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Hernias

Hernias happen when part of an organ bulges through a wall of tissue in the body. Doctors diagnose most hernias with a simple physical examination. Surgery is the only way to permanently repair a hernia.

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Hernias are tears in tissue that internal organs slip through. Hernias can be painful, but some people with hernias may not experience symptoms.

Doctors can diagnose hernias with physical exams in most cases. Most patients can self-diagnose hernias.

Hernia repair is one of the most frequent surgeries performed in the U.S. There are more than one million hernia repairs each year. About 900,000 of those procedures use hernia mesh.

What Causes Hernias?

A combination of muscle weakness and strain causes hernias. Hernias may happen suddenly or develop slowly over a long time.

Conditions That Can Cause Hernias
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Age
coughing icon
Chronic or persistent coughing
Congenital defects icon
Congenital defects
Heavy lifting icon
Heavy lifting
Injuries icon
Injuries
Pregnancy icon
Pregnancy
Sudden weight gain icon
Sudden weight gain
Surgery icon
Surgery

Am I at Risk for a Hernia?

Hernias are one of the most common anatomical conditions people suffer. The chance of someone having a hernia at some point in their life is about 10 percent. The likelihood is higher for men (27 percent) than for women (3 percent). Obesity plays a role in developing and treating hernias. So does smoking.

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How to Prevent Hernias

Coughing, body weight and strain on the body all help cause hernias. Addressing these can help prevent hernias.

Elderly couple exercising
Exercising has been known to reduce hernia strain
Control coughing
Treating persistent coughs can help prevent hernias. Smoking can increase hernia risk because of the coughing it causes. Quitting or avoiding the habit can reduce hernia risk.
Avoid muscle strain
Lift heavy objects with the knees, never with the back. People should avoid trying to lift any weight too heavy for them.
Lose weight
Excess body fat can strain muscle tissue. Maintaining a healthy weight can cut strain.

Signs of a Hernia

People who suffer a hernia may not experience signs that something is wrong. Pain is the most likely symptom someone with a hernia experiences. Different types of hernias may share certain symptoms. But some symptoms may be unique to a particular type of hernia.

Typical Hernia Symptoms
  • Pain in the abdomen, testicle or pelvic region
  • Abdominal discomfort
  • Distended abdomen
  • Discomfort or tenderness in the groin

When to See a Doctor About a Hernia

People should seek medical attention before a hernia becomes serious. In some cases, the intestines can become trapped in the hernia. This can cut off blood flow. If this happens, a surgeon may have to remove part of the intestines.

Hernia Symptoms That Need Immediate Medical Attention
  • A painful hernia that cannot be easily pushed back into the abdomen
  • A hernia that turns red, purple, dark or discolored
  • Inability to pass gas or have bowel movements

How Doctors Diagnose Hernias

Doctors diagnose most hernias with a physical examination. Patients can often diagnose a hernia on their own.

The most obvious sign is a bump under the skin at the hernia site. This can show up even if a person experiences no other hernia symptoms.

A doctor may use X-rays to diagnose a hiatal hernia or to look for bowel obstructions. An ultrasound can help diagnose umbilical hernias in children and femoral hernias in adults.

Common Hernia Types

There are several types of hernias. Inguinal and umbilical hernias account for most of them. Symptoms can vary based on type and location in the body.

Most Common Hernias
inguinal hernia
Inguinal Hernia
Umbilical Hernias icon
Umbilical Hernias
Femoral Hernia icon
Femoral Hernias
Hiatal Hernia icon
Hiatal Hernias
Incisional Hernias icon
Incisional Hernias

What Is an Inguinal Hernia?

Inguinal hernias happen in the groin. The intestine or bladder juts through the abdominal wall. About 19 in every 20 groin hernias are inguinal hernias. Most happen in men. One in three people with inguinal hernias may not experience symptoms.

