What is inguinal hernia?

Inguinal Hernia

Inguinal hernia: Overview

An inguinal hernia occurs when tissue bulges through a weak spot in your groin area. You may see or feel a tender bulge in the groin or scrotum. You may also have pain, pressure or burning, or a feeling that something has "given way."

Hernias are caused by a weakness in the belly wall. The bulge or discomfort may occur after heavy lifting, straining, or coughing. Hernias do not heal on their own, and they tend to get worse over time.

If your hernia does not bother you, you most likely can wait to have surgery. Your hernia may get worse, but it may not. In some cases, hernias that are small and painless may never need to be repaired.

Inguinal hernia

An inguinal hernia (say "IN-gwuh-nul HER-nee-uh") happens when tissue pushes through a weak spot in your groin muscle. This causes a bulge in the groin or scrotum that may hurt or burn.

Surgery is the only way to fix it. But you may not need surgery if your hernia is small and painless.

What happens when you have an inguinal hernia?

Inguinal hernias typically flatten or disappear when they are pushed gently back into place or when you lie down. Over time, hernias tend to increase in size as the abdominal muscle wall becomes weaker and more tissue bulges through.

If you can't push your hernia back into your belly, it is incarcerated. A hernia gets incarcerated when tissue moves into the sac of the hernia and fills it up. This is not necessarily an emergency.

But if a loop of the intestine is trapped very tightly in the hernia, the blood supply to that part of the intestine can be cut off (strangulated), causing tissue to die. In a man, if tissue is trapped, the testicle and its blood vessels can also be damaged.

A strangulated hernia is a medical emergency that requires immediate surgery.

What are the symptoms of an inguinal hernia?

The main symptom of an inguinal hernia is a bulge in the groin or scrotum. It often feels like a round lump. The bulge may form over a period of weeks or months. Or it may appear suddenly after you've been lifting heavy weights, coughing, bending, straining, or laughing. The hernia may be uncomfortable or painful. Some cause no pain.

A hernia also may cause swelling and a feeling of heaviness, tugging, or burning in the area of the hernia. These symptoms may get better when you lie down.

In babies, a hernia may bulge when the child cries or moves around.

Strangulated hernias, which happen when part of the intestine gets trapped in the hernia, are more common in babies and children than in adults. They can cause nausea and vomiting and severe pain. A baby with a strangulated hernia may cry and refuse to eat.

How is an inguinal hernia treated?

Only surgery can repair an inguinal hernia. But if your hernia does not bother you and it causes no other problems, you may not need treatment right now. Hernias in babies and young children can be more dangerous and generally need to be repaired with surgery right away.

Preventing an inguinal hernia

Most inguinal hernias cannot be prevented, especially in infants and children. Adults may be able to prevent a few hernias or prevent a hernia from recurring by using some common self-care steps.

  • Avoid becoming overweight.

    Being overweight creates greater abdominal pressure and increases your risk for developing an inguinal hernia. Stay at a healthy weight through diet and exercise.

  • Avoid rapid weight loss (such as in crash dieting).

    Rapid weight-loss programs may be lacking in protein and vitamins that are needed for muscle strength, causing weakness in the muscles of the abdomen.

  • Stop smoking.

    Chronic coughing from smoking increases the risk for developing a hernia.

  • Avoid constipation and straining.

    Constipation and straining during bowel movements and urination causes increased pressure inside the abdomen.

  • Lift carefully.

    Use good body mechanics when you lift heavy objects. Lift with your legs, not with your back.

How is an inguinal hernia diagnosed?

A doctor can usually tell if you have an inguinal hernia based on your symptoms and a physical exam. The bulge of a hernia is usually easy to feel.

How can you care for yourself when you have an inguinal hernia?

  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • Use proper lifting techniques, and avoid heavy lifting if you can. To lift things more safely, bend your knees and let your arms and legs do the work. Keep your back straight, and do not bend over at the waist. Keep the load as close to your body as you can. Move your feet instead of turning or twisting your body.
  • Lose weight if you are overweight.
  • Include fruits, vegetables, legumes, and whole grains in your diet each day. These foods are high in fiber and will make it easier to avoid straining during bowel movements.
  • Do not smoke. Smoking can cause coughing, which can cause your hernia to bulge. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

What causes an inguinal hernia?

Most inguinal hernias happen because an opening in the muscle wall does not close as it should before birth. Pressure on that area can cause tissue to push through the belly and bulge out.

Inguinal hernia

Bulge of inguinal hernia in groin area

An inguinal hernia occurs when a small portion of the bowel bulges out through the inguinal canal and into the groin. (The inguinal canal is a passage or opening through the muscles of the abdominal wall.) The bulge usually contains tissue lining the inside of the abdomen (belly) as well as fatty tissue from inside the belly. Or it may contain a loop of intestine.

There are two types of inguinal hernias:

  • Direct inguinal hernias. These occur when a weak spot develops in the lower belly muscles. Often the cause of the hernia is not known. But the cause is often thought to be lifting, straining, or coughing. Or it may be being obese, pregnant, or constipated.
  • Indirect inguinal hernias. These occur when the inguinal canal fails to close before birth. The hernia may appear in a male's scrotum or in the fold of skin at the opening of a female's vagina. This is the most common type of inguinal hernia. And it may occur at birth or later in life. Indirect hernias are more common in males.

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