How to Know if You Have a Hernia

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In the human body, each organ is held inside a hollow chamber, or "cavity." When an organ sticks out through its cavity, you may suffer from a hernia — a condition that is not usually life-threatening, and can sometimes go away on its own. Usually, hernias happen in the abdomen (anywhere between the chest and hips), with 75%-80% occurring in the groin areas. [1] The chances of getting a hernia increase as you get older, and the surgery to treat it becomes riskier with age. [2] There are several types of hernias, and each requires a specific kind of treatment, so it's important to arm yourself with knowledge.

Part 1
Part 1 of 4:

Recognizing Symptoms

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  1. Although hernias can happen to anyone, certain factors might put you at a higher risk for herniation. These may be chronic conditions, or they may pass with time — for example, if you have a bad cough. Risk factors for hernias include: [3]
    • Increased abdominal pressure
    • Coughing
    • Heavy lifting
    • Constipation
    • Pregnancy
    • Obesity
    • Advancing age
    • Smoking
    • Steroid use
  2. A hernia is an imperfection in the muscular container of an organ. Because of this imperfection, the organ is pushed through an opening, resulting in a hernia. As the organ comes through the opening, it will create a swollen area or bulge in the skin. A hernia often gets bigger when you are standing or when you are straining. The site of the swollen area may vary depending on what kind hernia you have. The terms for different hernia types refer either to the location or the cause of the hernia. [4]
    • Inguinal - These are hernias occurring in the inguinal region (between the hip bone and crotch) or groin.
    • Umbilical - Occur around the belly button
    • Femoral - Occur along the inner thighs
    • Incisional - Occur when incisions from prior surgeries create weak points in an organ's muscular container
    • Diaphragmatic or hiatal - Occur when there's a congenital defect in the diaphragm
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  3. If the hernia affects your intestine, it can change or even block the flow of food through your digestive system. This can cause an intestinal back-up that results in nausea and vomiting. [5] If the intestine is not completely blocked, you may just see milder symptoms, like nausea without vomiting or decreased appetite. [6]
  4. You may experience constipation if you suffer from an inguinal or femoral hernia low in the body. Constipation is, in essence, the exact opposite of vomiting. When the flow of feces is blocked, you may experience constipation -- instead of it all coming out, it stays in. Needless to say, this symptom necessitates immediate surgical intervention. [7]
    • Hernias can be very serious when they interfere with the functions your body needs in order to survive. If you are experiencing any constipation, see your doctor immediately.
  5. Many people with hernias don’t have any complaints of pain or severe or significant noticeable symptoms. But, they may have a feeling of heaviness or fullness in the affected area, especially in the abdomen. You might chalk this up to complaints of bloating. If nothing else, you'll feel keenly aware of your abdominal area, whether it's feeling full, weak, or just has a mysterious pressure. [8] You can relieve the "bloating" from hernias by resting in a reclined position. [9]
  6. Though it's not always present, pain is a sign of hernia — especially if there are complications. Inflammation can cause a burning sensation or sharp pain. Pressure build-up can result in a tearing pain that suggests the hernia is directly touching the muscle walls. Here's how pain affects hernias in different stages:
    • Irreducible hernia: the hernia cannot return to a normal state, but instead gets larger; you may feel occasional pain.
    • Strangulated hernia: the bulging organ is losing its blood supply, and could be dead soon without medical attention. You'll feel significant pain in this case, along with nausea, vomiting, fever, trouble moving your bowels. This condition requires emergency surgery. [10]
    • Hiatal hernia: the stomach bulges out of its cavity, causing chest pains. This also affects the flow of food, causing acid reflux and making it hard to swallow. [11]
    • Untreated hernia: hernias are usually painless and symptomless, but if left untreated, may cause pain and other health problems.
  7. All hernias have the potential to become dangerous. If you suspect you have one, you need to see a doctor for evaluation as soon as possible. He or she will determine whether you actually have one, and also discuss its severity and your treatment options. [12]
    • If you know you have a hernia and feel sudden throbbing or pain in the area, go to the emergency room immediately. The hernia could become "strangulated" and cut off blood supply, which is highly dangerous.
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Part 2
Part 2 of 4:

