Hernia

A hernia is where an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall.

Key Information

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What should I do?

If you think you have this condition, you should see a doctor within 2 weeks.

How is it diagnosed?

If your doctor suspects a hernia based on your symptoms and physical examination findings, they will refer you for further tests. An ultrasound scan will be required to confirm the diagnosis.

What is the treatment?

The definitive treatment for a hernia is surgical repair. Your doctor might discuss the options of the type of surgery with you and recommend which one will be most suitable.

Heavy lifting is not recommended while waiting for your surgery appointment.

When to worry?

If you develop any of the following symptoms, please see a doctor immediately:

  • severe abdominal or groin pain
  • swelling or redness in the groin
  • constipation
  • blood in your stools
  • vomiting.

A hernia is where an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall.

The muscles are usually strong enough to keep the organs in place. However, a weakness may cause a hernia to occur.

Types of hernia

Hernias can occur anywhere in your abdomen (the area of your body between your chest and hips).

There are several different types of hernia, which are described below.

  • Inguinal hernias – occur when part of your bowel pokes through your lower abdomen into your groin.
  • Femoral hernias – occur when fatty tissue or a part of your bowel pokes through into your groin, at the top of your inner thigh.
  • Incisional hernias – occur when tissue pokes through a surgical wound in your abdomen that has not fully healed.
  • Umbilical hernias – occur when fatty tissue or a part of your bowel pokes through your abdomen near your navel (belly button).
  • Hiatus hernias – occur when part of your stomach pushes up into your chest by squeezing through an opening in the diaphragm (the thin sheet of muscle that separates the chest from the abdomen).
  • Epigastric hernias – occur when fatty tissue pokes through your abdomen, between your navel and the lower part of your sternum (breastbone).
  • Spigelian hernias – occur when part of your bowel pokes through your abdomen at the side of your abdominal muscle, below your navel.
  • Muscle hernias – occur when part of a muscle pokes through your abdomen; muscle hernias can also occur in leg muscles as the result of a sports injury.

How common are hernias?

Different types of hernia tend to affect different groups of people. About three-quarters of all abdominal hernias are inguinal hernias.

Inguinal hernias

Inguinal hernias are the most common type of hernia, and account for three out of four hernia cases.

About 1 in 4 men and 3 in every 100 women will have an inguinal hernia at some point during their lifetime.

Risk factors for inguinal hernias include:

  • sex – they are more common in men than in women
  • age – your risk of developing one increases as you get older
  • being obese – having a body mass index (BMI)of 30 or over
  • doing lots of heavy lifting
  • having a long-term cough
  • having long-term constipation (an inability to empty your bowels)

Femoral hernias

Femoral hernias are less common than inguinal hernias.

Femoral hernias are about four times more common in women than men, and can affect women of any age. Apart from sex and age, femoral hernias have similar risk factors to inguinal hernias.

Incisional hernias

Incisional hernias can develop as a complication of abdominal surgery. The risk of an incisional hernia developing after surgery will vary depending on the type of surgery involved.

Umbilical hernias

Umbilical hernias are very common in infants, particularly in black infants. The reasons why they tend to affect black infants more are unclear.

In 9 out of 10 cases, an umbilical hernia will get better without treatment as a child gets older.

Hiatus hernias

Hiatus hernias are common, affecting up to 1 in 10 people.

They do not always cause symptoms, although in some people they can cause heartburn (pain or discomfort in the chest that usually occurs after eating).

Assessing and treating hernias

A hernia will often be assessed using an ultrasound scan, which uses high-frequency sound waves to create an image of part of the inside of the body.

In many cases, hernias cause no (or very few) symptoms. However, there is a chance that a hernia could:

  • cause an obstruction in the bowel
  • interrupt the blood supply to the herniated tissue (known as a strangulated hernia)

Both are medical emergencies. If they occur, you should go immediately to the accident and emergency (A&E)department of your nearest hospital.

Due to potential risks associated with these complications, surgery to repair a hernia is usually recommended.

The exceptions to this are umbilical hernias, which usually get better on their own, and hiatus hernias, which are sometimes initially treated with medication. In some cases, surgery is also needed for hiatus hernias.

Read more about treating hiatus hernias.

Surgery

If you have a hernia, whether or not you will need surgery will depend on:

  • where the hernia is located – femoral hernias and hernias in the groin are more likely to require surgery; abdominal hernias less likely
  • your symptoms – some hernias may not cause symptoms, others may be painful
  • the content of your hernia – the hernia may consist of part of your bowel, muscle or other tissue

If you need surgery, your surgeon will explain the benefits and risks of the procedure to you in detail.

Common questions about hernia

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What does a hernia feel like?

If you have a hernia, you may notice a swelling or lump in your tummy or groin. You may find that the lump:

  • disappears when you lie down
  • can be pushed back in
  • appears when you cough or strain

Some hernias can cause aching and discomfort, particularly after doing physical activity.

However, in many cases, a hernia causes few or no noticeable symptoms.

What does a hernia look like?

A hernia usually looks like a swelling or lump in your tummy or groin. The lump may:

  • disappear when you lie down
  • be pushed back in
  • appear when you cough or strain

How do you diagnose a hernia?

A hernia is unlikely to disappear on its own, so see a doctor if you think you have a hernia.

Your doctor will usually be able to diagnose a hernia by examining the affected area. You may also need an ultrasound scan to confirm the diagnosis.

Do hernias hurt?

Many hernias do not cause pain. However, some hernias can cause aching and discomfort, especially after physical activity.

If your hernia suddenly becomes painful or any existing pain gets worse, see your doctor or go to hospital immediately. A sudden increase in pain may indicate that the blood supply to the organ or tissue trapped in the hernia has been cut off (strangulation) or a piece of bowel has entered the hernia and become blocked (obstruction).

Can you die from a hernia?

A hernia can lead to a life-threatening situation if it becomes strangulated (blood supply to tissue trapped in the hernia is cut off) or if a piece of bowel enters the hernia and becomes blocked (bowel obstruction).

Both of these scenarios can cause complications, such as a hole in the bowel or blood poisoning, which can carry a risk of death.

If you have a strangulated or obstructed bowel, you may develop:

  • sudden, severe pain
  • vomiting
  • difficulty opening your bowels or passing wind
  • a firm or tender hernia that cannot be pushed back in

See your doctor or go to hospital immediately if you develop any of these symptoms.

How do you prevent hernia?

Hernias can occur in adults who have lifestyle or health factors that raise the pressure in their tummy. This increased pressure can lead to a weakness in the abdominal wall, resulting in a hernia. Increased tummy pressure can be caused by:

  • straining on the toilet e.g from constipation
  • chronic persistent cough
  • being overweight
  • pregnancy
  • lifting, carrying or pushing heavy loads

You may be able to reduce your risk of a hernia by minimising these activities, where possible, by:

  • losing weight if you are overweight or obese
  • seeking treatment for an ongoing cough
  • making diet and lifestyle changes to prevent constipation

How do you treat a hernia?

Surgery is the usual treatment for a hernia. If you have a hernia, speak to your doctor to find out if you need treatment.

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