What is inguinal hernia?

An inguinal hernia occurs when tissue bulges through a weak spot in the groin area. Your child may have a tender bulge in the groin or, in a boy, the scrotum. Your child 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.

In most cases, a child with an inguinal hernia will need surgery.

Infants 12 months of age and younger who have these hernias have a much higher risk of problems than older children and adults. For example, the intestines may become trapped in the hernia. When this happens, it cuts off blood supply. Because of that risk, hernia surgery is often not delayed for infants.

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.

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.

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.

Most hernias that come back do so within 5 years after surgery.

The risk that a hernia will come back after surgery depends on the surgeon's experience, the type of hernia, and whether mesh is used. It also depends on your age and overall health.

Inguinal hernias that come back are harder to repair. And they have more risks than the first hernia repair. These risks include having more scar tissue, numbness, and pain after surgery and having a greater chance of injury to a testicle or the spermatic cord.

The risk of the hernia coming back may be higher if your belly muscles aren't strong or healthy enough to "hold" the stitching (suture) material. The risk is also higher if you have bleeding or infection that weakens the repair.

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.

• Give pain medicines exactly as directed.
  • If the doctor gave your child a prescription medicine for pain, give it as prescribed.
  • If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.
• Help your child stay at a healthy weight.
• Include fruits, vegetables, legumes, and whole grains in your child's diet each day. These foods are high in fiber and will make it easier to avoid straining during bowel movements.
• Keep your child away from smoke. Do not smoke or let anyone else smoke around your child or in your house. Smoke can cause coughing, which can cause your child's hernia to bulge.

In most cases, a child with an inguinal hernia will need surgery.

Infants 12 months of age and younger who have this type of hernia have a much higher risk of strangulation of the intestine than older children and adults. Strangulation happens when a loop of intestine becomes tightly trapped in a hernia. This cuts off the blood supply to that part of the intestine. So surgery for these hernias in infants isn't delayed like it can be for adults. Synthetic patches aren't needed to repair this type of hernia in an infant.

There are two types of surgery to repair inguinal hernias. They are:

• Open inguinal hernia repair.
• Laparoscopic inguinal hernia repair.

Laparoscopic surgery may not be an option for a child who has tissues that have grown together (adhesions) from previous surgeries in the belly area.

An inguinal hernia (say "IN-gwuh-nul HER-nee-uh") happens 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."

Inguinal hernias are caused by:

• An opening in the passage from the belly to the genitals, called the inguinal canal, that does not close as it should be before birth.
• Belly (abdominal) muscles that are weakened or torn.

Both of these things can result in a weak area in the belly muscle. Pressure on the area can then cause tissue to push through the belly muscles and into the groin. This causes a bulge in the groin or scrotum.

A hernia can happen soon after birth or much later in life.

A femoral hernia, which is sometimes mistaken for an inguinal hernia, happens when tissue bulges from the lower belly into the upper thigh, just below the groin crease. The cause of a femoral hernia is often hard to determine.