Hernia: Causes, Signs & Symptoms, Diagnosis, Prevention, and Treatment
A hernia is a medical condition in which an internal organ or tissue pushes through a weak spot in the muscle or surrounding connective tissue known as fascia. Most hernias occur in the abdomen, particularly in the groin area, but they can also appear in the diaphragm, belly button, or upper thigh.
While small hernias may be harmless, most tend to enlarge with time and can lead to serious complications, such as strangulation (cut-off blood supply). Therefore, understanding its causes, symptoms, and timely treatment is essential.
What is a Hernia?
A hernia forms when the abdominal muscles become too weak to keep organs in place, allowing fat or intestines to protrude outward. The bulge may:
• Appear when standing or coughing
• Disappear when lying down
• Cause discomfort or pain, especially on exertion
Hernia is most common in:
High-Risk Group Reason
Older adults Muscle weakening with age
Pregnant women Increased abdominal pressure
Overweight individuals Extra strain on abdominal wall
People with chronic cough or constipation Frequent pressure increase
Heavy weight-lifters Sudden internal pressure rise
Types of Hernia
Here are the most common forms:
Type of Hernia Location
Inguinal Hernia Groin Men Bulge near pubic area; worsens with lifting
Femoral Hernia Upper thigh Women (especially pregnant) Smaller but higher risk of strangulation
Umbilical Hernia Belly button Infants + adults (obesity, pregnancy) Visible protrusion near navel
Hiatal Hernia Diaphragm opening of esophagus Adults >50 Heartburn, GERD-like symptoms
Incisional Hernia Previous surgical site Post-surgery patients Weak abdominal scar tissue
Other less common forms:
• Epigastric hernia
• Spigelian hernia
• Diaphragmatic hernia
• Obturator hernia
Causes of Hernia
Hernias are caused by a combination of muscle weakness and increased abdominal pressure.
1. Muscle Weakness
• Aging and wear-and-tear
• Birth defects (congenital weakness)
• Injury or abdominal trauma
• Previous abdominal surgery
2. Increased Internal Pressure
• Chronic coughing (COPD, smoking)
• Heavy lifting without support
• Straining due to constipation or urination difficulty
• Obesity or rapid weight gain
• Pregnancy and multiple childbirths
• Fluid buildup in abdomen (ascites)
Lifestyle & medical factors contributing:
• Poor nutrition
• Lack of exercise weakening core muscles
• Smoking (weakens connective tissue)
Signs & Symptoms of Hernia
Common Symptoms
• Visible bulge in abdomen or groin
• Pain while coughing, bending, lifting
• Heaviness or discomfort in affected area
• Burning sensation or pressure
• Pain improves when lying down
Hiatal Hernia Symptoms
• Heartburn / Acid reflux (GERD)
• Difficulty swallowing
• Chest pain
• Regurgitation of food
Symptoms of Strangulated Hernia Emergency
• Severe pain at hernia site
• Redness, tenderness
• Nausea and vomiting
• Fever
• Inability to pass stools or gas
If strangulation occurs → Immediate surgery required to prevent tissue death.
Diagnosis of Hernia
Doctors diagnose hernia using:
1. Physical Examination
Bulge becomes noticeable when patient stands, coughs, or strains.
2. Imaging Tests
• Ultrasound – commonly used for groin hernias (inguinal/femoral)
• CT scan – identifies internal or small hernias
• MRI – helpful for diagnosing hidden or femoral hernias
Other assessments:
• Barium swallow test for Hiatal hernia
• Endoscopy for GERD or esophageal involvement
Complications of Untreated Hernia
Complication Description
Incarceration Hernia becomes stuck outside the abdomen
Strangulation Blood supply cut off → tissue death
Obstruction Intestine blockage causing severe pain, vomiting
Untreated hernia can be life-threatening.
Prevention of Hernia
You can lower hernia risk by strengthening abdominal muscles and reducing strain.
Best Preventive Tips
• Maintain a healthy weight
• Stop smoking to avoid chronic cough
• Avoid straining during bowel movements
• Consume high-fiber diet to relieve constipation
• Practice safe lifting techniques
• Keep back straight
• Use leg muscles
• Avoid sudden heavy lifting
• Strengthen core through regular exercise
• Manage chronic cough or prostate problems promptly
Foods That Help Prevention
• Whole grains (oats, brown rice)
• Vegetables and fruits rich in fiber
• Lean proteins
• Adequate water intake
Avoid:
• Processed foods
• Excessive weight gain
• Frequent heavy lifting without support
Treatment of Hernia
Treatment depends on the type, size, and severity.
1. Watchful Waiting
Recommended only when:
• Hernia is small
• No symptoms or pain
• Low strangulation risk
Regular monitoring is required.
2. Surgical Repair (Definitive Treatment)
Two major surgical options:
Surgery Type Description Recovery Time Advantage
Open Hernia Repair Larger incision, pushing organ back, reinforcing muscle with stitches or mesh Longer Best for large, complex or strangulated hernias
Laparoscopic Repair Keyhole surgery using a camera and mesh Faster recovery Less pain, minimal scarring
Mesh repairs are common because they reduce recurrence.
Hiatal Hernia Treatment
• Lifestyle modifications (diet, weight control)
• Antacids / Proton pump inhibitors for GERD
• Nissen fundoplication for severe cases
Post-surgery Care
• Avoid heavy lifting for 6–8 weeks
• Maintain healthy diet and weight
• Gradual return to physical activity
Long-Term Outlook
Most hernias do not heal naturally and gradually worsen.
With timely surgery and preventive care, recurrence risk remains low, and quality of life improves significantly.
Frequently Asked Questions (FAQs)
1. Can hernia go away without surgery?
No. Hernias usually do not heal by themselves. Surgery is the only permanent cure.
2. Is hernia dangerous?
Yes, if untreated, it can cause strangulation, leading to tissue death and emergency operation.
3. Can you exercise with a hernia?
Light exercises like walking may be okay, but avoid heavy lifting or abdominal strain until treated.
4. Which doctor treats hernia?
A general surgeon or gastro surgeon handles surgical treatment.
5. What foods worsen hernia symptoms?
Spicy, fried foods, caffeine, alcohol especially aggravate hiatal hernia symptoms (acid reflux).
6. How soon can I resume work after hernia surgery?
Light work: 1–2 weeks
Heavy physical labor: 6–8 weeks (after doctor approval)
7. Can women also get hernias?
Yes. Umbilical and femoral hernias are more common in women.
Conclusion
Hernia is a common yet serious condition that requires timely diagnosis and treatment. While lifestyle changes may prevent worsening, surgical repair remains the most effective treatment. Awareness of symptoms and early medical consultation helps prevent complications like intestinal strangulation and obstruction.
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Writer: Vandita Singh, Lucknow (GS India Nursing Group)