Hernia 

Introduction  

Hernia: animation

This animation explains how a hernia occurs and the procedures used to treat it

Media last reviewed: 14/11/2013

Next review due: 14/11/2015

Illustration of an inguinal hernia

 

  1. Inguinal ligament
  2. Bowel
  3. Inguinal hernia

 

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A hernia is where an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall.

The muscles are usually strong enough to keep the organs in place. However, a weakness may cause a hernia to occur.

Types of hernia

Hernias can occur anywhere in your abdomen (the area of your body between your chest and hips).

There are several different types of hernia, which are described below.

  • Inguinal hernias – occur when part of your bowel pokes through your lower abdomen into your groin.
  • Femoral hernias – occur when fatty tissue or a part of your bowel pokes through into your groin, at the top of your inner thigh.
  • Incisional hernias – occur when tissue pokes through a surgical wound in your abdomen that has not fully healed.
  • Umbilical hernias – occur when fatty tissue or a part of your bowel pokes through your abdomen near your navel (belly button).
  • Hiatus hernias – occur when part of your stomach pushes up into your chest by squeezing through an opening in the diaphragm (the thin sheet of muscle that separates the chest from the abdomen).
  • Epigastric hernias – occur when fatty tissue pokes through your abdomen, between your navel and the lower part of your sternum (breastbone).
  • Spigelian hernias – occur when part of your bowel pokes through your abdomen at the side of your abdominal muscle, below your navel.
  • Muscle hernias – occur when part of a muscle pokes through your abdomen; muscle hernias can also occur in leg muscles as the result of a sports injury.

How common are hernias?

Different types of hernia tend to affect different groups of people. About three-quarters of all abdominal hernias are inguinal hernias.

Inguinal hernias

Inguinal hernias are the most common type of hernia, and account for three out of four hernia cases.

About 1 in 4 men and 3 in every 100 women will have an inguinal hernia at some point during their lifetime.

In England, during 2010-11, just under 71,000 surgical operations were carried out to repair inguinal hernias.

Risk factors for inguinal hernias include:

  • sex – they are more common in men than in women 
  • age – your risk of developing one increases as you get older
  • being obese – having a body mass index (BMI) of 30 or over
  • doing lots of heavy lifting
  • having a long-term cough
  • having long-term constipation (an inability to empty your bowels)

Femoral hernias

Femoral hernias are less common than inguinal hernias, with around 3,500 femoral repair operations carried out in England during 2010-11.

Femoral hernias are about four times more common in women than men, and can affect women of any age. Apart from sex and age, femoral hernias have similar risk factors to inguinal hernias.

Incisional hernias

Incisional hernias can develop as a complication of abdominal surgery. The risk of an incisional hernia developing after surgery will vary depending on the type of surgery involved.

Umbilical hernias

Umbilical hernias are very common in infants, particularly in black infants. The reasons why they tend to affect black infants more are unclear.

In 9 out of 10 cases, an umbilical hernia will get better without treatment as a child gets older.

Hiatus hernias

Hiatus hernias are common, affecting up to 1 in 10 people.

They do not always cause symptoms, although in some people they can cause heartburn (pain or discomfort in the chest that usually occurs after eating).

Assessing and treating hernias

A hernia will often be assessed using an ultrasound scan, which uses high-frequency sound waves to create an image of part of the inside of the body.

In many cases, hernias cause no (or very few) symptoms. However, there is a chance that a hernia could:

  • cause an obstruction in the bowel
  • interrupt the blood supply to the herniated tissue (known as a strangulated hernia)

Both are medical emergencies. If they occur, you should go immediately to the accident and emergency (A&E) department of your nearest hospital.

Due to potential risks associated with these complications, surgery to repair a hernia is usually recommended.

The exceptions to this are umbilical hernias, which usually get better on their own, and hiatus hernias, which are sometimes initially treated with medication. In some cases, surgery is also needed for hiatus hernias.

Read more about treating hiatus hernias

Surgery

If you have a hernia, whether or not you will need surgery will depend on:

  • where the hernia is located – femoral hernias and hernias in the groin are more likely to require surgery; abdominal hernias less likely
  • your symptoms – some hernias may not cause symptoms, others may be painful
  • the content of your hernia – the hernia may consist of part of your bowel, muscle or other tissue

If you need surgery, your surgeon will explain the benefits and risks of the procedure to you in detail.

Page last reviewed: 02/07/2012

Next review due: 02/07/2014

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Comments

The 10 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Jamesfl said on 15 April 2014

I need some advise I have a Inguinal hernia I have had it for a about a year I have no pain at all. It is small but when Woking lifting Heavy items it get really big. But it is small when I am not doing anything. Can someone give me some advise on what to do I am 19 years old and I am male.

