15757 Hernia

Overview

A hernia happens when an internal part of the body, such as a piece of intestine, pushes through a weak spot in the muscle or tissue that holds it in place. This often causes a soft bulge under the skin. Hernias most commonly appear in the groin, belly button, or along a previous surgical scar.

Yes. Hernias are very common, especially in the groin area. Many people live with a hernia for years without needing urgent treatment.

Anyone can get a hernia, but they are more common in men, in people over 50, and in those who do heavy lifting or have long-term constipation or a chronic cough.

Symptoms

Common symptoms

• A soft bulge or swelling in the groin, scrotum, belly button, or around a previous scar
• A dull ache or burning feeling at the bulge
• A feeling of heaviness, pressure, or dragging in the groin or abdomen
• Discomfort when coughing, straining, lifting, or standing for a long time
• A bulge that comes and goes, or flattens when you lie down

Symptoms in children

• A bulge near the belly button or groin that appears when the child cries, coughs, or strains
• Fussiness or the child pulling at the area
• Visible discomfort during feeding or nappy changes

Symptoms in older adults

• Vague discomfort or pressure in the lower belly or groin
• A bulge that may be harder to see, especially in the abdomen
• Constipation or difficulty emptying the bowels
• Symptoms that are easy to mistake for normal ageing

Causes

Main causes

• A weakness in the muscle or connective tissue wall
• Increased pressure inside the belly that pushes tissue through the weak spot — for example, from straining, heavy lifting, coughing, or difficulty passing urine or stool
• Sometimes a weakness that has been present since birth

Risk factors

• Heavy lifting or a job that involves frequent straining
• Chronic constipation or straining on the toilet
• A long-term cough, including from smoking or a chest condition
• Being overweight or obese
• Pregnancy and childbirth
• Older age and a family history of hernia
• Previous surgery in the abdomen or groin

When to see a doctor

See a doctor urgently if:

• A painful bulge that does not disappear when you lie down
• A bulge that is tender, red, hard, or dark in colour
• Nausea, vomiting, or a swollen belly along with a hernia

Book a routine appointment if:

• A bulge with mild or no symptoms
• Any new lump or swelling you are unsure about
• A constant dull ache in the groin or belly

Diagnosis

A doctor usually diagnoses a hernia by asking about your symptoms and examining the area. They may ask you to stand, cough, or bear down to make the bulge appear. In many cases, no further tests are needed.

Tests that may be done

• Physical examination — the most common way to diagnose a hernia
• Ultrasound scan — a quick, painless scan using sound waves to look at the area
• CT or MRI scan — sometimes used if the diagnosis is unclear or the hernia is deep

What to expect at your appointment

The doctor will discuss whether the hernia is causing any risk, how much it affects your daily life, and what your options are. They may refer you to a surgeon if treatment is needed. This advice follows internationally recognised guidance, including UK NHS guidance.

Treatment

Treatment depends on the type of hernia, its size, and whether it causes symptoms. Some hernias can be safely monitored with no surgery. Others may need repair to prevent complications or relieve discomfort. Your healthcare team will help you decide what is best for you.

Self-care at home

• Avoid heavy lifting and straining while you are living with a hernia
• Lie down and rest if the bulge becomes uncomfortable
• Eat high-fibre foods and drink plenty of fluids to avoid constipation
• Seek treatment for a long-term cough
• Do not ignore a painful bulge that becomes hard or tender

Medical treatments

The main treatment for a hernia is surgery. It is usually done either with a single small cut (open surgery) or through several small keyhole cuts (laparoscopic surgery). The surgeon repairs the weak area and may use a small mesh patch to reinforce it. Medicines cannot cure or shrink a hernia, so surgery is the only way to permanently fix it.

When is surgery considered?

Surgery is usually recommended if the hernia is painful, growing, or at risk of becoming stuck or strangulated. A strangulated hernia is a medical emergency and needs urgent surgery. For some people with no symptoms, a safe approach is 'watchful waiting' — keeping the hernia under review and having surgery later if symptoms appear.

Living with this condition

Most hernias are managed safely by keeping an eye on symptoms and avoiding actions that make the bulge worse. Learn the signs of a strangulated hernia and seek urgent care if the bulge becomes painful, hard, or tender.

Lifestyle tips

• Keep a healthy weight to reduce pressure on your belly
• Lift with your legs, not your back, and avoid sudden heavy lifting
• Eat high-fibre foods to prevent constipation
• If you smoke, talk to your doctor or nurse about support to quit

Diet and exercise

Gentle exercise, such as walking, is usually fine with a hernia. Avoid heavy weightlifting or exercises that make you strain. A balanced, high-fibre diet with enough water helps keep your bowels regular and reduces pressure on the weak area.

Mental health and emotional wellbeing

Living with a hernia can cause worry, especially if you notice changes or are waiting for surgery. It can also affect body image or intimacy. These feelings are normal. Talking to your doctor, a trusted friend, or a counsellor can help you feel more in control.

Prevention

Not all hernias can be prevented, because some people have naturally weak spots in their muscles. However, you can reduce your risk by avoiding unnecessary strain, keeping a healthy weight, and treating chronic cough or constipation early.

Vaccines

There is no vaccine to prevent hernias.

Screening programmes

There is no routine screening test for hernias. If you notice a new bulge or discomfort, it is best to have it checked by a doctor.

Complications

If left untreated

• Incarceration — the hernia becomes stuck and cannot be pushed back.
• Strangulation — the blood supply to the trapped tissue is cut off, which is a medical emergency.
• Bowel obstruction — if part of the intestine is trapped, it can block the passage of food and stool.
• Chronic pain or disability that interferes with everyday activities.

Long-term outlook

The outlook for a hernia is very good. Most hernias can be either safely monitored or repaired with a planned operation that is very effective. The risk of serious complications is low when you know what to look for and seek help promptly.

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