Hernia Types & Hernia Symptoms

So, what is a hernia?

A hernia is a bulge or abnormal protrusion of the abdominal wall that usually increases in size on standing or coughing and may go away on lying down.

The most common area to develop a visible hernia is the lower abdomen/groin (inguinal and femoral hernia). This may give rise to a painful lump under the skin. 

The most common internal hernia (the hernia is not visible) is a hiatus hernia.

A hernia develops at a point of weakness or where there is a defect in the muscles of the abdominal wall. As the hernia enlarges a bulge appears which is most easily seen when standing.

Lying down allows the tissue to return to it’s proper position and the bulge may disappear temporarily. The hernia may contain fat, bowel or other structures that are normally present within the abdomen.

Hernias will not go away on their own and surgery is the only permanent cure.

Inguinal/groin hernias

The most common hernia.

1 in 20 men have an inguinal hernia

Generally, abdominal hernias need to be seen and felt to be diagnosed.

What are the different types of hernia?

Usually the hernia will increase in size with an increase in abdominal pressure, so coughing makes the hernia more noticeable.

Once a diagnosis of an abdominal hernia has been made, your GP may arrange for a surgical consultation as surgery is the only way to cure abdominal wall hernias. There are many different types of hernias. The most common hernias are those that occur in the abdominal wall. They occur in different areas and depending on the location, the hernia is given a different name.

The most common hernia

Inguinal hernia

An inguinal hernia appears as a bulge in the inguinal or groin crease.

It is the most common type of external hernia and more than 100,000 inguinal hernia repairs are performed in the United Kingdom each year. Hernias at this site may come and go depending on the position of the person or their level of physical activity. In men, the protrusion may descend into the scrotum. Inguinal hernias account for 80% of all hernias and are 25 times more common in men than women.

More common in women that men

Femoral hernia

 This hernia causes a bulge below the groin or inguinal crease.

The femoral canal is the way that the femoral artery, vein, and nerve leave the abdominal cavity to enter the thigh. Although normally a tight space, sometimes it becomes large enough to allow abdominal contents (usually intestine) into the canal. They are less common compared to inguinal hernias. They also differ from inguinal hernias in that they are proportionately more common in women compared to men. These hernias are particularly at risk of becoming irreducible and strangulated. More information on femoral hernias.

Also called a belly-button hernia

Umbilical hernia

These common hernias are often noted at birth as a protrusion at the bellybutton (other names being the navel or umbilicus). They are more common in Black and Chinese babies. The hernia occurs when an opening in the abdominal wall, which normally closes before birth, doesn’t close completely. If small (less than three quarters of an inch) this type of hernia usually closes gradually by age 2. Larger hernias and those that do not close by themselves usually require surgery at age 2-4 years. Even if the area is closed at birth, these hernias can appear later in life because this spot remains a weaker place in the abdominal wall. They most often appear later in elderly people and middle-aged women who have had children. More information on umbilical hernias.

What does a hernia contain?

The contents of the hernia (usually portions of intestine or abdominal fatty tissue) are often enclosed within a thin membrane or sac called the peritoneum (see above). This normally lines the inside of the abdominal cavity (peritoneal cavity). In themselves, hernias are usually harmless.

However with some hernias there is a risk that the contents may not reduce and become stuck within the sac (incarcerated or irreducible). This may result in a reduction in the blood supply and may lead to strangulation of the hernia contents, a medical and surgical emergency

Want to see a specialist about your hernia?

Contact the Scottish Hernia Centre

What are the symptoms of a hernia?

Most hernias do not cause too much pain and many cause no pain at all.

Most abdominal hernias appear suddenly when the abdominal muscles are strained. You may feel tenderness, a slight burning sensation, or a feeling of heaviness in the bulge. It may be possible to push the hernia back into place with gentle pressure, or the hernia may disappear by itself when you lie down.

Being able to push the hernia back is called reducing the hernia. On the other hand, some hernias cannot be pushed back into place, and are termed incarcerated or irreducible. Persistent, severe or increasing discomfort is a worrying feature and might indicate that the hernia has become “stuck” or incarcerated. This situation can progress to the development of tissue damage or even gangrene within the hernia which becomes a surgical emergency.

How are hernias diagnosed?

Did you know, most hernias are first noticed by patients themselves

Generally, abdominal hernias need to be seen and felt to be diagnosed.

Usually the hernia will increase in size with an increase in abdominal pressure, so coughing makes the hernia more noticeable.

Once a diagnosis of an abdominal hernia has been made, your GP may arrange for a surgical consultation as surgery is the only way to cure abdominal wall hernias.

Why do hernias develop?

Abdominal wall hernias occur as a result of an opening or weakness in the muscular structure of the abdominal wall. Factors that may lead to such a weakness developing include the following

  • Muscle tear or injury
  • Congenital or birth weakness
  • Increase in abdominal pressure with
  • Persistent coughing
  • Straining
  • Heavy lifting
  • Pregnancy
  • Excessive weight may also predispose to hernia formation
  • Previous surgery
  • Older aged patients are also predisposed to hernias