A hernia occurs when an organ or tissue pushes through an opening or weak spot in the muscle or tissue holding it. There are various types of hernias that occur in different parts of the body, each with specific causes, symptoms and treatments. The following are among the more common types.
The most common type of hernia, an inguinal hernia occurs when the intestines push through a weak spot or tear in the lower abdominal wall, often in the inguinal canal, located in the groin. Inguinal hernias occur more often in men than women and are often the result of a birth defect. Before birth, the testicles descend and leave an opening in the muscle wall, which usually closes before birth. If not, a hole remains that can allow tissue to push through, which may not happen until later in life.
Causes and Risk Factors
Some inguinal hernias have no apparent causes. Others may occur as a result of:
- Failure of the abdominal wall to close properly in the womb
- Increased abdominal pressure
- A weakness in the abdominal wall
- A combination of the above
- Strain from bowel movements or urination
- Strenuous activity
- Chronic cough or sneezing
Factors that increase your risk of developing inguinal hernia include:
- Males are at a much greater risk than females
- Older persons are a greater risk, as muscles weaken with age
- White persons have a higher risk of developing inguinal hernia
- Lifting heavy weight
- Family history of inguinal hernia
- Chronic cough
- Chronic constipation, which causes straining during bowel movements
- Pregnancy, which can weaken the abdominal muscles and increase abdominal pressure
- Prior hernia or hernia repair
- Bulge or protrusion in the groin area. Although the bulge may go away when you lie down, the hernia is still there.
- Burning or sharp pain in the lower abdomen, especially when bending over, lifting or coughing
An inguinal hernia may become incarcerated, meaning the contents of the hernia can become entrapped in the abdominal wall, obstructing the bowel and potentially causing vomiting, nausea and pain. If blood flow is cut off to part of the intestine, the intestine may also become strangulated, causing death to affected bowel tissue. Either of these conditions can be life-threatening and requires immediate medical attention and likely surgery.
Get emergency care if your hernia bulge turns red, purple or dark, or if you develop nausea, vomiting or fever.
Inguinal hernia is usually diagnosed with a physical examination. Your doctor will check for a bulge in the groin area, and may ask you to stand, cough or strain. In certain cases, imaging tests, such as an abdominal ultrasound, CT scan or MRT, may be required.
Hernias that become enlarged or painful usually require surgery. Your surgeon may perform either a laparoscopic repair, a minimally invasive procedure (performed under general anesthesia) in which the surgeon inserts a tiny camera (laparoscope) into a small incision to make the repair, or an open hernia repair. If surgery is required, your surgeon will discuss the best option for you.
Other Types of Hernias
Another common type of hernia, the femoral hernia, occurs more often in women than men, and occurs much lower than an inguinal hernia. Femoral hernias are typically painful and because of their location can often lead to strangulation of blood supply to tissue in the groin area, requiring immediate surgery.
Umbilical hernias occur around the navel. They most often occur in infants but can also occur in adults, especially if they are pregnant or overweight. Umbilical hernias in infants can close by themselves; umbilical hernias do not self-correct in adults and typically require surgical repair. If left untreated, they can become strangulated, which is a medical emergency.
Incisional / Ventral Hernia
Incisional or ventral hernias occur in the belly or abdomen as a result of prior abdominal surgery. They are more frequent in people who are overweight, older and have had multiple operations using the same incision. They are quite painful and require medical attention.
Epigastric hernias are lumps or bulges that occur in the upper part of the abdominal wall, between the navel and the breastbone. Epigastric hernias can occur in men, women or children. Like umbilical hernias, epigastric hernias can be present in infants when they are born and will sometimes self-heal as the abdominal wall strengthens. Epigastric hernias in adults will not self-heal and require surgical repair. As with other hernias, if left untreated, epigastric hernias can become incarcerated or strangulated, requiring emergency surgery.
Whereas all of the hernias described above occur when the intestine protrudes through an abdominal wall, hiatal hernias occur when the stomach protrudes thorough the diaphragm into the chest, often causing chronic or recurring heartburn, which can lead to erosion of the esophagus. Treatment options include surgery, diet changes and /or medications.
The skilled, board-certified general surgeons affiliated with Memorial Hermann Memorial City Medical Center specialize in abdominal surgeries, performing over 400 surgeries for the treatment of hernias every year.
If you or a family member suffers from the symptoms described above, schedule an appointment with a physician affiliated with Memorial Hermann by clicking here or calling 713-222-CARE (2273).