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Katie72 said on 16 March 2014

I had an operation for a large tumor in the abdomen 6 weeks ago, I ended up with an adhesion hernia. Three weeks ago I had another operation. I have been having pain especially if I try to lay on my left side or getting in and out of a chair. its like a dragging pain and sometimes excruiating. I have tried to hang on until I see the consultant again on the 18th March. I am now wondering whether I have a strangulated hernia. Really worried about having another operation so soon. You are now only kept in hospital for 1 day. I did phone the hospital but was told it would be painful for a while but this is 3 weeks and swelling has appeared..

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risylee said on 18 September 2013

i had surgery for an inguinal hernia 6 weeks ago and would anyone to be very careful. I now have constant pain. My hospital did this in a day and sent me home with no follow up appointment. The consultant gave me little detailed information. For example they tell you that 10% of people get constant pain, and advise you to have the operation, in case it gets 'stangulated'. I had no pain with my hernia and was not told what the chances were of it becoming strangulated. I now have a hard painful lump which radiates to my hip, whereas before I had no pain. I have many further criticisms of this hospital. For example they publish statistics showing very good outcomes for hernia surgery, but as they do not give follow up appointments how do they know? I would advise everyone to question doctors about every aspect of this surgery.

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melmer07 said on 28 June 2013

I noticed a lump in my left groin area and had been getting some pain in that region for over 6 months but the lump was a new thing.
It got that when I was walking the pain would get really intense and I literally had to stop walking and sit down to get relief.
The lump was getting bigger and pain more frequent.
I went to my GP who instantly said it was a hernia and the lump was part of my bowel sticking out.
I was given no advice at all but told it would mean an operation and refered to Hospital.
Got an appointment about 2 months later and consultant confirmed it would need operated on as there was a fair sized bit of my bowel or sack as he described it sticking our and the lump was just a small piece of it.
It will mean an epidural due to lung problems .
Can't say I am looking forward to it but I have no choice as it is causing problems with everyday life and the pain can be horrendous at times.
Should have went to GP sooner!

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lopezuk said on 16 April 2013

i just went to my doctor today,she says i have a hernia,its right above,almost in my belly button. Its a lump about the size of a ping pong ball,the doctor said just to monitor it,and if i get pain or constipation,to get to the surgery.
first she said i would need an ultrasound scan,then said,i cant have one, the lump appeared about 2 weeks ago,and was tender and bigger.a bit sore.the doctor said that they dont operate anymore on hernias because they come back out again usually. so it wouldnt be worth it. ( or is it about saving money) so thats how shes left me ,and i dont think its the correct diagnosis to tell the truth,im not sure,never had anything wrong with me before,like this.i didnt even know what a hernia was.

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eve70 said on 12 October 2012

I have gone back to a different doctor this time i took a photo with me showing when the lump comes up ,now i am being referred so i am nervous but happy

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eve70 said on 05 September 2012

i went to the doctors about a lump in my groin said how it seems to come up when i lie on my belly then turn over she explained to me it was muscle and showed as i was low weight I took a photo of it the other day and showed it to my mum she also thinks it is a hernia ,it seems to come up all of a sudden when i lie on my back i can see it rise it causes me pain but reluctant to go to drs again i think it is a inguinal hernia ,i have had to in the past lift heavy objects i am a carer i wonder if there are any tips to prevent it going worse

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Flopsy12 said on 09 June 2012

To User369800
Go back to your GP and insist that something is done, politely but firmly. Keep checking up on your GP until the surgery is arranged. Don't be put off. You owe it to yourself to do this, you only get one life!! 67 is NOT that old these days! Good luck.

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Rwthless said on 22 May 2012

I had a hemicolectomy in September 2007 for bowel cancer. Nobody warned me about heavy lifting after the wound healed. I had chemotherapy beginning November 2007, and was afraid I would become very thin so ate well at the beginning. Although I gained weight, nobody offered me a corset, or said anything about the danger of a hernia. By the end of the first year, the hernia had happened and now I have no offers of surgery to correct it. It is reasonably stable, but not very pretty. It makes me feel old and tired. Even though I am old and tired (67) I should have some quality of life.

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mike1953blue said on 24 September 2011

I recently visited my GP with regard to hip problems. They decided to examine me for hernia. The GP discovered a palpable thrill in the left groin and told me to keep an eye on it for the next month. She sent me for an X-Ray on my left hip and I am currently awaiting the result.
Should I suggest on my next visit that they refer me to the surgeon with regard to the hernia?

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