Understanding Risk Factors

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  1. [13] Men are more likely to develop hernias than women. According to studies, even if a hernia that is present at birth — which is common in newborn babies — most of them are in male babies. The same is true throughout adult life! Men's greater risk can be explained through a hernia's connection to having undescended testicles. This is because a man’s testicles descend through the inguinal canal shortly before birth. A male's inguinal canal — which holds the chords that connect with the testicles — usually closes after birth. In some cases, though, it does not close properly, making hernias more likely.
  2. [14] If you have a family member with a history of having hernia's, you are at a greater risk yourself. Some hereditary disorders affect connective tissues and muscles, and leave you vulnerable to hernia. Keep in mind that this genetic likelihood only applies to hereditary defects. In general, there's no known genetic pattern for hernias. [15]
    • If you have a history of hernias yourself, you're at higher risk of having another one in the future.
  3. Cystic fibrosis (a life-threatening lung condition) fills the lungs with thick mucus plugs. [16] Patients with this condition develop a chronic cough as the body attempts to clear away the mucus plugs. This increased pressure from coughing is a risk factor of having hernias. This kind of cough puts so much pressure and force on your lungs that it damages the muscle walls. Patients feel pain and discomfort when coughing.
    • Smokers are also at high risk for developing a chronic cough, and are also more likely to develop hernias.
  4. Constipation forces you to strain your abdominal muscles when moving your bowels. If you have weak abdominal muscles and are constantly forcing pressure against them, you're more likely to develop a hernia.
    • Weak muscles are caused by poor diet, lack of exercise, and old age.
    • Straining when urinating can also put you at risk of having a hernia. [17]
  5. Growing a baby in your uterus creates a lot of increased pressure inside your abdomen. You're also increasing your abdominal weight, which is a factor of developing hernias. [18]
    • Premature babies are also at risk of hernias because their muscles and tissues have not yet fully developed and strengthened. [19]
    • Genital defects in babies can stress the areas most likely to develop hernias. These include abnormal position of the urethra, fluid in the testicles, and ambiguous genitalia (the baby has genital characteristics of each sex). [20]
  6. Obese or overweight people are more likely to develop hernias. Just like with pregnant women, a larger belly increases abdominal pressure, which can affect weak muscles. [21] If you're overweight, it's advisable to start a weight loss plan now. [22]
    • Beware that large, sudden weight loss from crash dieting weakens the muscles and causes hernias, too. [23] If you lose weight, lose it healthily and gradually.
  7. You are at risk of herniation if your job demands long stretches of standing and a lot of physical strength. Some people vulnerable to work-induced hernias include construction workers, salesmen and women, carpenters, etc. If this describes your current job, talk to your employer. You may be able to arrange a different situation that's less conducive to hernias.
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Part 3
Part 3 of 4:

Identifying Hernia Type

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  1. During a physical examination for a hernia, the doctor should always have you stand up. While the he or she gently probes the swollen area, you'll be asked to cough, strain, or perform a movement to the best of your ability. [24] The doctor will evaluate the flexibility and movement in the area where a hernia is suspected. [25] After assessment, he or she will be able to diagnose whether you have one, and what type of hernia you may have.
  2. [26] This is the most common type of hernia, and happens when the intestines or bladder push the lower abdominal wall into the groin and inguinal canal. In men, this canal holds chords that connect to the testicles, and hernias are usually caused by a natural weakness in the canal. In women, the canal holds ligaments that keep the uterus in place. There are two types of inguinal hernia: direct and, more commonly, indirect. [27]
    • Direct inguinal hernia: Place your finger on the inguinal canal — the crease along the pelvis where it meets the legs. You will feel a bulge that pops out toward the front of the body, and coughing will make the larger.
    • Indirect inguinal hernia: When you touch the inguinal canal, you will feel a bulge going from outside towards the center of your body (lateral to medial). This bulge may also move down towards the scrotum.
  3. Hiatal hernias happen when the upper part of your stomach pushes through the opening of the diaphragm, and into the chest. This type of hernia usually happens in people over 50 years old, though. If a child has a hiatal hernia, it's likely because of a birth defect. [28]
    • The diaphragm is a thin sheet of muscle that helps you breathe. It's also the muscle responsible for separating the organs in the abdomen and in the chest.
    • This kind of hernia causes burning sensations in the stomach, chest pain, and difficulty swallowing
  4. Though they can occur later in life, umbilical hernias commonly occur in newborns or babies less than 6 months old. They happen when intestines push out in the abdominal wall near the belly button or the navel. The bulge is especially noticeable when the child is crying. [29]
    • With umbilical hernias, you will see a bulge at the "umbilicus," or belly button.
    • Umbilical hernias usually go away on their own. But, if it lasts until the child is 5 to 6 years old, is very large or is causing symptoms, the hernia may need surgery. [30]
    • Take note of the size; small umbilical hernias, around half an inch (1.25cm), can go away on their own. Large umbilical hernias require surgery. [31]
  5. The incisions (cuts) performed during surgery take time to heal and scar over properly. It also takes time for the surrounding muscles to regain their strength. If organ tissue pushes out through the incision scar before it's healed, an incisional hernia occurs. It's most common in elderly and overweight patients.
    • Place gentle but firm pressure near the surgical site with your fingers. You should feel a bulge somewhere in the area.
  6. While femoral hernias can happen to both men and women, the vast majority of cases occur in women because of their wider pelvic shape. In the pelvis, there's a canal that carries arteries, veins and nerves into the upper-inner thigh. This canal is normally a tight space, but it often becomes larger if the woman is pregnant or obese. [32] When it stretches out, it becomes weak, and thus vulnerable to potential hernias. [33]
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Part 4
Part 4 of 4:

Getting Treated

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  1. [34] If the hernia's symptoms come on suddenly, the first thing the doctor will do is try to manage your pain. In the case of an incarcerated hernia, the doctor may first try to physically push the hernia back into its original position. This can reduce the acute inflammation and swelling and provide more time to allow for an elective surgical repair. Strangulated hernias need immediate surgery to avoid tissue cell death and organ tissue puncture. [35]
  2. Even if the hernia is not terribly dangerous, your doctor may recommend elective surgery to repair it before it progresses to a more dangerous state. Studies have shown that preemptive elective surgery lower morbidity and mortality significantly. [36]
  3. Depending on the type of hernia and the individual patient, there's a wide range in the likelihood of a hernia recurring. [37]
    • Groin (pediatric): These hernias have a low recurrence rate of <3% after surgical treatment. They can sometimes heal spontaneously on their own in infants.
    • Groin (adult): Depending on the experience level of the surgeon operating on this hernia, the recurrence rate after surgery can be anywhere from 0-10%. [38]
    • Incisional: About 3%-5% of patients will have a hernia recurrence after their first surgery. If the incisional hernias are larger, patients may see rates of up to 20%-60%. [39]
    • Umbilical (pediatric): These types of hernias can usually resolve on their own spontaneously.
    • Umbilical (adult): There is a higher recurrence of umbilical hernias in adults. Usually, a patient can expect up to 11% recurrence rate after surgery. [40]
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      Tips

      • Avoid heavy lifting, severe coughing, or bending over if you think you may have a hernia. [41]
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      Warnings

      • See your doctor immediately if you think you have a hernia. It could quickly turn into a very serious issue. Signs of a strangulated hernia include nausea, vomiting or both, fever, rapid heart rate, sudden pain that quickly intensifies, or a hernia bulge that turns red, purple or dark.
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      • Acute hernia repairs usually carry a lower survival rate and a higher morbidity than elective hernia repair. [42]
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      References

