You Wanted to Know: Hernias

Young woman in pain

Hernias, which occur when fatty tissue or an organ protrudes through the body wall that normally contains it, are one of the oldest recorded human maladies. Groin hernias are estimated to affect 5 to 10% of all Americans and are the third leading cause of outpatient doctors’ visits for gastrointestinal complaints.

Rachel asked us about the symptoms of a hernia on Twitter:

hernia

There are multiple types of hernias depending where and how they occur. Inguinal and femoral hernias occur in the groin, while umbilical hernias occur around the belly button and hiatal hernias occur when part of the stomach protrudes into the chest cavity. Incisional hernias can occur at the site of a surgical incision.

Of these, groin hernias are the most common, and inguinal hernias make up about 96% of all groin hernias. Men are about eight times more likely to get a hernia and 20 times more likely to require surgical repair compared to women. Approximately one in four men will develop a groin hernia in his lifetime, compared to fewer than one in 20 women. Other risk factors include older age, family history of hernia, smoking and being white. Conditions that chronically increase abdominal pressure such as chronic cough or constipation may also raise hernia risk.

Symptoms of an inguinal hernia include:

  • A sensation of heaviness, fullness or dull discomfort in the groin, particularly if it worsens when abdominal pressure is increased, as with heavy lifting, coughing, straining, or long periods of standing. The infamous “turn your head and cough” exam for men looks for hernias that may protrude into the scrotal sac during coughing.
  • Swelling or a bulge that can be seen or felt in the groin or scrotum. This is more commonly seen on the right side than the left.
  • Moderate to severe pain may occur and can be a sign of a potentially life-threatening condition called strangulation. If the hernia becomes trapped, it may swell and limit blood flow to the strangulated tissue. The organ or tissue that forms the hernia may begin to die, which can lead to nausea, vomiting, fever, rapid heart rate and even death if treatment is not sought quickly.

Some hernias are asymptomatic. If you think you could have a hernia, be sure to consult your doctor. History and physical exam are usually sufficient to diagnose a hernia, but scans such as ultrasounds, CTs or MRIs may also be used. If you have a hernia and experience the sudden onset of pain, nausea or vomiting, seek emergency help immediately.