Symptoms Of Inguinal Hernias
  • Burning, aching or a sensation of heaviness or weakness in the groin
  • Pain when coughing or during physical exertion
  • Swelling of the scrotum in men or boys

Types of Inguinal Hernias

There are two types of inguinal hernias: incarcerated and strangulated. A doctor can determine which one a patient may have.

strangulated hernia illustration
Illustration of a strangulated hernia
Incarcerated Inguinal Hernia
The intestine or bladder passes through the abdominal wall. The organ becomes stuck and cannot go back. A doctor may be able to push the trapped tissue back into place, but surgery may still be necessary.
Strangulated Inguinal Hernia
These are life-threatening medical emergencies. The abdominal wall traps and squeezes internal organs. This can cut off blood flow in the small intestine. It requires emergency surgery.

What Is an Umbilical Hernia?

Umbilical hernias are most common in infants. They can sometimes heal themselves by the time the child turns four. But they require surgery if they happen in adults.

Symptoms Of Umbilical Hernias In Infants
  • Most often painless
  • Swelling over the belly button that bulges when the baby cries, strains or sits up
  • Bulge may flatten if the baby lies on its back or is quiet

Umbilical hernias form around the navel. These happen when muscle around the belly button does not close after birth. Organs push through the abdominal lining around the navel. Umbilical hernias appear as an outward bulge.

Umbilical hernias are very small. They range from less than one-third of an inch to about two inches wide. People with an umbilical hernia may never notice they have one. Doctors or other health care workers are most likely to discover them in patients.

Umbilical Hernia in Adults

While most common in children, umbilical hernias still occur in adults. About one in 10 adult abdominal hernias are umbilical hernias. For adults, umbilical hernias can be far more serious.

An umbilical hernia squeezing the intestine can cause a medical emergency. Adults may experience sudden pain and vomiting. It requires immediate surgery.

Symptoms Of Umbilical Hernias In Adults
  • Visible bulge on the abdomen
  • Bulge is more prominent when coughing or straining
  • Pain or pressure at the hernia site

What Is a Hiatal Hernia?

Hiatal hernias occur when part of the upper stomach presses into the chest. The exact cause of these hernias is unknown, but it may be due to weakness in the diaphragm.

The diaphragm is the sheet of muscle dividing the chest from the abdomen. Hiatal hernias are common and the risk of developing one increase as a person ages.

Most hiatal hernias occur in people older than 50, but some children are born with them.

By themselves, hiatal hernias seldom cause symptoms. But people who suffer them may experience pain and discomfort. This is from stomach acid, bile or even air flowing upward from the stomach into the esophagus.

Symptoms Of A Hiatal Hernia
  • Chest pain
  • Heartburn that gets worse when bent over or lying down
  • Difficulty swallowing

Hernia Treatment Options

Hernia treatments depend on the hernia’s severity and the patient’s pain.

Monitoring
It is possible to live with some hernias. Doctors may suggest “watchful waiting.” The doctor and patient watch a hernia to make sure it does not get worse. There is a strangulation risk. The hernia may squeeze the intestine. If this happens, a surgeon may have to remove part of the intestine.
Diet and Lifestyle
Losing weight or stopping smoking may prevent a hernia from getting worse. These can reduce strain from extra weight or persistent coughing. Dietary changes can also treat hiatal hernia symptoms.
Medication
Doctors may recommend medicines to treat hiatal hernias. Medications include proton pump inhibitors (PPIs) to control stomach acid. These can present their own complications. If medication alone cannot relieve a hiatal hernia, a patient may need surgery.
Surgery
Surgery is the only permanent fix for a hernia. Doctors recommend surgery if the hernia gets larger or a patient is in pain.

Hernia Surgery

There are two main types of hernia surgery: open and laparoscopic.

Open surgery involves cutting into the layers of skin and other tissue around the hernia.

Fact
Hernia repair is one of the most common surgeries in the U.S.

Laparoscopic is a minimally-invasive technique. A doctor makes small incisions in the area around the hernia. The doctor inserts medical instruments through these incisions to perform the surgery.

Surgeons can repair hernias using pure-tissue techniques or hernia mesh.

