Hernias might not cause any pain at first, and the only sign you potentially have one is swelling. However, when pain does occur, it can feel quite worrying and you may wonder when you need to seek medical help.
This page will explain what a hernia is, what the symptoms are, and when you need to worry about hernia pain.
What is a hernia?
A hernia is a visible, irregular lump or bulge caused by the protrusion of an internal organ pushing through weakened muscle or tissue wall. In most cases, they appear in the groin crease, but they can also be present around the naval or other parts of the abdomen.
The lump can be pushed back in or may disappear slightly when you lie down flat. It may appear or become more pronounced when you cough, strain or bend.
There are different types of hernia, and the type that you have can determine the cause.
Inguinal hernia
This type of hernia develops when the fatty tissue or part of the bowel protrudes into the groin at the top of the inner thigh. This type of hernia is most common in men, and it can be linked to ageing and repetitive strain.
Femoral hernia
Femoral hernias are similar to inguinal hernias, caused by fatty tissue or the bowel poking into the groin.
However, they are much less common and seem to impact women more than men. They are associated with ageing and repeated stomach strain as well.
Umbilical hernia
This type of hernia develops when fatty tissue or part of the bowel protrudes through the stomach near the belly button.
Umbilical hernias occur mostly in babies and young children, and can particularly affect premature babies. They are caused by the opening of the removed umbilical cord not sealing completely after birth, leaving a weak spot in the surrounding muscle wall.
Umbilical hernias can also affect adults. In adults, certain factors may contribute to developing an umbilical hernia, such as repetitive straining while lifting heavy objects, being overweight or having a severe, persistent cough.
Hiatus hernia
A hiatus hernia happens when a part of the stomach pushes into the chest by squeezing through a gap in the diaphragm.
Most people don’t notice that they have this type of hernia, as the symptoms aren’t obvious. However, it can cause acid reflux and heartburn.
There is no clear reason as to why a hiatus hernia develops, but it is thought that it may be due to the weakening of the diaphragm with age or pressure on the stomach.
Other, more uncommon types of hernia include:
- Incisional hernia
- Epigastric hernia
- Spigelian hernia
- Diaphragmatic hernia
- Muscle hernia
What causes a hernia?
The causes of most types of hernia are thought to be ageing and repetitive strain on the stomach. However, some risk factors can increase the chances of you developing a hernia.
These risk factors are:
- Being male — research shows that men are more likely to develop a hernia
- Family history of hernia
- Chronic coughing
- Chronic constipation
- Pregnancy
- Being overweight
Hernia signs and symptoms
The most common signs and symptoms of a hernia include, but aren’t limited to:
- A bulge in the groin or naval area that reduces when pressed
- Burning or aching around the bulge
- Pain in the groin — particularly when bending, coughing or lifting
- Weakness or a feeling of pressure in the groin area
- Bloating sensation
Some people don’t notice that they have a hernia until it becomes more severe. You may have no symptoms at first.
What can be mistaken for a hernia?
Other conditions can cause similar symptoms to a hernia and may appear as a lump in the abdomen or groin area.
For example, a lipoma is a lump that grows under the skin and can be moved slightly when you apply pressure. It may look similar to a hernia lump, but a lipoma is a fatty, non-cancerous tumour.
Hematomas could be mistaken for a hernia too, as a lump can develop under the skin. However, these can be accompanied by surrounding bruising and are often the direct result of impact or injury. A hematoma will also disappear on its own, whereas a hernia will not.
When to worry about hernia pain
If you think that you have a hernia, seek medical advice as treatment may be needed.
Most people will have slight discomfort when they have a hernia, but they might not think it’s bad enough to do anything about it. However, if the pain becomes severe, you will need to head to Accident and Emergency (A&E) right away.
Other severe symptoms that need immediate medical treatment include:
- Sudden pain
- Vomiting
- Difficulty emptying your bowels
- Inability to pass wind
- A hernia that has become firm and can’t be pushed back in
When these symptoms occur, it may mean the blood supply to a section of an organ or tissue has become trapped in the hernia. This is called a strangulated hernia.
It could also mean that a piece of the bowel has entered the hernia and become blocked. This is called an obstructed bowel.
An obstructed bowel and strangulated hernia are both medical emergencies, so you need to seek help immediately.
Hernia treatment
Surgery is almost always the recommended treatment for a hernia in adults. Surgery can prevent the hernia from becoming bigger and avert more severe symptoms.
The treatment itself is a simple day surgery, which means you can be released within a few hours of the operation. During the procedure, a mesh is used to help reinforce the abdominal wall. This is to lower the risk of the hernia coming back.
The hernia procedure can be performed by keyhole surgery, which is less invasive then open hernia surgery and means there is little scarring or physical trace of the procedure. There is a quicker recovery time when you have keyhole hernia surgery, so you should be able to return to work within one to two weeks.
Seeking treatment for your hernia is important as it could become severe if left. Hernia pain may start as a dull ache, and this can be bearable. However, when it becomes increasingly painful, you need to seek medical attention.
It’s always better to speak to a doctor if you suspect you have a hernia. They will be able to advise you on what treatment is best for you.