Know the Signs of a Hernia

Different types can have different symptoms, and some are more common in men or women.

You spent the weekend moving furniture, and now your stomach hurts. Or maybe every time you cough there’s a burning pain in your pelvis. Could it be a hernia?

This relatively common condition can affect anyone, but hernia symptoms can vary based on who you are and where it is.

What is a hernia?

A hernia occurs when an organ or fatty tissue protrudes through a weak spot in the surrounding muscle or connective tissue, typically in the abdomen.

“They can be caused by muscle weakness, straining from heavy lifting or a previous injury,” explains Alanna Gretschel, DO, a general surgeon at Geisinger Lewistown and Geisinger Family Health Associates in Mifflintown.

What makes you more likely to get a hernia

Various things can increase your chances of developing a hernia, some you can control and others you can’t.

“Sometimes people are born with weak abdominal muscles, or their muscles weaken with age,” says Dr. Gretschel.

You’re more at risk of getting a hernia if you:

Are overweight
Smoke
Have a family history of hernia
Get constipated often
Are pregnant
Cough or sneeze frequently
Had abdominal surgery before
Participate in sports with motions that are high-impact, repetitive or explosive like soccer, football, hockey and rugby.

How do I know if I have a hernia?

No matter the cause, the following signs and symptoms are common:

A bulge in the groin or scrotum or swelling in the scrotum, especially one that gets larger when you stand, cough or strain
A bulge you can push back into your abdomen when you lay down
Discomfort in the groin that gets worse when you bend, cough, lift something or do other physical activities
Heaviness or pressure in the groin or abdomen
Pain or discomfort during a bowel movement or urination
Pain, achiness or discomfort toward the end of the day, particularly if you were standing a lot
Fever, vomiting, nausea and severe cramping, which could be signs of a strangulated hernia

It's a common misconception that hernias only affect men, but they can also happen in women and infants, just with slightly different symptoms.

“In women, hernias might not produce a visible bulge, or the pain could be sharper or feel more like burning,” explains Dr. Gretschel. “Since pelvic pain in women could be a symptom of other conditions like endometriosis or uterine fibroids, hernias are often underdiagnosed.”

If you’re a parent, you might notice a lump in your infant’s groin or belly button while they are crying, coughing or making a bowel movement. If so, contact your pediatrician so they can determine if any treatment is needed.

Common types of hernias

The type and location also matter when it comes to symptoms. The five most common are:

Inguinal

Inguinal hernias, also called groin hernias, are the most common type and typically occur in men but can also occur in women. These happen when the intestine or bladder extends into the abdominal wall or into the groin’s inguinal canal. You might see swelling and have pain at the top of your thigh where it meets your groin.

Incisional

These types of hernias occur when the intestine protrudes through the abdominal wall at the site of a previous surgery. This can happen even years following surgery. Incisional hernias usually affect people who are older, overweight or inactive following abdominal surgery.

Femoral

A femoral hernia is when part of the intestine causes a bulge in the upper part of the thigh, close to the groin. You might have no symptoms or have pain around your thigh or hip. This type is rare and is usually seen in women, particularly those who are pregnant or overweight.

Umbilical

Umbilical hernias occur when part of the intestine extends into the umbilical opening in the abdominal area, typically causing swelling around the belly button. Infants are most susceptible to this type, 1 in 5 has one. In babies, they are usually harmless and 80% close on their own over time.

Hiatal

A hiatal hernia is when the upper part of the stomach squeezes through an opening in the diaphragm. A small one might be harmless, but a larger one can cause symptoms like heartburn. These typically affect both men and women and are more common in older adults.

What to do if I suspect I have a hernia

Some hernias need to be repaired with surgery. If you think you have a hernia, talk to your healthcare provider. They can examine you and decide next steps.

Occasionally a hernia can be an emergency. If you have the following symptoms, seek medical care right away:

Severe pain
Nausea or vomiting
Difficulty having a bowel movement
Tenderness or discoloration over the bulge

Treatment and prevention

You may have heard that you can “repair” a hernia yourself if it’s small and not too painful, but it’s always best to talk to your doctor.

“Hernias typically can’t heal on their own — if left untreated, they usually get bigger and more painful and could cause serious health risks,” says Dr. Gretschel. “If the tissue protruding through the hernia becomes squeezed too tightly, it can cause a strangulated hernia, which cuts off blood flow to the bowel and requires emergency surgery.”

You can help reduce your risk by focusing on maintaining a healthy lifestyle and strengthening your abdominal muscles.

“Simple habits like exercising regularly, eating a healthy diet and not smoking can all help them from developing in the first place,” says Dr. Gretschel.