A hernia is a common problem in which an organ or other tissue pushes through the muscle or connective tissue. It often leads to an out-of-place lump you can see or feel. Most hernias aren't an urgent issue, but they can be painful.
When left untreated, a hernia can worsen over time. In rare cases, it can cause a blocked bowel or part of the tissue to lose blood supply. For these reasons, doctors often suggest surgery to fix a hernia.
On this page:
What Is A Hernia?
A hernia happens when one part of the body pushes through a weak spot in the muscle or connective tissue that normally holds it in place.
A hernia can be:
- An organ.
- Fatty tissue.
- Part of the intestine.
Our muscles work with a connective tissue called fascia to keep the organs and tissues of our abdomen in place. A hernia is a bulge or lump that pokes through the fascia or muscles.
What are the types of hernias?
Almost all hernias occur in the abdomen, groin, or top of the thigh.
Types of hernias include:
- Hiatal hernias — This type of hernia occurs when part of the stomach pushes through the diaphragm, the muscle separating the abdomen from the chest.
- Incisional hernias — This type of hernia occurs when tissue bulges through a surgical wound that hasn't fully healed. They happen in 10% to 15% of people who have had abdominal surgery.
- Inguinal hernias — This is the most common type of hernia. It occurs when the bowel or fatty tissue bulges past the fascia in the groin, and it's nine times more common in men than in women.
- Umbilical hernias — This occurs when fatty tissue or part of the bowel pokes through a small opening at the belly button. It can happen in babies if the opening of the umbilical cord doesn't close properly. Adults can also get umbilical hernias.
Other rare types of hernias are:
- Femoral hernias — A hernia that happens when tissue in the abdomen pokes through the muscles in the groin. They're most common in women, at the top of the inner thigh.
- Lumbar hernias. When organs or tissue push past the muscles of the flank or back.
- Perineal hernias — When organs or tissue push past the pelvic muscles.
How common are hernias?
Hernias are common. About 10% of people in the U.S. will get a hernia at some point.
What causes a hernia?
Hernias can occur without injury or any provoking factors.
Common causes of hernia in adults include:
- Strain during heavy lifting or bowel movements that put pressure on the intestines or other tissues.
- Weakened muscles and fascia in the abdominal wall, often due to age, surgery, or another health condition.
Hernia risk factors
The following factors can increase the risk of getting a hernia:
- Age — Adults over 45 years are more likely to develop hernias.
- Health conditions — Diseases that cause chronic coughing or constipation can strain the abdominal walls
- Lifestyle — A poor diet can cause hernias. They're also more common in people who are obese and those who smoke.
- Sex — Men are more likely than women to get hernias.
- Underlying issues — Genetic disorders, prior surgery, autoimmune disorders, poorly controlled diabetes, and malnutrition can increase hernia risk.
Complications of hernias
Many hernias don't require treatment right away.
But they can cause serious complications such as:
- Blockage in the bowel that limits food from passing through the intestine.
- Damage or loss of blood supply to part of the tissue or organ.
- Infection or inflammation.
How can I reduce my risks of hernias?
You can reduce your risk of developing a hernia by:
- Avoiding excessive straining during bowel movements.
- Eating a fiber-rich diet and staying hydrated to prevent constipation.
- Maintaining a healthy weight as excess weight puts pressure on the abdominal muscles.
- Not lifting heavy objects.
- Quitting smoking, which weakens abdominal muscles and increases coughing, causing abdominal wall strain.
- Strengthening abdominal muscles through exercise.
What Are the Signs and Symptoms of Hernias?
Hernia symptoms can vary depending on the type of tissue involved. For instance, a hiatal hernia can lead to heartburn, while an inguinal hernia can cause burning in the groin.
Some of the more common hernia symptoms include:
- A bulge or lump (especially in the abdomen or groin) that you can push back in.
- Pain at the site of the bulge, which gets worse over time.
- Pain with lifting or straining during a bowel movement.
- Swelling in the groin area.
When should I see a doctor about my hernia symptoms?
Seek care right away if you have a hernia and notice any of the following signs of a complication:
- A hernia bulge that you can no longer push back into the abdomen.
- Fever.
- Nausea, vomiting, inability to pass stool, or bloating.
- Redness around the hernia site.
- Sudden or severe pain that is different than your usual pain.
How Do You Diagnose A Hernia?
Doctors diagnose a hernia using the following methods.
A physical exam
During the exam, your doctor will:
- Ask about your symptoms and medical history, such as prior surgeries and chronic conditions.
- Look at and gently touch the skin covering the suspected hernia.
- Likely ask you to stand, cough, or strain certain muscles to see how it affects the hernia.
Imaging tests to diagnose a hernia
A doctor often diagnoses a hernia with a physical exam alone. But if they're unclear on the diagnosis or need more information, they may order an imaging test. An ultrasound or CT scan lets your doctor see your organs and tissues inside the abdomen.
How Do You Treat a Hernia?
If your hernia causes symptoms or poses a risk, the most common treatment is surgery. However, your doctor will work with you on a hernia treatment plan. They'll take the time to explain your treatment options in detail and ask you about any concerns, as well as which option or options you prefer.
Options include:
Nonsurgical options
Watchful waiting
If your hernia isn't causing symptoms, doctors may suggest watching it to make sure it doesn't get worse. A hernia can weaken the abdominal wall and surrounding tissues as it grows larger over time. So, often, doctors suggest surgery when the hernia is small and not painful.
Doctors may also watch a hernia if they want you to make changes to improve your health before surgery. Factors such as losing weight and stopping smoking can help with the surgery's success.
Medicine to treat hernias
Surgery is the only cure for hernias; however, the symptoms of some hernias can be managed through medication.
Symptoms from hiatal hernias can often be managed through medications, such as:
- Antacids.
- H-2 blockers.
- Proton pump inhibitors (PPIs) to reduce stomach acid.
Other things that can provide temporary relief for the pain caused by hernias include:
- Acetaminophen (Tylenol).
- Ibuprofen (Motrin).
- Ice packs.
- Hernia support belts.
Surgical options
Open hernia surgery
During open surgery, the surgeon makes a single cut and pushes the hernia back into place. Then, they close the tissue or muscle with stitches.
They may also use surgical mesh to repair a hernia. This mesh can be synthetic (medical-grade plastic) or biologic (derived from animal or donated human tissue). Mesh reduces the risk of hernias coming back in most people.
Minimally invasive hernia repair
In minimally invasive surgery, the surgeon makes smaller cuts and passes the tools through a thin tube. The tube features a light and a video camera, allowing them to see what they're doing.
The surgeon pushes in the herniated tissue and uses stitches and surgical mesh to strengthen the muscle or fascia.
