Hernias are a common health condition, with the NHS performing almost 100,000 hernia repair surgeries each year in England. However, there are different types of hernia, so knowing the difference between them is vital.
In this post, we explain what a hernia is and why you should know the various types, including the most and least common hernias. Discover the symptoms and treatments for different hernia types with Mr Achal Khanna – an expert in treating hernia with laparoscopic and robotic techniques that enhance outcomes and recovery.
What is a hernia?
A hernia occurs when an internal body part pushes through a weakened area of muscle or tissue. Hernias generally develop between your chest and hips and don’t always cause symptoms, making it hard to know whether you have one.
The most noticeable hernia symptom is a lump that you can push in or make disappear when you hold it down. The lump may also appear when you cough or strain.
Your doctor will physically examine the area to diagnose a hernia. They may ask you to cough while they press on the bulge. Sometimes, they may refer you for an ultrasound scan to confirm their hernia diagnosis, especially if your bulge isn’t noticeable.
Not all hernias need treatment immediately, but some can be medical emergencies.
Always call 999 if you have a hernia and develop:
- Sudden, severe pain
- Vomiting
- Problems emptying your bowels or passing wind
- A hard hernia that you cannot push back
These symptoms may signal a strangulated hernia (where the surrounding muscle cuts off blood supply to a section of organ or tissue in the hernia) or a piece of bowel that has entered your hernia and caused an obstruction (blockage).
Learn more about when to have hernia surgery in our blog ‘How long can you wait to have hernia surgery?’
Why should I know the different types of hernia?
Knowing the various hernia types is essential because they do not always cause the same symptoms. Moreover, when you know something is wrong with your hernia, you can seek medical attention when needed.
The most common types of hernia
There are six common types of hernia. While they may not always cause symptoms immediately, it’s still essential to treat them as they may grow larger or become strangulated or obstructed.
Let’s look at some of the most common types of hernia.
Inguinal hernias
Inguinal hernias are the most common hernia type. These occur when part of your intestine or fat bulges into your lower stomach wall. In women, inguinal hernias can also contain female reproductive organ parts.
A bulge usually develops at the top of your inner thigh and can sometimes be confused with femoral hernias due to their similar location.
Other inguinal hernia symptoms can include:
- Pain or discomfort in your groin that worsens when standing or straining
- Pressure in your groin
- Swelling or redness in the area
Not all inguinal hernias need treating, especially if they’re tiny. However, it’s always essential to treat a hernia as it could cause complications like strangulation and obstruction. Hernia repair surgery is the most effective treatment for inguinal hernias.
Umbilical hernias
In umbilical hernias, tissue bulges through a weakened area near your navel (umbilicus). The bulge will be noticeable and worsen when you cough or strain. Although umbilical hernias can occur in older adults, they’re more common in babies under six months old. They happen because the muscles surrounding their umbilical cord don’t close properly after birth.
Umbilical hernias often repair themselves within the first few years of life and are rarely painful, so they don’t usually require treatment. You may need reparative surgery if they do not go away independently or cause significant symptoms.
Hiatus hernias
With a hiatus hernia, your stomach bulges through a weak point in your diaphragm (the muscle separating your lungs from your abdominal organs and supporting breathing). Experts are not sure what causes hiatus hernias, but they’re more common if you’re pregnant, overweight or aged over 50.
Some people have a hiatus hernia without realising it, as this type does not typically result in a lump. However, common symptoms of a hiatus hernia can include:
- Heartburn
- Difficulty swallowing
- Nausea or vomiting
- Burping more than usual
- Bloating
- Gastro-oesophageal reflux disease (GORD)
Treating a hiatus hernia depends on its severity. Sometimes, it helps to lose weight, improve your diet or take prescribed medication. However, a severe hiatus hernia may require reparative surgery.
Femoral hernias
Tissue pushes through a weak point in your groin or inner thigh to create a femoral hernia. This hernia type is often small to medium-sized and sometimes forms if you strain during bowel movements or lift heavy objects or weights.
Women are more likely to have femoral hernias due to their larger pelvis, which increases the risk of tissue poking through.
Common symptoms of a femoral hernia, in addition to a lump in your groin or upper thigh, include:
- Pain or discomfort in the area, especially when coughing, bending or lifting
- Weakness or pressure in your groin
Femoral hernias typically need fast treatment as your femoral artery and vein are nearby and your hernia could potentially affect them and stop blood flow to your legs. Reparative surgery is the best and most effective treatment.
Incisional hernias
Incisional hernias develop at the site of previous abdominal surgery and the cause is usually the incision not healing correctly.
Common incisional hernia symptoms include:
- A bulge or swelling near the incision
- Pain or discomfort
- Pressure or heaviness in your abdomen
Your incisional hernia’s complexity and severity will determine the treatment. Before recommending surgery, your doctor may observe your hernia over a few days or weeks to see if it grows or causes complications. If it doesn’t, then you may not need treatment. If it does, then a hernia repair will be necessary.
Epigastric hernias
Epigastric hernias are found above your navel and below your rib cage, also called the epigastric region. Fat tissue poking through your abdomen because of a gap between the two sides of your abdominal wall causes this hernia.
An epigastric hernia can cause symptoms like:
- Pressure on your abdominal wall when coughing, laughing or emptying your bowels
- Pain or tenderness in the area
However, many epigastric hernias are minor and do not cause noticeable symptoms. Larger epigastric hernias, on the other hand, can and will need surgery to repair it.
Less common types of hernia
Some hernia types are rarer than others, making them all the more vital to know.
Let’s look at some of the less common hernia types.
Spigelian hernias
These infrequent types of hernia occur along the tissue of your abdominal wall below your rib cage and above the hip bone. This hernia occurs in around 0.12% to 2% of abdominal wall hernias.
They’re also challenging to diagnose but can cause symptoms such as:
- A lump in your abdominal wall that becomes noticeable when standing or straining
- Pain or discomfort
- Constipation
Spigelian hernias require hernia repair surgery. If left untreated, this hernia type can become larger and more painful, so it’s vital to treat it.
Diaphragmatic hernias
Diaphragmatic hernias happen when an abdominal organ part pushes through a weakened area of your diaphragm. These hernias are either congenital (you’re born with them) or a result of a trauma or injury to your diaphragm.
Common diaphragmatic hernia symptoms include:
- Chest pain or discomfort
- Problems breathing
- Abdominal pain
- Difficulty swallowing
This hernia type can also cause no significant symptoms and doctors often only find them when you have imaging tests for other health conditions.
Hernia repair surgery is the one treatment for diaphragmatic hernias.
Muscle (myofascial) hernias
Muscle hernias occur when part of your muscle tissue pokes through a weakened area in the fascia (the connective tissue surrounding and separating muscle). This hernia generally occurs because of a sudden injury to the area or repetitive strain. People who play sports are more likely to develop a muscle hernia.
Muscle hernias are not always symptomatic but can cause:
- Pain or weakness in the area
- A lump in the muscle
Depending on your muscle hernia’s severity, a doctor may recommend physiotherapy or surgery.
Discover hernia treatment with Mr Achal Khanna
Mr Achal Khanna offers many ways of treating various hernia types. He uses minimally invasive laparoscopic techniques and modern, robotic technology to treat your hernia effectively.
Contact us today to learn more about Mr Achal Khanna’s effective hernia repair surgery treatments.