A hernia is caused by an internal part of the body pushing through a weak spot in the muscle or surrounding tissue wall. You would usually find a hernia between your chest and hips, and the most common type is an inguinal hernia in the groin. Not every hernia needs a hernia operation straight away, so this page explains the main types, the symptoms to look out for and when surgery is advised.
Hernias can cause no symptoms or very few. More commonly, you may notice swelling or a lump in your groin. You might find you can push the hernia back in, so that it disappears when you lie down and reappears when you stand up or are active. Hernias can trap bowel and tend to get bigger over time, restricting your activities, and for these reasons surgical repair is usually advised.
What are the different types of hernias?
Inguinal hernia: This is the most common type of hernia and usually affects men. It is found in the inner groin area and is caused by fatty tissue or part of the bowel pushing through the abdominal wall. Sometimes a hernia develops on both sides of the groin at once, which is known as a bilateral or double hernia.
Femoral hernia: This type of hernia is found at the top of the thigh, near the groin, in a passage called the femoral canal. It is much less common but is more likely to occur in women, particularly women over 50. Femoral hernias are more likely to become strangulated, so surgery is usually recommended. You can read more on our femoral hernia treatment page.
Umbilical hernia: This type of hernia develops around the belly button. It can cause pain and soreness and may be noticeable through clothing.
Incisional hernia: This type of hernia forms through the scar of a previous operation on the abdomen, where the muscle has not fully healed.
Hiatus hernia: This is when part of the stomach pushes up into the chest. It often causes heartburn and is usually managed with medication, although some people need surgery.
Signs You May Need Surgery
You should see your GP or a specialist if you notice:
- a lump in your groin, tummy or upper thigh that gets bigger when you cough, strain or stand up
- an aching, burning or dragging feeling around the lump
- pain that stops you working, exercising or lifting
- a lump that is growing over time
Most hernias can be diagnosed with a simple examination. Sometimes an ultrasound scan is used to confirm the diagnosis or to look for a hernia that cannot be easily felt.
Repair Options
Most hernias need surgery to be repaired, and there are two main approaches. Both are usually carried out as a day case.
Laparoscopic (keyhole) surgery: A small camera is inserted through a small cut near the belly button, and instruments are passed through two other small cuts. This allows the surgeon to place a mesh over the weakness in the abdominal wall so the area becomes strong again. Keyhole surgery means smaller scars, less pain after surgery, a quicker return to normal activities and a lower risk of long-term discomfort compared with open surgery.
Open surgery: A cut is made in the groin over the weakness. The hernia is pushed back into the abdomen and the abdominal wall is strengthened with stitches and a mesh. Strenuous activity and exercise are restricted for 4 to 6 weeks after your surgery.
For a detailed look at what happens on the day, recovery and possible risks, see our guide to hernia surgery.
Is Watching and Waiting on Option?
Sometimes it is advised to keep an eye on your hernia and wait. This can be a sensible choice if it is causing few or no symptoms, or if you are very elderly, frail or inactive.
However, most people eventually need a hernia operation. A long-term study of men with inguinal hernias that caused few or no symptoms found that around two in three (68%) went on to have surgery within about ten years, most often because of pain. For men over 65, the figure was 79%. Delaying treatment can also allow the hernia to grow and become more challenging to repair.
When might I need an emergency hernia operation?
If you think your hernia has become stuck or strangulated, you need immediate medical attention. This can be life-threatening and may mean you need an emergency hernia operation.
Call 999 or go to A&E straight away if you have a hernia and:
- the bulge has become larger than before
- you have a high temperature or feel hot and shivery
- the hernia can no longer be pushed back inside the abdomen
- the skin over the hernia has turned red or dark
- you have sudden or severe pain around the hernia
- you have tummy pain, bloating, feel sick or are being sick, or you cannot pass wind or open your bowels
Frequently Asked Questions
No. A hernia in an adult will not heal by itself and usually gets bigger over time. Umbilical hernias in babies are different and often close naturally by the age of 5.
Gentle activity such as walking is usually fine. Avoid heavy lifting and straining, which can make the hernia bigger or more painful, until you have seen a specialist.
Yes. Inguinal hernias are more common in men, but women can get them too. Femoral hernias are more common in women and carry a higher risk of strangulation.
A truss or support garment can ease discomfort by holding the hernia in place, but it does not repair it. It may suit people who are not well enough for surgery.
Speak to a Hernia Specialist
If you have a lump or pain that could be a hernia, Mr Andrew Clarke can examine you, confirm the diagnosis and explain whether a hernia operation is right for you. Call 07501 150298 or book an appointment to arrange a private consultation in Poole or Bournemouth.