      1. ↑ https://www.uofmhealth.org/conditions-treatments/surgery/groin-hernias
      2. ↑ Domino, F. (n.d.). The 5-minute clinical consult standard 2015 (23rd ed.).
      3. ↑ https://emedicine.medscape.com/article/189563-overview#a5
      4. ↑ https://familydoctor.org/condition/hernia/
      5. ↑ Domino, F. (n.d.). The 5-minute clinical consult standard 2015 (23rd ed.)
      6. ↑ https://familydoctor.org/condition/hernia/
      7. ↑ https://familydoctor.org/condition/hernia/
      8. ↑ https://my.clevelandclinic.org/health/diseases/15757-hernia
      9. ↑ Domino, F. (n.d.). The 5-minute clinical consult standard 2015 (23rd ed.)
      1. ↑ https://www.nhs.uk/conditions/hernia/
      2. ↑ https://my.clevelandclinic.org/health/diseases/8098-hiatal-hernia
      3. ↑ https://www.nhs.uk/conditions/hernia/
      4. ↑ https://www.surgjournal.com/article/S0039-6060%2806%2900300-X/abstract
      5. ↑ Domino, F. (n.d.). The 5-minute clinical consult standard 2015 (23rd ed.).
      6. ↑ https://pubmed.ncbi.nlm.nih.gov/23423330/
      7. ↑ https://www.nhlbi.nih.gov/health-topics/cystic-fibrosis
      8. ↑ http://www.nlm.nih.gov/medlineplus/ency/article/000960.htm
      9. ↑ https://my.clevelandclinic.org/health/diseases/15757-hernia
      10. ↑ Brandt ML. Pediatric hernias. Surg Clin North Am. 2008;88:27–43, vii–viii
      11. ↑ Buch KE, Tabrizian P, Divino CM. Management of hernias in pregnancy. J Am Coll Surg. 2008;207(4):539–542. Epub 2008 Jun 24.
      12. ↑ Domino, F. (n.d.). The 5-minute clinical consult standard 2015 (23rd ed.).
      13. ↑ https://www.helpguide.org/articles/diets/how-to-lose-weight-and-keep-it-off.htm
      14. ↑ http://www.ncbi.nlm.nih.gov/pubmed/21072668
      15. ↑ https://my.clevelandclinic.org/health/diseases/15757-hernia#diagnosis-and-tests
      16. ↑ Domino, F. (n.d.). The 5-minute clinical consult standard 2015 (23rd ed.)
      17. ↑ Domino, F. (n.d.). The 5-minute clinical consult standard 2015 (23rd ed.).
      18. ↑ https://my.clevelandclinic.org/health/diseases/16266-inguinal-hernia
      19. ↑ Domino, F. (n.d.). The 5-minute clinical consult standard 2015 (23rd ed.).
      20. ↑ https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/umbilical-hernia-in-children.aspx
      21. ↑ https://www.nlm.nih.gov/medlineplus/ency/article/002935.htm
      22. ↑ http://emedicine.medscape.com/article/189563-overview
      23. ↑ Buch KE, Tabrizian P, Divino CM. Management of hernias in pregnancy. J Am Coll Surg. 2008;207(4):539–542. Epub 2008 Jun 24.
      24. ↑ http://www.nhs.uk/conditions/hernia/Pages/Introduction.aspx
      25. ↑ Domino, F. (n.d.). The 5-minute clinical consult standard 2015 (23rd ed.).
      26. ↑ https://www.nhs.uk/conditions/hernia/
      27. ↑ Domino, F. (n.d.). The 5-minute clinical consult standard 2015 (23rd ed.).
      28. ↑ Domino, F. (n.d.). The 5-minute clinical consult standard 2015 (23rd ed.).
      29. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2999775/
      30. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6527885/
      31. ↑ https://jamanetwork.com/journals/jamasurgery/fullarticle/2599143
      32. ↑ http://www.nlm.nih.gov/medlineplus/hernia.html
      33. ↑ http://emedicine.medscape.com/article/189563-treatment

      About This Article

      Article Summary X

      To know if you have a hernia, look for any bulges around your groin, belly button, and inner thighs, which are common places for hernias to occur. Depending on the type of hernia you have, you may experience nausea, vomiting, and constipation. You may also develop a feeling of heaviness or fullness in the affected area, as well as a burning sensation or sharp pain. If you suspect you have a hernia, visit your doctor as soon as possible so they can determine the best course of treatment. To learn how to identify the different types of hernias, scroll down!

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        Dec 16, 2017

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