What Is a Hernia? Types, Symptoms, and Treatment

Health Line

2 days ago

Hernias typically result from muscle weakness and strain. Depending on the severity, doctors may suggest watchful waiting or surgery to repair the hernia.
A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. For example, the intestines may break through a weakened area in the abdominal wall.
Many hernias occur in the abdomen between your chest and hips, but can also appear in the upper thigh and groin areas.
Most hernias aren't immediately life threatening, but they don't go away on their own. Sometimes they can require surgery to prevent dangerous complications.
Types of hernia
There are several different types of hernias. Keep reading to learn some of the most common types.
Inguinal hernia
Inguinal hernias are the most common type of hernia. They occur when the intestines push through a weak spot or tear in the lower abdominal wall, often in the inguinal canal.
The inguinal canal is located in your groin. In males, it's the area where the spermatic cord passes from the abdomen to the scrotum. This cord attaches to the testicles. In females, the inguinal canal contains a ligament (called the round ligament) that helps hold the uterus in place.
Inguinal hernias are more common in males because the testicles descend through the inguinal canal shortly after birth. The canal is supposed to close almost completely behind them. Sometimes the canal doesn't close properly, leaving a weakened area. However, inguinal hernias can also occur in females.
Doctors may repair these hernias surgically.
»Learn more: Inguinal hernias
Hiatal hernia
A hiatal hernia occurs when part of your stomach protrudes through the diaphragm into your chest cavity. The diaphragm is a sheet of muscle that helps you breathe by contracting and drawing air into the lungs. It separates the organs in your abdomen from those in your chest.
This type of hernia is most common in people over 50. If a child has the condition, it typically results from a congenital birth irregularity.
Hiatal hernias almost always cause gastroesophageal reflux disease (GERD). In GERD, the stomach contents leak backward into the esophagus, causing a burning sensation. Doctors may recommend following a specific diet, taking care when exercising, and surgical repair for some people.
»Learn more: Hiatal hernias
Umbilical hernia
Umbilical hernias can affect children and babies. They occur when the intestines bulge through the abdominal wall near the belly button. You may notice a bulge in or near your child's belly button, especially when crying.
An umbilical hernia is the only kind that often goes away as the abdominal wall muscles get stronger. This typically happens when the child is 1 or 2 years old. If the hernia hasn't gone away by 5 years of age, doctors may perform surgery to correct it.
Adults can also have umbilical hernias. They can occur from repeated strain on the abdomen due to conditions such as obesity, fluid in the abdomen (ascites), or pregnancy.
»Learn more: Umbilical hernias
Ventral hernia
A ventral hernia happens when tissue bulges through an opening in the muscles of your abdomen. You may notice that a ventral hernia decreases in size when lying down.
Although a ventral hernia can be present from birth, acquiring one at some point during your lifetime is more common. Common factors in ventral hernia formation include:
obesity
pregnancy
strenuous activity
Ventral hernias can also occur at the site of a surgical incision. This is called an incisional hernia and can result from surgical scarring or weakness of the abdominal muscles at the surgical site.
They generally require surgery to repair, as complications like hernia strangulation are possible if they're left untreated.
»Learn more: Ventral hernias
Hernia causes
Hernias result from a combination of muscle weakness and strain. Depending on its cause, a hernia can develop quickly or slowly over time.
Common causes of muscle weakness or strain that can lead to a hernia include:
a congenital condition, which occurs during development in the womb and is present from birth
aging
damage from an injury or surgery
strenuous exercise or lifting heavy weights
chronic coughing or chronic obstructive pulmonary disorder (COPD)
pregnancy, especially having multiple pregnancies
constipation, which causes you to strain when having a bowel movement
being overweight or having obesity
ascites, which can develop if the liver stops working as it should
Certain risk factors make you more likely to develop a hernia. They include:
being born prematurely or having a low birth weight
being over 50
chronic cough (likely due to the repetitive increase in abdominal pressure)
cystic fibrosis
pregnancy
chronic constipation
being overweight or having obesity
smoking, which leads to the weakening of connective tissue
a personal or family history of hernias
Hernia diagnosis
To diagnose your condition, a doctor will first perform a physical examination. During this examination, the doctor may feel for a bulge in your abdominal or groin area that gets larger when you stand, cough, or strain.
Your doctor will then take your medical history. They may ask you a variety of questions, including:
When did you first notice the bulge?
Have you experienced any other symptoms?
Do you think something in particular may have caused it to occur?
