What to know about an inguinal hernia
An inguinal hernia occurs when part of the intestine or fatty tissue pokes through a weakened area of the abdominal wall to either side of the inguinal canal. The inguinal canal is a passage that occurs on each side of the lower abdomen and connects to the genitals.
When part of the intestine sticks through the abdominal wall, it creates a bulge. In males, this occurs most often near the groin area on one or both sides.
An inguinal hernia may be direct or indirect. A direct inguinal hernia forms slowly over time due to a weakened abdominal wall. Direct inguinal hernias usually only happen to male adults. This can happen due to aging or excess strain on the abdominal muscles.
An indirect inguinal hernia is present from birth due to a problem with the abdominal wall. Indirect inguinal hernias are more common in males but can occur in females as well.
Treatment for inguinal hernias often involves surgery. One estimate suggests doctors perform more than 800,000 surgeries to repair inguinal hernias, making this one of the most common surgical procedures in the United States.
In this article, we discuss inguinal hernias, their symptoms, causes, and treatment options.
Symptoms of an inguinal hernia may not appear at first. One of the first symptoms may be the feeling of heaviness or pressure on the groin. Other symptoms may occur as the hernia grows larger.
Some of the symptoms of an inguinal hernia may include:
- small bulge to one or both sides of the groin that may disappear on lying down
- the scrotum may appear enlarged in males
- pressure or heaviness in the groin
- weakness in the groin
- pain, burning, or gurgling at the bulge site
- sharp pain or discomfort that increases when lifting, coughing, bending, or exercising
There is a risk that part of the intestine may become trapped in the abdominal wall, which can cause a loss of blood flow to this section of the intestine.
This condition is an incarcerated hernia and typically causes severe pain, fever, and an increased heart rate.
If the blood supply to the intestine does not resume quickly, the part of the intestine that is protruding may die. Someone with an incarcerated hernia requires immediate medical attention.
Several potential risk factors can make a person more susceptible to having an inguinal hernia. One potential cause or risk factor is a weakness in the abdominal wall. Pressure on the weakened spot can cause the inguinal hernia to occur.
Some other risk factors include:
A person should see their doctor if they notice a bump appear in the groin area, particularly if it is painful. Typically, a doctor will ask questions related to the bump, including:
- How long has it been there?
- Is it painful?
- Has it grown in size?
The doctor will likely do a physical examination of the area. They will feel the bump and get an idea of its size. A doctor may ask for the person to cough to better see and feel the bump.
A doctor may push the hernia back into place temporarily using gentle pressure.
In other cases, a doctor may need to confirm the bump is due to an inguinal hernia. A doctor may use an ultrasound, X-ray, or CT scan of the area to rule out other conditions and check for a hernia.
Surgery is the primary option for fixing an inguinal hernia. In some cases, a doctor may not recommend surgery immediately if there are no symptoms, and they can push the hernia back into place.
Otherwise, there are two surgical options:
- Open surgery: The surgeon creates a large incision in the abdomen, pushes the intestine into the proper place, and uses stitches to reinforce the abdominal wall.
- Laparoscopic surgery: The surgeon uses multiple incisions to inject gas into the abdominal cavity. They then use an instrument called a laparoscope to examine the area and move the intestine back into place. A laparoscope is a small tube with a light and camera at one end. A surgeon will then use surgical staples or stitches to seal the incisions.
A surgeon will perform both surgeries in a hospital setting. Both procedures require local or general anesthesia and some recovery time.
Laparoscopic surgery usually has shorter recovery times than open surgery, although the chance of recurrence is higher. A person should discuss the surgical options with their doctor before deciding which procedure to pursue.
Although inguinal hernias do not heal by themselves, not all inguinal hernias need surgical treatment. In some cases, a doctor may be able to massage the inguinal hernia back into place.
If people have an incarcerated hernia, which means it is stuck outside of the abdominal wall, they will require surgery. People will also require surgery if a hernia grows in size or causes symptoms.
In some rare cases, people may need to wear a truss as a long term solution. A truss is a padded support belt that applies pressure to keep the hernia in place.
Otherwise, the treatment for inguinal hernias is one form of surgery or the other.
There are some steps a person can take to reduce the risks of experiencing an inguinal hernia. Some preventative methods include:
- avoiding the lifting of heavy objects
- maintaining a healthy weight
- avoiding smoking
- eating plenty of fiber
People who have had surgery to repair a previous inguinal hernia should take extra care, as there is a higher chance that they will develop a hernia again in the future.
A person should see their doctor for an inguinal hernia if:
- the bump grows in size
- they have sharp pain
- they have a persistent feeling of heaviness
- the area is tender to touch
- the condition occurs in a child or infant
People with an inguinal hernia have a high chance of full recovery after a surgical procedure to correct the condition. However, they are at greater risk for developing a hernia again in the future.
Following surgery, people should avoid strenuous exercise and heavy lifting to reduce the chances of a hernia returning.
In most cases, doctors can easily correct inguinal hernias. If people experience severe pain, nausea, or fever with a hernia, they should seek immediate medical attention.