Pure-tissue techniques involve suturing together the damaged tissue. Sometimes this will include different layers of tissue.

Most hernia surgeries in the U.S. rely on hernia mesh. Hernia mesh surgery may involve either an open or laparoscopic method. A surgeon places the mesh around the hernia. He attaches it using surgical staples, tacks or sutures. Over time, tissue grows into the mesh’s holes. This adds strength to the repair.

Please seek the advice of a medical professional before making health care decisions.

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20 Cited Research Articles

  1. National Institutes of Health. (2017, May 31). Hernia; Also Called: Enterocele. MedlinePlus. Retrieved from https://medlineplus.gov/hernia.html
  2. U.S. National Library of Medicine. (2016, September 17). Hernia. Retrieved from https://medlineplus.gov/ency/article/000960.htm
  3. U.S. National Library of Medicine. (2017, April 24). Hiatal Hernia. Retrieved from https://medlineplus.gov/ency/article/001137.htm
  4. U.S. National Library of Medicine. (2015, July 10). Umbilical Hernia. Retrieved from https://medlineplus.gov/ency/article/000987.htm
  5. American College of Surgeons. (2016, April). Adult Umbilical Hernia Repair. Retrieved from https://www.facs.org/~/media/files/education/patient%20ed/adultumbilical.ashx
  6. National Institutes of Health. (2014, June). Inguinal Hernia. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/inguinal-hernia
  7. American College of Surgeons. (2016). Groin Hernia Repair. Retrieved from https://www.facs.org/~/media/files/education/patient%20ed/groin%20hernia.ashx
  8. Wake, B.L. et al. (2005). Two different laparoscopic techniques for repairing a hernia in the groin. Retrieved from http://www.cochrane.org/CD004703/COLOCA_two-different-laparoscopic-techniques-for-repairing-a-hernia-in-the-groin
  9. Michigan Surgery. (n.d.). A Brief History of Hernia Surgery. Retrieved from http://michigansurgery.com/general-surgery/hernia-surgery/a-brief-history-of-hernia-surgery/
  10. Zogbi, L. (2011). The Use of Biomaterials to Treat Abdominal Hernias. Retrieved from http://www.intechopen.com/books/biomaterials-applications-for-nanomedicine/the-use-of-biomaterials-to-treat-abdominal-hernias
  11. Sherwinter, D.A. et al. (2016). Laparoscopic Inguinal Hernia Repair. Retrieved from http://emedicine.medscape.com/article/1534321-overview
  12. Society of American Gastrointestinal and Endoscopic Surgeons. (n.d.). Laparoscopic Inguinal Hernia Repair. Retrieved from https://www.sages.org/publications/patient-information/patient-information-for-laparoscopic-inguinal-hernia-repair-from-sages/2/
  13. Landro, L. (2012, February 28). A Secret for Patients Undergoing Hernia Repair. Retrieved from http://www.wsj.com/articles/SB10001424052970203833004577249344022834000
  14. Mayo Clinic Staff. (2015, December 31). Treatment - Intestinal obstruction - Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/diagnosis-treatment/treatment/txc-20168482
  15. Lockhart, K. et al. (2015, February 16). Mesh Versus Non-Mesh for Inguinal and Femoral Hernia Repair. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011517/full
  16. Ryan, J.J. (2001). The McVay Operation. Retrieved from https://link.springer.com/chapter/10.1007/978-1-4419-8574-3_52
  17. Shouldice Hernia Hospital. (n.d.). The Global Leader in Non-Mesh Hernia Repair. Retrieved from http://www.shouldice.com/
  18. Sonmez, M.G., et al. (2016, June 20). Does Inguinal Hernia Repair have an Effect on Sexual Functions? Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4986302/
  19. Healthline. (n.d.). Inguinal Hernia. Retrieved from https://www.healthline.com/health/inguinal-hernia#causes
  20. Kulacoglu, H. (2015, September 1). Current Options in Umbilical Hernia Repair in Adult Patients. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4605112/
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