When Hernias Happen

Types of Hernias

• Inguinal Hernia, the most common type, happen when part of the intestine pushes through a weak spot in the groin area.
• Femoral Hernia is located in the upper thigh near the groin and located too deep in the body to be externally visible.
• Umbilical Hernia, most common in infants and young children, happen when tissue protrudes through the navel.
• Incisional Hernia develops through an improperly healed surgical scar.
• Hiatal Hernia, the result of a part of the stomach pushing through the diaphragm into the chest cavity, is not visible outside the body.
• Epigastric Hernia occurs between the breastbone and the belly button.

Signs and Symptoms

Some hernias are externally visible. They may slide in and out of the muscle opening, protruding when you squat, bend over, strain, laugh, cough, or otherwise exert yourself, and then disappear when you rest. You may even be able to gently push the hernia back into the abdominal cavity. A hernia that moves like this is referred to as a "reducible."

Hernias can be very painful, but often you may just feel pressure, a dull ache, or a pinching sensation when the hernia pokes out through an opening. You may also not feel anything at all, especially if your hernia is small. A hiatal hernia may cause symptoms of chronic heartburn. Femoral hernias, located in the groin, can lead to visible testicular swelling in men. While femoral hernias are not visible in women, they may cause pain in the groin area.

If a baby or child has a hernia, you’ll likely notice a bulge in the groin or belly button. The area can be painful or tender. The bulge often gets bigger when the youngster is crying, coughing, or straining to go to the bathroom. In some case, there may be vomiting, fever, and redness around the hernia. If your child develops any of these symptoms, call your pediatrician right away.

Risk Factors for Developing a Hernia

• Being male – 27% of men will develop an inguinal hernia, the most common type, over the course of their lives compared to 3% of women
• Work involving heavy lifting or standing for hours
• Chronic cough or sneezing
• Chronic constipation
• Pregnancy, especially repeat pregnancies
• Obesity, defined as a body mass index, or BMI, greater than 30
• A surgical scar that has not healed properly

Hernia Complications

Most hernias eventually require surgery. If you have a small hernia that isn’t bothering you, your healthcare provider may suggest waiting. However, other than umbilical hernias in babies, hernias don’t go away on their own and they do eventually worsen.

Pain or complications should send you to the doctor right away. Seek medical attention if your hernia goes numb, changes color, or causes fever, nausea, and vomiting. Surgery is usually prescribed if a hernia is large, fast growing, or putting pressure on a nerve. A hernia may get stuck and not be able to move back in (incarceration). If the incarcerated hernia is in your bowel, you could develop an obstruction that blocks the passage of food or gas. The hernia may lose access to blood supply (strangulation), resulting in tissue death and necrosis.

Hernia Repair

There are two types of hernia repair surgery: herniorrhaphy and hernioplasty. The aim of herniorrhaphy is to return displaced tissues to their normal position. Hernioplasty involves sewing a mesh patch over the weakened tissue so the hernia can no longer poke through. The type of repair will depend on the hernia’s size and location. Both types of surgery can be performed either through open surgery or laparoscopically.

If you suspect you have a hernia, talk to your doctor. Even if it’s not causing you any pain or concern right now, they will want to monitor it. For help finding a doctor, click here.

This article first appeared in the March 2025 edition of the HealthPerks newsletter.