It’s important to catch a hernia before it causes problems. These signs will help you know what to look for.
Hernias are pretty common: Researchers estimate that about 27% of men will develop a hernia in their groin at some point in their lives. For women, that figure is about 3%.
A hernia occurs when part of a tissue or internal organ, such as the intestine, pushes through a weak spot, or hole, in the muscle and tissue that surround it. Basically, what’s supposed to be inside your body is now poking toward the outside, and you can feel and see a bulge beneath the skin.
“There are several different types of hernias, but the two most common types are ventral hernias and inguinal hernias,” says Nikolai A. Bildzukewicz, MD, a surgeon at Keck Medicine of USC and clinical associate professor of surgery at the Keck School of Medicine of USC. “Inguinal hernias, which are the most common, occur in either the left or right groin, whereas ventral hernias occur in the wall of the abdomen. When ventral hernias happen at the site of a previous surgical procedure or scar, they’re called incisional hernias.”
Other types of hernias include hiatal, where part of the stomach moves up into the chest through a small opening in the diaphragm; umbilical, which occurs around the belly button; and congenital diaphragmatic, which is a rare birth defect that frequently requires surgery.
Anyone can develop a hernia. It’s thought that a combination of weak muscles and straining, such as when lifting a heavy object, may contribute to their development. “Risk factors for a hernia also include increasing age, male sex, smoking and a chronic cough and/or constipation,” Bildzukewicz adds.
If any of the following symptoms sound familiar, it might be a good idea to be evaluated for a hernia.
Sign #1: There’s a bulge in your abdomen or groin.
The first sign of a hernia is the hernia itself — that is, the bulge created by the tissue or organ. You might not even notice it, until you do something that increases the pressure within your abdomen, such as coughing, jumping, standing up or straining.
Sign #2: You have soreness or pain.
Bulges are typically associated with mild discomfort that can be exacerbated by coughing, straining or strenuous physical activity, according to Bildzukewicz. But that’s not always the case. “Your bulge can sometimes be completely asymptomatic,” he says.
Sign #3: You feel nauseated and may be constipated.
A hernia can progress to the point of strangulation, meaning the section of the organ or tissue protruding through the hole gets stuck, and its blood supply is cut off. At this point, you may experience more severe symptoms, such as worsening pain accompanied by nausea and vomiting or the inability to move your bowels or pass gas. A strangulated hernia will quickly become life-threatening, requiring emergency surgery.
What should you do, if you think you have a hernia?
Visit your doctor, who will do a physical exam. Bildzukewicz explains that you’ll be examined while both standing and lying down and will be asked to bear down or strain, which tenses the abdominal wall and should make the bulge appear. If the hernia is not detected in the physical exam, imaging with a focused ultrasound or CT scan will often make the diagnosis.
“If the hernia is causing minimal or no symptoms, you can consider elective surgical repair,” he says, “but if you’d like to avoid surgery, a hernia may be observed with close clinical follow-up (watchful waiting). However, surgery is generally warranted, if there are significant symptoms.”