Hernia (inguinal, femoral, umbilical or incisional hernia)

Overview

A hernia or “breach” occurs when part of an organ (e.g. small intestine) is displaced and squeezes through a weak spot in the abdominal wall to make a bulge under the skin. The hernia is visible as a bulge that can often easily be pushed back into the abdominal cavity. If it suddenly becomes very painful, however, a doctor should be consulted immediately.

Symptoms

Main symptoms

• Twinges or shooting pains at the gap where the hernia pokes through (hernial opening)
• Possible locations: Inguinal hernia (groin hernia, more common for men), femoral hernia (similar location, more common for women), umbilical hernia (belly button) or incisional hernia (old stomach wound)
• The bulge can be permanent or may only appear when standing or straining (e.g. coughing)
• The bulge can often be pushed back by hand, or disappears on its own when lying down
• In men, the breach can sometimes descend into the scrotum (scrotal hernia)

Complication

• If the contents of the hernia become trapped (incarcerated), the bulge can no longer be pushed back into place and the blood flow to the hernia is cut off
  • Extremely painful, red hernia bulge of firm elastic consistency, dough-like swelling
  • If it’s not treated, part of the intestinal tissue can die and cause life-threatening blood poisoning

Causes and treatment

Causes

Breaches of the abdominal wall occur when the muscles weaken slowly until a gap is formed (hernial opening). This usually happens if there is increased pressure on the abdominal wall, which happens in the following situations, among others:

• Chronic constipation
• Obesity
• Chronic coughing
• Hard physical labour
• Pregnancy

Weak spots in the abdominal wall that allow hernias to form are often congenital.

Further treatment by your doctor / in hospital

A hernia can often be diagnosed by careful visual inspection and a physical examination.

Possible tests

• Ultrasound (sonography)

Possible therapies

• Treatment of the cause (e.g. obesity, chronic constipation, etc.)
• Surgery to close the hernial opening is the only way to fully repair a hernia. This is not always necessary, however (e.g. very small opening)

If there is no pain and the hernia spontaneously glides back into the abdominal cavity or can easily be pushed back in, an operation is not yet warranted. There is always a risk, however, that the situation may change suddenly.

What can I do myself?

• Avoid chronic constipation
• Maintain a normal body weight
• Be careful when engaging in unusually strenuous activities (e.g. lifting heavy loads)

When to see a doctor?

• Babies / children who have hernias
• Very painful hernia
• Hernia increases in size
• If the hernia can't be pushed back in

Synonyms

hernia, breach, groin hernia, bellybutton hernia, inguinal hernia, umbilical hernia, abdominal wall hernia, incisional hernia