A hernia is a gap in the tissue that supports muscles, typically occurring when the abdominal wall weakens, leading to a bulge. Similar to an inner tube pushing through a damaged tire, the inner lining of the abdomen can push through this weakened area, forming a sac. This can allow intestine or abdominal tissue to protrude, causing discomfort, severe pain, or other serious issues that may require emergency surgery. Hernias can affect both men and women, and they may occur in children as well. They can be present at birth (congenital) or develop over time.
Inguinal and Femoral Hernias
Inguinal and femoral hernias can result from weakened muscles present since birth or due to aging and repeated strains on the abdominal and groin areas. This strain can be caused by physical exertion, obesity, pregnancy, frequent coughing, or straining during bowel movements. Adults may develop an umbilical hernia from straining the abdominal area, being overweight, experiencing a long-lasting heavy cough, or after giving birth. The cause of hiatal hernias is not fully understood, but it may involve a weakening of the diaphragm with age or pressure on the abdomen.
Common Hernia Areas
Hernias commonly occur in the groin (inguinal), belly button (umbilical), and at the site of a previous operation (incisional). Other types include outer groin (femoral) and upper stomach (hiatal). Most hernias are external, causing a visible bulge.
Hernias are typically easy to recognize. They may be detected during a routine physical exam by your doctor. Symptoms can range from sharp, immediate pain to a dull ache that worsens throughout the day. Severe, continuous pain, redness, and tenderness are signs of a potentially serious issue like entrapment or strangulation. If you experience these symptoms, contact your physician or surgeon immediately.
Diagnosis
The most common way to diagnose a hernia is through a history and physical exam by your healthcare provider or surgeon, which can sometimes be done via telehealth. Additional studies like ultrasound or CT scans may be needed to confirm the diagnosis.
While most hernias are not dangerous, some can lead to complications like incarceration or strangulation, especially if the area becomes red, hot, or tender. In such cases, immediate medical attention is necessary. It’s generally advised not to limit activity due to a hernia, but to listen to your body; if an activity causes pain, avoid it. Hernias do not improve over time and typically require surgery for repair. Temporary solutions like abdominal binders or hernia truss belts are available but surgery is often the definitive treatment. When considering surgery, discuss all options with your surgeon, including traditional open procedures and minimally invasive techniques, which offer quicker recovery and less pain.
Recovery
After a minimally invasive or robotic hernia repair, you’ll spend 1-2 hours in the recovery room before going home once you’re awake, walking, and your pain is managed. Expect soreness for the first 24-48 hours. You’re encouraged to resume normal activities gradually, and most patients can do so within a week. Return to work depends on your job and hernia repair; consult your surgeon. Mesh has significantly reduced hernia recurrence but alternatives are available, and your choice will be discussed with your surgeon.
Learn more about mesh hernia repair.
