Hernias can develop many years after the surgery. If this is the case, the individual may notice a bulge along a faint scar.

Sometimes a hernia becomes strangulated, or constricted. This can occur if herniated tissue becomes trapped, or incarcerated. A strangulated hernia will cut off the blood supply to vital organs in the stomach, including the intestines.

The symptoms of a strangulated hernia include:

  • slowly intensifying pain in the stomach
  • tenderness or pain on or near the hernia
  • nausea and vomiting
  • redness and swelling of the stomach

A strangulated hernia is a medical emergency. Anyone who experiences pain or gastrointestinal problems following a cesarean delivery should go to the emergency room.

Are hernias common after a cesarean delivery?

Hernias following a cesarean delivery are rare.

A 2014 study of 642,578 women in Australia found that just 0.2 percent of participants needed a hernia repair. The likelihood of hernia repair surgery increased with the number of cesarean deliveries.

Another 2014 study of women in Denmark estimated that 0.2 percent of women who had a cesarean delivery needed a hernia repair within 10 years. The risk was higher in the first 3 years after the birth.

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A doctor should usually be able to diagnose a hernia by examining the area. Sometimes a hernia is only visible in certain positions, or when coughing, so a doctor may touch the incision and ask the individual to bend forward or cough.


nurses rushing patient into er
A general anesthesia is required for emergency hernia removal.

When a hernia becomes strangulated, it requires emergency surgery.

A person may also need treatment for the side effects of a complex hernia, which may include bowel perforations or infections. They may require additional surgery, antibiotics, or monitoring in the hospital.

Even if a hernia is not yet strangulated, most doctors still recommend removal to prevent this from occurring in the future. This type of surgery is called elective surgery, and people can schedule it at their convenience.

Emergency hernia removal requires general anesthesia. The person will be fully asleep and unaware of what is happening. Sometimes, local anesthesia may be sufficient for elective hernia removal, depending on the hernia and its location. With local anesthesia, the individual is awake, but the area around the hernia is numb.

A surgeon may perform the hernia removal through either a cut in the stomach or keyhole surgery, also called laparoscopic surgery. Laparoscopic surgery uses a tiny incision, often in the bellybutton. These incisions tend to heal more quickly and allow a more rapid recovery.

It is important to discuss the relative merits of each type of surgery with a doctor. In some cases, it may only be possible to treat the hernia through a large incision.


Most people recover quickly from hernia repair surgery. Unless the hernia was large or complex, they are usually able to walk around and go home on the day of surgery. Experiencing pain and tenderness following the procedure is normal.

Remaining active following surgery can help to speed up healing and reduce the risk of complications such as blood clots.

People should notify their doctor if they develop a fever, notice excessive bleeding, or experience extreme pain.

People who work in offices can usually return to work within a week or two. Those who work in more physically demanding environments may need to wait longer. A doctor will discuss the recovery time and restrictions with the individual before surgery.

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Risk factors

baby born via cesarean delivery
Multiple cesarean deliveries can be a risk factor for a hernia.

Certain factors increase the likelihood of a person experiencing an incisional hernia after cesarean delivery.

The risk of having a hernia is higher among women who have multiple cesarean deliveries. According to a 2014 study, having two cesarean deliveries makes a hernia three times more likely, while having five cesarean deliveries increases the risk sixfold.

A hernia can occur any time after cesarean delivery, but it is more likely in the 3 years after surgery.

People who have a history of abdominal hernias may be more likely to experience a hernia after cesarean delivery, as there may be an existing weakness in the abdominal wall. However, because hernias are rare, no recent research has shown a direct link between previous hernias and the likelihood of an additional one.

It is important to discuss risk factors with a doctor. People who have had hernia surgery previously should ensure that their doctor is aware of this.


In some cases, a small hernia can heal on its own. However, there is a risk of the hernia becoming trapped or strangulated, so it is essential to seek medical care.

The primary complication of a hernia is strangulation, which can be life-threatening. It may cause problems such as:

  • perforated bowels
  • blockages in the bowels
  • internal bleeding
  • fluid in the abdominal cavity

Some people go into shock when experiencing a strangulated hernia. People awaiting elective surgery for a hernia should ask their doctor about the warning signs and symptoms of a strangulated hernia. If they experience any of these, they must seek emergency medical care.

Outlook and recurrence rate

Surgical repair of hernias following cesarean delivery is usually effective, but people should discuss the possibility of recurrence with a doctor.

According to the American College of Obstetricians and Gynecologists (ACOG), people who attempt a vaginal birth following a previous cesarean delivery have a 60–80 percent chance of success. Therefore, a person who is concerned about experiencing another hernia may prefer to avoid surgery and attempt a vaginal delivery instead.

Hernias are rare after cesarean delivery, so there is little data available on the rate of recurrence. It is not possible to predict whether or not a person will develop another hernia.

With proper care, the majority of people recover from incisional hernias after cesarean delivery. Most will be able to have healthy subsequent births, and vaginal delivery might be possible.

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