What’s an Inguinal Hernia?

Sometimes doctors will sew in a mesh for inguinal hernia repair to support the weak muscle.

Have you noticed a bulge in the lower part of your tummy or groin area? It could be an inguinal hernia. That’s a kind of hernia that forms in both adults and kids. Here’s information you can use to get an understanding of what hernia is and how serious it might me.

There’s also information here explaining the symptoms, what the risk factors are, and how doctors can treat it. Finally there’s a discussion of how you might be able to prevent hernia and keep it from affecting you and your healthy life.

The muscles in your abdomen and groin area help hold your intestines in place. There is a natural passageway through these muscles in the groin area. That’s the inguinal canal. Sometimes, due to a defect in the inguinal canal or the muscles of the abdominal wall, part of your intestines or fat tissue can poke through. That is what doctors call an inguinal hernia.

There are two types of inguinal hernias: indirect and direct.

A defect in your inguinal canal that you have at birth causes an indirect inguinal hernia. Babies and children can have this type of hernia. Up to 5% of healthy, full-term babies have an inguinal hernia. As many as 30% of premature babies have them too. Both boys and girls can have them, but they’re much more common in boys.

A weakness in your muscles that worsens over time can cause a direct inguinal hernia. This type of hernia usually happens to men. About a quarter of adult men will get an inguinal hernia at some point. Women can get them, but it’s rare. You can get one when you strain to move or lift something heavy.

Inguinal hernias aren’t always serious. But they don’t get better on their own either. Sometimes, they can be painful or cause problems that threaten your life.

In adults, direct inguinal hernias may appear as a bulge under the skin on one or both sides of your groin. The bulge may gradually get larger over time. You may not see it when you lie down.

You might see the bulge best when you lift an object, cough, bend over, or strain your muscles. You may also feel pain or discomfort in your groin.

Other symptoms include:

• Burning or aching in the area of the bulge
• Heavy feeling, weakness, or pressure in your groin
• Swelling or pain around your testicles

Babies and young children with an indirect inguinal hernia may seem fussy or have little appetite. When your baby cries, coughs, or strains to poop, you may see a small bulge in his groin.

The bulge may not be noticeable in babies until a few weeks or months after birth. Hernia bulges may seem smaller when your baby or young child relaxes during sleep.

Hernia bulges may be easier to see in an older child when he coughs, stands up for a long time, or strains on the toilet while pooping.

Inguinal hernias can get bigger over time. This may cause you to feel increased pressure, tenderness, or discomfort.

A hernia opening in your groin or scrotum can trap fats or intestinal tissue that slips through. This is an incarcerated hernia. A twist in the tissue can cut off the blood supply to it. That’s a strangulated hernia. One telltale sign of a strangulated hernia is that the skin over your bulge looks red, purple, or darker than normal.

A strangulated hernia can also cause symptoms like these:

• Sudden, severe pain that rapidly gets worse
• Nausea
• Vomiting
• Fever
• Inability to poop or pass gas

Get medical treatment for a strangulated hernia right away. It can be life-threatening.

A defect in the inguinal canal that’s present at birth causes an indirect inguinal hernia. Here’s what happens.

The testicles of a male fetus begin to develop in the fetus’s belly. Next, they move down the inguinal canal and through an opening in the scrotum. This opening usually closes up about two months after birth.

If the opening doesn’t close properly, an indirect inguinal hernia can form. It happens when tissue or fat slips through the hole and stays there. In female fetuses, the ovaries or bowel tissue can spill through the opening and cause a hernia.

Premature or low-birth-weight babies have a higher risk for indirect inguinal hernias than full-term babies.

Direct inguinal hernias often happen to men age 40 and older. Your abdominal muscle wall can weaken as you age. Heavy lifting can cause it too.

If you’ve had lower abdominal surgery in the past, it increases your risk of an inguinal hernia.

Other risk factors for direct inguinal hernia include:

• Being white
• Chronic cough or constipation
• Family history of hernia
• Pregnancy
• Smoking
• Past hernia in childhood

Your doctor can easily diagnose a hernia with a physical exam. The doctor will see the bulge through your skin. He may also ask you to cough or stand up to see how the bulge grows larger or smaller.

Just to be sure your bulge is an inguinal hernia, your doctor may do an MRI, CT scan, or abdominal ultrasound.

Inguinal hernias that are small may not need treatment. Talk to your doctor before you try any home remedy such as a truss. When trusses don’t fit right, they can cause harm. Your doctor can fit you with one.

Kids with inguinal hernias may not need treatment either. Your pediatrician may try to gently push the bulge to make it go back down.

If your hernia grows larger or causes pain, surgery can repair it.

There are two types of inguinal hernia surgery: open and laparoscopic.

For open hernia repair surgery, you will receive local or general anesthesia. Local anesthesia numbs the affected area. General puts you in a sleep-like state. The surgeon will make a cut into your groin and push the protruding tissue back into your abdomen. Next, she will stitch up the hernia opening. Sometimes, the surgeon will sew in a mesh sleeve to shore up the weak muscle, then close your incision.

You typically can get up and move around soon after your open surgery. But you’ll need to take it easy for a few weeks before you feel back to normal.

Laparoscopic hernia repair surgery is minimally invasive. You’ll have general anesthesia. Your surgeon will make a few tiny cuts in your abdomen and inflate your belly with gas.

She will insert a small, thin tube with a camera on one end called a laparoscope as well as instruments to close up your hernia and install the mesh sleeve. You’ll be able to get back to your normal activities sooner than with open surgery. But, your hernia may be more likely to come back after laparoscopy.

There’s no way to prevent indirect inguinal hernias from developing in your child. They are the result of a birth defect and just happen.

These tips may help you prevent a direct inguinal hernia as you get older:

• Maintain a healthy weight.
• Don’t smoke.
• Avoid lifting objects that are too heavy for you.
• If you have to lift something heavy, bend at your knees, not at your waist.
• Exercise regularly.
• Try not to strain if you have a difficult bowel movement.
• Eat plenty of fiber to ease bowel movements.