What Is a Hernia?

The body’s muscles do a good job of protecting internal organs and keeping them in place. But sometimes muscles can tear or weaken, allowing an organ or fatty tissue to push (or herniate) into an area where it doesn’t belong.

When that happens you might notice a bump or bulge, although sometimes these protrusions can’t be felt. Other times, the bulge might come and go, depending on your position or what you’re doing. These weakenings in the muscle wall and the subsequent tissue or organs that push through are called hernias.

Types of Hernia

Most hernias occur in the abdominal area, between your chest and hip bones. Hernias that can be pushed back into place are called reducible hernias. Those that can’t be popped back into position are termed irreducible or incarcerated.

If you can feel the hernia on the outside of your body (you might notice a bump), you have an external hernia. Those that can’t be felt are labeled internal hernias.

Most Common

Hernias are further classified by the body region where they occur. Some of the more common ones include:

• Inguinal hernias: These typically occur in the inguinal canals, which are located on either side of the groin. Inguinal hernias are one of the most common types of hernia, affecting 27% of men and 3% of women.
• Umbilical hernias: These occur when tissue or parts of the intestine push through a weak area near the navel. They account for 6-14% of adult abdominal hernias, making them the second most common type. Up to 20% of newborns have this hernia. If not closed by age 5, it needs to be closed surgically.
• Hiatal hernias: These occur when parts of the stomach or other organs break through an opening in the diaphragm. Hiatal hernias are very common and the overwhelming majority are what’s known as “sliding” hiatal hernias, meaning they can move in and out of place.
• Femoral hernias. These are found in the lower groin area, near the upper thigh. Women, because of their wider pelvises, are four times more likely to develop femoral hernias than men.
• Incisional hernias: The cutting and sewing of surgery can weaken a muscle wall, making it more likely a hernia will develop. Roughly 15% of people will develop an incisional hernia after surgery involving the abdominal wall.

Hernia Symptoms

Most hernias can be felt. You might notice a bump or bulge (it may be hard or soft) in an area of your body. Not all hernias produce discomfort, but when they do you might experience:

• Burning
• Pulling
• Pain
• Pressure
• Swelling
• Digestive issues like heartburn or gastroesophageal reflux disease (GERD).

The discomfort may be more intense when you strain (for example, while having a bowel movement or lifting a heavy object) or tighten your abdominal muscles (when you’re coughing, sneezing or exercising, for instance).

Complications

If you feel pain around the hernia that’s sudden or severe, or you experience nausea and vomiting along with the pain, seek immediate medical attention. This could be a sign that an organ or tissue is dangerously stuck within the torn area (incarcerated) or that its blood supply is being cut off (called a strangulated hernia), which is a medical emergency.

Causes

Hernias can happen to anyone—male or female, young or old. Sometimes you’re born with a weakening in muscle walls and other times it develops over time. Some risk factors for hernia development include: 

• Sex: Males are about twice as likely as females to have hernias, largely due to male anatomy. When the testicles descend from the abdomen during fetal development, the opening doesn’t always close properly (or at all), making a hernia, particularly an inguinal hernia, more likely at some point in life.
• Being overweight or obese: Extra weight increases pressure on muscles and organs, weakening the structures that hold things in place.
• Pregnancy, especially multiple pregnancies: As a fetus grows and develops, so, too, does the strain on the abdominal wall of the pregnant person. 
• Age: Muscles become weaker as people age.
• Prior surgery: Surgery in the abdominal or groin area can weaken the muscles.
• Performing activities that can strain abdominal muscles: This includes heavy lifting.
• Persistent coughing: Coughing places pressure on the chest and abdomen.
• Tobacco use: This can lead to chronic coughing.
• Family history of hernias: Men with a family history of inguinal hernias are eight times more likely to develop one than men without a family history.
• Constipation: This can result in straining during a bowel movement, placing pressure on the abdomen.

Diagnosis

Your doctor will perform a physical exam, feeling for a hernia while you sit, stand or even cough. Imaging tests like an ultrasound or computerized tomography (CT) scan may also be ordered.

Your doctor may also perform an endoscopy, which uses a flexible scope equipped with a light and camera to examine the inside of your esophagus and your stomach.

Treatment

How your hernia is treated depends on a number of factors, including where the hernia is located, its size, whether it’s growing and if it’s causing you discomfort.

Even sex-based anatomy plays a role. Inguinal hernias in women may be treated more aggressively than in men, for example, as correctly distinguishing them from femoral hernias, which have a 30% chance of being incarcerated, can be difficult. 

Surgery

In general, for hernias that are small and asymptomatic, your doctor may advise simply watching the hernia. For hernias that are large, causing pain or impacting your quality of life, surgery may be recommended. Types of hernia surgery include open surgery, laparoscopic surgery, and robotic surgery.

Open Surgery

In open surgery, the surgeon cuts through the body where the hernia is located. The bulging parts are put back into place and the tear is stitched.

Instead of sutures, a doctor might use a mesh panel (usually made of plastic or animal tissues) to provide added support. Those who have their inguinal and femoral hernias repaired with a mesh appear to have a reduced risk of hernia recurrence.

Laparoscopic Surgery

Using small incisions through which surgical tools (usually a flexible tube with a camera and light that guides the surgeon), the organs/tissues are moved back to where they belong and the hole is repaired. This is considered minimally invasive surgery and has a quicker recovery time than open surgery. 

Robotic-Assisted Surgery

Robotic-assisted surgery is similar to laparoscopic surgery, but the surgeon operates the tools from a console.

Prevention

Other than the umbilical hernias that affect newborns, a hernia will not go away on its own. See your doctor if you notice a bulge. If you have any of the risk factors for a hernia, make sure your doctor is checking for them at your physical exams.

To keep hernias at bay, stay on top of your health game:

• Maintain a healthy weight.
• Stay hydrated and eat a diet rich in fruits, whole grains and vegetables to avoid constipation.
• Don’t lift more than you’re able.
• Don’t smoke.

A Word From Verywell

Finding a bump or bulge on your body can be scary, and your first step is to get it checked out by a doctor. But if you’re diagnosed with a hernia, rest assured that you’re not alone.

Hernias are quite common, and the surgeries that are often used to treat them are some of the most frequently performed surgeries in the U.S. More than 20 million hernias are repaired every year, worldwide, with 700,000 of those in the U.S. alone.

While there are risks with any surgery, hernia surgery is considered safe and effective. Recovery will depend on your overall health and the type of surgery performed, but many people are back to their regular routines in just a couple of weeks.