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Hernia

A hernia is a lump under the skin, normally around the groin or abdomen. It happens when there is a rupture of muscle or tissue wall, and an internal part of the body (such as the bowel) or fatty tissue pushes out through this gap.

  1. Swelling under the skin
  2. Can be caused by strain from lifting or persistent coughing
  3. Usually treated with a minor operation

If you think you may have a hernia and would like to speak to a doctor online, our video consultation service can put you in touch with a GMC-registered practitioner. Click below to book an appointment at a time of your choosing.

Hernia
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Description

A hernia is a small lump under the skin, most typically around the groin, thighs or in the abdomen. It develops when we sustain a torn muscle in the abdomen, and fatty tissue or part of the bowel protrudes through. Contrary to popular belief, most hernias do not hurt, which means they can often go untreated for a long time. A bigger hernia usually causes less pain, whereas a smaller tear is more painful, as the motion of internal body parts squeezing through tissue is very uncomfortable.

There are four main types of hernia. Inguinal hernia is the most common type, accounting for around 7 in 10 hernias, according to the British Hernia Centre. It’s located in the groin, just by the pubic bone, and is much more common in men. A femoral hernia, on the other hand, is much more common in women, and is also found in the groin.

Umbilical hernias usually appear directly beneath the navel or just above. Hiatus hernias tend to happen higher up the body near the chest, and are caused by part of the stomach bulging through a torn muscle wall. 

Unlike other types, an incisional hernia isn’t associated with wear and tear on abdominal muscles, but with surgery. It happens when someone has an operation on their abdomen, and the tissues do not heal properly.

In many cases hernias are not serious, and only cause mild to moderate discomfort (if any). However, it’s possible for some types of hernias to cause complications, such as strangulation (where the supply of blood to a section caught up in the hernia becomes blocked) or obstruction (where a piece of the bowel becomes trapped and food cannot pass through). If you experience severe pain, difficulty passing stools or are sick, or if the hernia feels hard or tender, you should go to hospital as soon as possible.

The treatment for a hernia is surgery, but not all hernias will need to be operated on. A doctor will normally take into account whether a patient is at risk of complications before deciding if surgery is needed.

Keyhole surgery is one option. This involves a doctor making tiny incisions and fixing the tear in the muscle wall with small instruments, and a camera. Open surgery is a more traditional approach, where one cut is made and the surgeon pushes the hernia back, before addressing the tear.

People who are experiencing discomfort which may be due to a hernia can speak to our doctors online, through our secure video service. Book an appointment at a time that suits you, and one of our UK-based practitioners will consult with you over secure video link, and provide advice on what to do.

Page last reviewed:  06/05/2020
Diagnosis and treatment

What are the causes of a hernia?

There are several possible causes of a hernia. They usually happen because of a strain in the abdomen, which causes the abdominal wall to tear. Factors that can lead to this include coughing persistently, increasing pressure on the stomach by being overweight or pregnant, lifting or carrying heavy weights, or straining when on the toilet. They’re also more likely to occur with increasing age.

How is a hernia diagnosed?

Most cases of a hernia will involve a defined swelling around the abdomen, which becomes more pronounced when standing up or coughing, and gets smaller when lying down. 

A doctor will examine you for signs of asymmetry in the region of the body where the hernia has occurred. If there isn’t a clear lump, a doctor may ask you to cough in order to make the hernia visible.

Will I need tests?

For almost all hernias, diagnosis is usually made from the patient’s description of the symptoms and through an examination by a doctor. Testing is not usually required unless there is some uncertainty. 

If a clinician seeks a more conclusive diagnosis, a herniagram may be used. This procedure involves an injection containing a liquid, which shows up on an x-ray (the liquid passes through the hole in the abdomen if a hernia is present). However, it isn’t used commonly as it is an invasive procedure.

Ultrasound scans may also be conducted to examine a hernia, and to help a doctor to understand what the best course of action is.

How is a hernia managed?

It depends on the type of hernia and how severe symptoms are. There is some controversy about what the best course of action is - whether the hernia should be left alone or be operated on. Some people may not require surgery if their hernia remains stable, and doesn’t cause discomfort.

The two surgical methods of repair for hernia are open or keyhole surgery. In open surgery, the surgeon will make one cut and push the hernia back in; in keyhole surgery, they’ll make several smaller incisions and use equipment to stitch together the ruptured tissue.

Page last reviewed:  06/05/2020
Questions and Answers

How is a hernia treated?

A hernia is usually treated with surgery. However, sometimes it is not necessary to have treatment straight away. A doctor will sometimes advise waiting to see if the bulge gets bigger or more uncomfortable before recommending surgery. It’s possible for a hernia to not worsen over time, in which case you may not need surgery. 

During a procedure, a surgeon will normally push the hernia back in and repair the muscle tear.

How long will it take for me to recover?

Post-surgery, most people make a full recovery after a few weeks.

Having had surgery, it’s important to avoid straining yourself so as to prevent complications. Follow a diet that won’t lead to constipation, and refrain from any heavy lifting. 

Can I consult a doctor about a hernia online?

Yes. Our UK doctors are available to consult with at a time that’s convenient for you. You can use our online private video consultation service to speak to them about possible hernia symptoms, and for advice regarding whether you need any further examination.

Page last reviewed:  06/05/2020

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