Tell me a little bit about your lifestyle. Does your occupation involve heavy lifting? Do you exercise rigorously? Do you lift weights professionally or recreationally? Do you have a history of smoking?
Do you have a personal or family history of hernias?
Have you had any surgeries in your abdominal or groin area?
Your doctor will also likely use imaging tests to aid in their diagnosis. These can include:
Abdominal ultrasound: An abdominal ultrasound uses high-frequency sound waves to create an image of the structures inside the body.
Abdominal CT scan: An abdominal CT scan combines X-rays with computer technology to produce an image.
Abdominal MRI scan: An abdominal MRI scan uses a combination of strong magnets and radio waves to create an image.
If your doctor suspects a hiatal hernia, they may use other tests that allow them to assess the inside of your stomach:
X-rays of your digestive tract: A healthcare professional will have you drink a liquid containing diatrizoate meglumine/diatrizoate sodium (Gastrografin) or a liquid barium solution (barium swallow). These liquids help your digestive tract appear highlighted on X-ray images.
Endoscopy: During an endoscopy, a healthcare professional threads a small camera attached to a tube down your throat and into your esophagus and stomach.
Hernia treatment
The only way to effectively treat a hernia is through surgical repair. However, some people may not require surgery for treatment. Whether or not you need surgery depends on the size of your hernia and the severity of your symptoms.
Your doctor may want to monitor your hernia for possible complications. This approach is called watchful waiting.
In some cases, wearing a truss, a supportive undergarment that helps to hold the hernia in place, may help to ease the symptoms of a hernia. Always see your doctor to ensure a truss fits properly before using it.
If you have a hiatal hernia, over-the-counter (OTC) and prescription medications that reduce stomach acid can relieve your discomfort and improve symptoms. These include:
Home remedies for hernia
Home remedies won't cure a hernia, but you can take steps to help ease your symptoms.
Increasing your fiber intake may help relieve constipation. Constipation can cause straining during bowel movements, which can aggravate a hernia. High fiber foods include whole grains, fruits, and vegetables.
Dietary changes can also help with the symptoms of a hiatal hernia. Some things that may help include:
avoiding large or heavy meals
not lying down or bending over after a meal
maintaining a moderate body weight
avoiding foods that may cause acid reflux, such as spicy foods and tomato-based foods.
Additionally, if you smoke, giving up cigarettes may also help.
Hernia exercises
Exercise may work to strengthen muscles around the hernia and promote weight loss, helping reduce some symptoms.
A 2024 study investigated the effects of an exercise program on people undergoing hernia repair surgery. The people who completed the exercise program had fewer complications following surgery.
Remember that some types of exercise, such as weightlifting or exercises that strain the abdomen, may increase pressure in the area of the hernia, which may cause the hernia to bulge more. The same is true for exercises that are done improperly.
If you have a hernia, discussing exercise with a doctor or physical therapist is best. They can work closely with you to let you know which exercises are best for you and how to exercise safely with a hernia.
Hernia repair surgery
If your hernia is growing or causing pain, a surgeon may decide it's best to operate.
If the hernia causes an extra hole in your abdominal wall, your surgeon may repair it by sewing the hole closed during surgery. This is commonly done by patching the hole with surgical mesh.
Sometimes, a hernia results in one of the body's passageways opening even wider than it should. This can occur in the space where the esophagus is meant to pass through the diaphragm. In these cases, surgery can be performed to tighten the opening.
Doctors can repair hernias with either open or laparoscopic surgery, depending on your specific circumstances.
Open surgery for hernias
During open surgery, the surgeon makes an incision close to the site of the hernia and then pushes the bulging tissue back into the abdomen. They then sew the area shut, sometimes reinforcing it with surgical mesh. Finally, they close the incision.
Laparoscopic surgery for hernias
Laparoscopic surgery uses a tiny camera and miniaturized surgical equipment to repair the hernia. It only requires a few small incisions and is less damaging to the surrounding tissue.
Not all hernias are suitable for laparoscopic surgery. If your hernia requires an open surgical repair, your surgeon will work with you to determine which technique is best for your condition.
Recovery from surgery
After your surgery, you may experience pain around the surgical site. A surgeon typically prescribes medication to help ease this discomfort while you recover.
Be sure to carefully follow your surgeon's instructions involving wound care and contact them promptly if you notice any symptoms of infection, such as:
fever
discoloration or drainage at the site
pain that suddenly worsens
Following hernia repair, you may be unable to move around normally for several weeks. You'll need to avoid any strenuous activity. Additionally, you should avoid lifting objects heavier than 10 pounds (4.5 kilograms) during this period. This is slightly more than the weight of a gallon of milk. Your surgeon can tell you how long you should follow lift restrictions. They may recommend a gradual return to activity.
