What happens if part of the intestine bulges through a weak spot in abdominal muscle? This condition can be painful and often requires surgery to fix.
An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object. However, many hernias do not cause pain.
An inguinal hernia isn't necessarily dangerous. It doesn't improve on its own, however, and can lead to life-threatening complications. Your doctor is likely to recommend surgery to fix an inguinal hernia that's painful or enlarging. Inguinal hernia repair is a common surgical procedure.
Inguinal hernias occur when part of the membrane lining the abdominal cavity (omentum) or intestine protrudes through a weak spot in the abdomen — often along the inguinal canal, which carries the spermatic cord in men.
Inguinal hernia signs and symptoms include:
Inguinal hernias in newborns and children result from a weakness in the abdominal wall that's present at birth. Sometimes the hernia will be visible only when an infant is crying, coughing or straining during a bowel movement. He or she might be irritable and have less appetite than usual.
In an older child, a hernia is likely to be more apparent when the child coughs, strains during a bowel movement or stands for a long period.
If you aren't able to push the hernia in, the contents of the hernia may be trapped (incarcerated) in the abdominal wall. An incarcerated hernia can become strangulated, which cuts off the blood flow to the tissue that's trapped. A strangulated hernia can be life-threatening if it isn't treated.
Signs and symptoms of a strangulated hernia include:
Seek immediate care if a hernia bulge turns red, purple or dark or if you notice any other signs or symptoms of a strangulated hernia.
See your doctor if you have a painful or noticeable bulge in your groin on either side of your pubic bone. The bulge is likely to be more noticeable when you're standing, and you usually can feel it if you put your hand directly over the affected area.
Some inguinal hernias have no apparent cause. Others might occur as a result of:
In many people, the abdominal wall weakness that leads to an inguinal hernia occurs prior to birth when a weakness in the abdominal wall muscle doesn't close properly. Other inguinal hernias develop later in life when muscles weaken or deteriorate due to aging, strenuous physical activity or coughing that accompanies smoking.
Weaknesses can also occur in the abdominal wall later in life, especially after an injury or abdominal surgery.
In men, the weak spot usually occurs in the inguinal canal, where the spermatic cord enters the scrotum. In women, the inguinal canal carries a ligament that helps hold the uterus in place, and hernias sometimes occur where connective tissue from the uterus attaches to tissue surrounding the pubic bone.
Factors that contribute to developing an inguinal hernia include:
Complications of an inguinal hernia include:
You can't prevent the congenital defect that makes you susceptible to an inguinal hernia. You can, however, reduce strain on your abdominal muscles and tissues. For example:
A physical exam is usually all that's needed to diagnose an inguinal hernia. Your doctor will check for a bulge in the groin area. Because standing and coughing can make a hernia more prominent, you'll likely be asked to stand and cough or strain.
If the diagnosis isn't readily apparent, your doctor might order an imaging test, such as an abdominal ultrasound, CT scan or MRI.
If your hernia is small and isn't bothering you, your doctor might recommend watchful waiting. Sometimes, wearing a supportive truss may help relieve symptoms, but check with your doctor first because it's important that the truss fits properly, and is being used appropriately. In children, the doctor might try applying manual pressure to reduce the bulge before considering surgery.
Enlarging or painful hernias usually require surgery to relieve discomfort and prevent serious complications.
There are two general types of hernia operations — open hernia repair and minimally invasive hernia repair.
In this procedure, which might be done with local anesthesia and sedation or general anesthesia, the surgeon makes an incision in your groin and pushes the protruding tissue back into your abdomen. The surgeon then sews the weakened area, often reinforcing it with a synthetic mesh (hernioplasty). The opening is then closed with stitches, staples or surgical glue.
After the surgery, you'll be encouraged to move about as soon as possible, but it might be several weeks before you're able to resume normal activities.
In this procedure requiring general anesthesia, the surgeon operates through several small incisions in your abdomen. The surgeon may use laparoscopic or robotic instruments to repair your hernia. Gas is used to inflate your abdomen to make the internal organs easier to see.
A small tube equipped with a tiny camera (laparoscope) is inserted into one incision. Guided by the camera, the surgeon inserts tiny instruments through other small incisions to repair the hernia using synthetic mesh.
People who have a minimally invasive repair might have less discomfort and scarring after surgery and a quicker return to normal activities. Long-term results of laparoscopic and open hernia surgeries are comparable.
Minimally invasive hernia surgery allows the surgeon to avoid scar tissue from an earlier hernia repair, so it might be a good choice for people whose hernias recur after open hernia surgery. It also might be a good choice for people with hernias on both sides of the body (bilateral).
As with open surgery, it may be a few weeks before you can get back to your usual activity level.
You'll likely start by seeing your primary care provider. Here's some information to help you get ready for your appointment.
Make a list of:
Take a family member or friend along, if possible, to help you remember the information you get.
For an inguinal hernia, some basic questions to ask your doctor include:
Don't hesitate to ask other questions you may have.
Your doctor is likely to ask you several questions, such as:
Get emergency medical care if you develop nausea, vomiting or fever or if your hernia bulge turns red, purple or dark.