What is a Hernia?

A hernia occurs when a body organ, usually a portion of the intestines, is pushed through a tear in the tissue or muscle, most often in the abdominal wall. Hernias are common in people of all ages, newborn and up.

Inguinal hernias are the most commonly experienced type of hernia, accounting for more than 70 percent of all hernias. Inguinal hernias occur 10 times more often in men than women. Inguinal hernias appear in the groin area (inguinal canal) when part of the intestines push through a tear or weakened spot in the lower abdominal wall. 

Other types of hernias include: 

• Hiatal, which almost always cause gastroesophageal reflux (GERD) and are most common in people over the age of 50
• Ventral or incisional, which occur after an abdominal surgery
• Femoral, which are very rare and appear at the top of the inner thigh most often in women
• Umbilical, which most often occur in children and babies and typically heals on its own
• Internal, which are extremely rare (<1 percent of all hernia) and are contained in the abdominal cavity

How Hernias Happen

Muscle strain and weakness are the two major risk factors contributing to hernias, which may develop over a long period of time or occur suddenly. There are many causes of hernias, including:

• Straining on the toilet
• Carrying or pushing heavy loads
• Trauma/injury
• Surgery
• Pregnancy
• Fluid retention in the abdomen
• Sudden weight gain
• Persistent or chronic coughs
• Strong sneezes
• Obesity
• Smoking
• Undescended testicle
• Chronic conditions that have a persistent and strong cough, such as cystic fibrosis

Learn ways to prevent hernias here.

Symptoms of a Hernia

How do you know if you have a hernia? A visible bulge or lump is the most common sign of a hernia. The hernia can be felt and possibly be pushed back in. It may be most visible when standing up, bending down or coughing. Not all hernias are painful; however, inguinal hernias are usually painful. Hernia pain may include a heavy feeling or pressure in the abdomen, as well as burning or aching at the hernia bulge. Hiatal hernia symptoms can include chest pain, GERD and even difficulty swallowing.

Some hernias may have no signs or symptoms and may go undiscovered until a medical exam is performed for an unrelated condition, or never. Depending on the type of hernia, this situation may become a medical emergency. Red flag symptoms to watch for include:

• Intense pain
• Swollen and red skin over the hernia (the hernia itself may or may not be visible)
• Gray or blue skin tone and/or necrosis (caused by restricted blood flow to area)
• Gangrene
• If there is a visible bulge, an inability to push the bulge back in, meaning there is a loss of blood supply to the intestinal tissue (also called strangulation)
• Nausea and vomiting, but especially in conjunction with any of the above symptoms

Diagnosis of a Hernia

Diagnosis of hernia requires a physical exam, as so many hernias are visible and palpable (felt) in the exam. In some cases, other diagnostic tests may be needed for a correct diagnosis, such as an ultrasound, computerized tomography (CT) scan, urinalysis, blood tests, and possibly an electrocardiogram (ECG) to determine heart problems that would be a risk factor for surgery, if needed.

Misdiagnosis of a Hernia

Misdiagnosis is always possible because most hernias are diagnosed based on a visual and physical examination only. Misdiagnosis can occur even with an ultrasound. Sometimes, a magnetic resonance imaging (MRI) scan may be required to help properly diagnose a hernia. 

Because men are more likely to get hernias, they often tend to be misdiagnosed more than women. Also, hernias in women may not be visible or palpable. The hernia may feel like chronic, intense groin or abdominal pain, which may be misdiagnosed as another medical condition.

Other conditions that cause similar pain are groin strains, abscess, orchitis, vasitis (very rare condition), lymphoma, lymphadenopathy, metastatic neoplasm (cancer that has spread from its primary location of origin), hydrocele, epididymitis, testicular torsion, undescended testicle, hematoma and femoral artery aneurysm.

Advanced Laparoscopic Associates has the ability to perform robotic hernia surgery for inguinal, ventral and incisional hernias. Robotic hernia repair has many advantages over both traditional and laparoscopic hernia repair. Read more about our robotic hernia surgery here. If you have any signs and symptoms of a hernia, contact us today. Even if your hernia is painless, there are many risks to leaving it untreated. We can help and have you back to health quickly!