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What’s a hernia, and how soon should you seek care?

Most people discover a hernia by noticing a bulge.

A hernia occurs when part of an internal organ or tissue pushes through a weak muscular wall into an area it shouldn’t be located.

Hernias are common and can affect men and women of all ages

lifting objects can cause a hernia
A hernia occurs when part of an internal organ or tissue pushes through a weak muscular wall into an area it shouldn’t be located.

“Any activity that puts pressure on the abdomen can cause a hernia, such as heavy lifting, persistent coughing or diarrhea or constipation,” said Dr. Timothy Pitchford, general surgeon with Marshfield Clinic Health System. “Obesity, poor nutrition, smoking and infections after surgery can heighten your risk.”

There are different types of hernias, including:

  • Inguinal, or in the groin. Part of the intestine pushes into the inguinal canal area, a passageway through the abdominal wall in the groin.
  • Umbilical, where part of the intestine pushes through the abdomen near the belly button.
  • Incisional, where tissue protrudes through an abdominal scar.
  • Hiatal, where a small opening in the diaphragm allows the upper part of the stomach to move into the chest.
  • Congenital, a birth defect requiring surgery.

Diagnosing a hernia

“Many people will notice a lump that is present and may or may not be tender,” Dr. Pitchford said. “If patients experience pain, the pain level will depend on where the hernia is located. It could be localized to the site or extend to the surrounding area. For some patients, pain may be the first symptom.”

Other symptoms include pain while lifting, an increase in the bulge over time, an aching sensation and a sense of feeling full.

Hiatal hernias have no noticeable bulge, but patients will notice symptoms that include heartburn, indigestion, difficulty swallowing or chest pain.

Your provider can often diagnose a hernia with just a physical examination, though your provider may need to use a CT scan or ultrasound.

Hernias will not get better on their own

If you believe you have a hernia, or are experiencing signs or symptoms of a hernia, talk to your provider as soon as possible to discuss your treatment options.

“Surgical repair is generally recommended. Other than newborns with an umbilical hernia, hernias will not heal without surgery. Around 80% of cases of an umbilical hernia in newborns will close on their own before age four,” Dr. Pitchford said. “Other than in those cases of umbilical hernias, hernias will not go away without surgery.”

Putting off treatment to avoid surgery is not recommended. Electing for surgery is a common treatment plan for most patients because pain and discomfort often increases over time and hernias will not get smaller or go away.

If you notice constant pain, or pain associated with vomiting, immediate care should be sought. For hernias without associated painful symptoms, surgery can usually be done at the patient’s convenience.

“Most hernias are repaired through a laparoscopic approach, meaning it’s performed using small incisions with the aid of a camera and may be done with or without robotic assistance,” he said.

Surgery is often done on an outpatient basis, meaning patients are expected to go home the same day as their surgery. Following surgery, patients will be put on a lifting restriction for four to six weeks. Walking is allowed, as long as it’s well-tolerated. Patients also may require a short course of pain medication after surgery.

Lifestyle changes may aid in prevention

Maintaining an ideal body weight by eating a healthy diet and exercising may help prevent hernias. Eat plenty of fruits, vegetables and whole grains to avoid constipation. Use the correct form when lifting weights or heavy objects and avoid lifting beyond your ability. Don’t smoke – it can lead to coughing that may cause a hernia.

Learn more about hernias and when you should see a doctor from Dr. Gavin Ambrosi, general surgeon at Marshfield Medical Center-Minocqua in this video:

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