Open surgery often requires a longer recovery process than laparoscopic surgery. Your surgeon will let you know when you can return to your typical routine.
Hernia recovery
It's important to recognize the symptoms of a hernia and to see a doctor if you suspect that you have one.
An untreated hernia won't go away by itself, and sometimes, hernias can cause complications that are life threatening. A doctor can assess your hernia and determine the best treatment option.
Early medical care and lifestyle changes can minimize symptoms. However, surgery is the only way to resolve a hernia. There are different types of hernia repair surgeries, and a surgeon can advise on which is right for your condition.
The outlook for people who undergo hernia repair surgery is generally very good. However, it can depend on the nature of the hernia, your symptoms, and your overall health. In some cases, the hernia may recur after repair surgery.
Hernia in babies
Between 10 and 25% of babies are born with an umbilical hernia. This type of hernia is also more common in babies who are born prematurely or with a low birth weight.
Umbilical hernias occur near the belly button. They form when the muscles surrounding the hole left by the umbilical cord don't close properly. This causes a portion of the intestine to bulge out.
If your child has an umbilical hernia, you may notice it more when crying or coughing. Umbilical hernias in children are typically painless. However, some symptoms need emergency medical attention. These include:
pain
vomiting
swelling at the hernia site
It's best to talk with your child's pediatrician if you notice they have an umbilical hernia.
Umbilical hernias typically disappear when a child is 1 or 2 years old. If they don't disappear by age 5, doctors may recommend surgery to repair them.
Pregnancy and hernia
If you're pregnant and think that you have a hernia, be sure to talk with a doctor. They can evaluate it and determine if it poses any health risks.
Often, hernia repair can wait until after delivery. If a small hernia that's present before or during the pregnancy begins to get larger or cause discomfort, a doctor may recommend surgery to repair it. Experts generally recommend having this surgery during the second trimester.
Hernias repaired in the past may return with later pregnancies. This is because pregnancy strains abdominal muscle tissue that may have been weakened by surgery.
Hernias can also occur following a cesarean delivery (C-section). During a cesarean delivery, a doctor makes an incision into the abdomen and uterus. The baby is then delivered through these incisions.
An incisional hernia can sometimes occur at the site of a cesarean delivery.
Hernia complications
Sometimes an untreated hernia can lead to potentially serious complications.
Your hernia may grow and cause more symptoms. It may also put too much pressure on nearby tissues, which can cause swelling and pain in the surrounding area.
Bowel obstruction
A portion of your intestine could also become trapped in the abdominal wall. This is called incarceration. Incarceration can obstruct your bowel and cause severe pain, nausea, or constipation. A bowel obstruction can become life threatening and requires immediate medical care.
Hernia strangulation
If the trapped section of your intestines doesn't get enough blood flow, strangulation occurs. This can cause the intestinal tissue to become infected or die. A strangulated hernia is life threatening and requires immediate medical care.
Hernia prevention
You can't always prevent a hernia from developing. Sometimes a hernia occurs because of an existing inherited condition or a previous surgery.
However, you can make some simple lifestyle adjustments to help lower your risk of a hernia. These steps aim to reduce the strain on your body.
Here are a few general prevention tips:
Avoid lifting weights that are too heavy for you. If you must lift something heavy, bend at your knees, not your waist or back. Also, avoid holding your breath when lifting heavy objects. Instead, exhale during the lift to decrease the chance of a hiatal hernia developing or worsening.
Perform exercises that help to strengthen the muscles of your abdomen.
Get medicare care when you're sick to avoid developing a persistent cough.
Maintain a moderate body weight.
Try not to strain while having a bowel movement or during urination.
Eat enough high fiber foods to prevent constipation.
If you smoke, consider quitting. You can work with your doctor to create a smoking cessation plan that's right for you.
The bottom line
A hernia develops when an organ, like an intestine, pushes through an opening in the muscle or tissue that holds it in place. There are many types of hernias.
Hernias typically cause a visible bulge in the abdomen that's more visible when standing. Some people may also develop additional symptoms, such as acid reflux, depending on the type of hernia they have.
There is no way to resolve a hernia without surgery. However, surgery isn't always needed, especially for mild hernias. A doctor may instead recommend watchful waiting, which involves monitoring the hernia and only treating it with surgery if it worsens.