Hernia Overview (cont.)

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What causes an abdominal hernia?

A hernia may be congenital and present at birth or it may develop over time in areas of weakness within the abdominal wall. Increasing the pressure within the abdominal cavity can cause stress at the weak points and allow parts of the abdominal cavity to protrude or herniate.

Increased pressure within the abdomen may occur in a variety of situations including chronic cough, increased fluid within the abdominal cavity (ascites), peritoneal dialysis used to treat kidney failure, and tumors or masses in the abdomen. The pressure may increase due to lifting excess weight, straining to have a bowel movement or urinate, or from trauma to the abdomen. Pregnancy or excess abdominal weight and girth are also factors that can lead to a hernia.

What are the signs and symptoms of an abdominal hernia?

Most people can feel a bulge where an inguinal hernia develops in the groin. There may be a burning or sharp pain sensation in the area because of inflammation of the inguinal nerve or a full feeling in the groin with activity. If a hernia occurs because of an event like lifting a heavy weight, a sharp or tearing pain may be felt. However, many people do not have any complaint other than a feeling of fullness in the area of the inguinal canal.

Complications occur when a piece of intestine or omentum becomes trapped (incarcerated) in the hernia sac. A piece of bowel may enter the hernia and become stuck. If the bowel swells, it can cause a surgical emergency as it loses its blood supply and becomes strangulated. In this situation, there can be significant pain and nausea and vomiting, signaling the possible development of a bowel obstruction. Fever may be associated with strangulated, dead bowel.

A Richter's hernia causes only a part of the bowel wall to become trapped stuck in the hernia. It won't necessarily cause an obstruction since the passageway of the intestine still allows bowel contents to pass, but that portion of the bowel wall that is trapped can strangulate and die.

Femoral and obturator hernias present in much the same way as inguinal hernias, though because of their anatomic location, the fullness or lumps may be much more difficult to appreciate.

Umbilical hernias are easy to appreciate and in adults often pop out with any increase in abdominal pressure. The complications again include incarceration and strangulation.

A hiatal hernia does not cause many symptoms by itself, but when a sliding hernia occurs, the abnormal location of the gastroesophageal (GE) junction above the diaphragm affects its function and stomach contents can reflux into the esophagus. Gastroesophageal reflux (GERD) may cause burning chest pain, epigastric pain and burning in the upper abdomen nausea, vomiting, and a sour taste from stomach acid that washes into the back of the throat.

Sports hernias cause increased pain in the groin or inguinal area brought on by physical activity, usually involving twisting. It is not a true hernia and therefore is not complicated by incarcerated or strangulated bowel. However, sports and inguinal hernias may coexist.

Medically Reviewed by a Doctor on 10/14/2013

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