What is a Hernia?

What is a hernia? 

Your abdominal muscles are normally a firm, solid sheath, which keep your abdominal contents (such as fat and intestines) within your abdomen. There are, however, areas of natural weakness such as in the groin and belly button. In these areas the muscles can split, creating a hole through which the contents of your abdomen can push through. When this occurs, it is called a hernia. 

What causes a hernia? 

You can be born with a hernia, but in most cases, it develops later in life. Certain things increase your risk of developing one, such as chronic coughing, lifting heavy objects, and increased body weight. This is because it puts extra pressure on the muscles, making them more likely to split. 

Are there different hernias? 

Yes, there are many different types of hernia. The two most common ones are inguinal and femoral hernias, which occur near the groin. Another common type of hernia is an umbilical hernia, which is around your belly button. Less common hernias include paraumbilical hernias (below your belly button); epigastric hernia (between your belly button and the lower end of the chest wall), and incisional hernias (at the site of a scar where a previous open surgery was performed). 

How do I know if I have a hernia? 

If you have an inguinal or femoral hernia, you might notice a lump in your groin. This lump can usually be felt when you are standing up but disappear when you lie down. You might also have pain in the groin; and it’s possible to have pain but no lump when you have a hernia. 

If you notice a lump that does not disappear when you lie down, this might suggest your hernia is stuck. If this happens, it could become a medical emergency and may require emergency surgery to avoid the bowel becoming damaged. 

Other types of hernias (such as umbilicus or incisional hernias) can present in a very similar way too. 

How is a hernia diagnosed? 

Hernias are normally diagnosed from a combination of your medical history and a physical examination, looking for lumps and pain in the area. Your doctor will examine you both standing and lying down, and this is usually enough to confirm if it is a hernia. However, in cases where the doctor cannot find a lump, you will need further investigations to get a confirmed diagnosis. 

What investigations or tests might be offered to confirm my hernia diagnosis? 

Depending on your clinical examination, your surgeon may wish for additional confirmation that there is a hernia before they offer you treatment. This could include an ultrasound scan or herniogram (where contrast dye is injected into the area and then looked at via X-Ray to see if you have a hernia).

Do I always need my hernia treated? 

No, sometimes you may have a hernia without any symptoms; if the lump is very small, you may not need to get it fixed. 

What is an obstructed hernia? 

Hernias are caused by a split in the muscle (called a ‘mouth’) through which the contents of your abdomen, such as your bowel, can push through. An obstruction means those contents get stuck and can’t be pushed back through the mouth. The size of mouths can vary, but hernias with small mouths are more likely to become obstructed. 

An obstructed hernia is likely to cause constant pain. Sometimes it can become an emergency as the trapped bowel will be cut off from its blood supply, which can cause peritonitis and needs urgent treatment. 

What does the term ‘reducible hernia’ mean? 

A reducible hernia is one where the lump can be pushed back into the abdomen. If your hernia disappears when you lie down, this means you have a reducible hernia. If the lump can’t be pushed back through the abdomen, or does not disappear, this means you have an irreducible hernia.