Hernia (Hiatal, Inguinal, Ventral)
A hernia occurs when an organ or tissue pushes through a weak spot in the surrounding muscle or connective tissue. The three most common types are hiatal hernias (where part of the stomach pushes through the diaphragm into the chest), inguinal hernias (in the groin area), and ventral hernias (in the abdominal wall). These conditions range from asymptomatic to causing significant discomfort and may require surgical repair.
What is it?
Hernias develop when internal organs or tissues protrude through weaknesses in the muscle wall that normally contains them. A hiatal hernia occurs when part of the stomach pushes upward through the diaphragm (the muscle separating the chest from the abdomen) into the chest cavity, often causing acid reflux and heartburn. An inguinal hernia develops in the groin when abdominal contents push through the inguinal canal, appearing as a bulge in the groin or scrotum and affecting men more frequently than women. A ventral hernia occurs through the abdominal wall, often at sites of previous surgical incisions (incisional hernia) or around the belly button (umbilical hernia).
These conditions can result from a combination of muscle weakness and strain. Risk factors include aging, chronic coughing, heavy lifting, obesity, pregnancy, constipation, and previous abdominal surgery. While some hernias cause minimal symptoms and can be managed conservatively, others may become progressively larger or develop complications. The size, location, and symptoms determine whether watchful waiting or surgical intervention is appropriate.
Important to Know
Hernias require medical evaluation because they can lead to serious complications. Incarceration occurs when herniated tissue becomes trapped and cannot be pushed back into place, potentially cutting off blood supply (strangulation), which is a surgical emergency causing severe pain, nausea, vomiting, and inability to pass gas or have bowel movements. Warning signs requiring immediate medical attention include sudden severe pain at the hernia site, a hernia that becomes firm, tender, or discolored, fever with hernia pain, or inability to move bowels or pass gas. CT and MRI imaging can accurately identify hernias, assess their size and contents, detect complications, and help surgeons plan repair procedures. Many hernias can be successfully repaired with minimally invasive laparoscopic surgery.