Hernias: How to Tell if You Have One
Q: What is a hernia?
Q: What does a belly hernia or abdominal hernia feel like?
A: The outer surface of the abdomen may bulge if you have a ventral hernia in the belly area. A ventral hernia typically causes mild pain, aching, or a pressure sensation at the site. Any activity that puts pressure on the abdomen, such as heavy lifting, running or bearing down during bowel movements, worsens the discomfort. There are some patients who have a bulge but are not bothered by it.
Q: Who is at higher risk for a ventral hernia?
A: A ventral hernia can happen to anyone, but those who have undergone abdominal surgery are more likely to develop one. You're more likely to develop a hernia, known as an incisional hernia, if you have an incision that disrupts the abdominal wall. Up to 30% of patients who undergo open abdominal surgery experience this.
Women who are pregnant are more likely to develop umbilical hernias, another type of ventral hernia near the belly button. Of all the parts of the abdominal wall, the umbilicus is the thinnest. No matter your gender, you're likely to get a hernia in this area.
Q: Is it possible to tell if you have an inguinal (groin) hernia?
A: Inguinal hernias can occur in both men and women. A common misconception is that only men suffer from inguinal hernias, and for anatomical reasons they do have a higher risk. However, women can certainly suffer from them as well.
Women tend to present with different symptoms than men, making them likely to be under diagnosed for this condition. Bulges may not be noticeable in women. An MRI can provide definitive evidence if your doctor can't confirm a hernia based on your symptoms.
Symptoms in Men
- You can see or feel a bulge
- An aching pain in the area
- There is a feeling of pressure
- A tugging sensation around the testicles in the scrotum
- An increase in pain with activities such as heavy lifting, pushing, and bending
Symptoms in Women
- Pain that is aching or sharp
- Sensation of burning
- There may be a bulge at the hernia site, but it may not be present in groin hernia
- Increased discomfort with activity
Q: What is the treatment for hernias?
A: Treatment depends on the type of hernia, symptoms, and gender of the patient.
Inguinal (Groin) Hernias
There is a higher risk of inguinal hernias becoming emergencies in women. Complications are also more likely to occur in women than in men. As a result, we usually recommend surgical repair after diagnosis.
Hernia surgery may be postponed or avoided if the hernia is small. Wearing a hernia belt while awaiting surgery can reduce your discomfort significantly. This hernia truss has a pad that applies compression directly over the hernia to prevent it from bulging out further.
It is common for men with inguinal hernias to put off surgery if they are not experiencing any symptoms. The risk of an emergency, such as the bowel becoming trapped or strangled in the muscle gap, is quite low in men with inguinal hernias. In spite of this, most men will require surgery within 10 years of being diagnosed with a hernia because hernias tend to grow larger or cause symptoms over time.
For inguinal hernias, there are two surgical treatments available. There are several methods of minimally invasive surgery, including laparoscopic surgery in which a small camera and instruments are inserted through a keyhole-sized incision. It is also possible to perform minimally invasive robotic surgery (similar to laparoscopy, but with the use of a controller to move the instruments). Within two weeks of minimally invasive surgery, patients can resume their normal activities. Another treatment option is open surgery, which takes four to six weeks to recover from.
In most cases, abdominal hernias should be repaired by both men and women. There is an exception to this rule if you have risk factors for complications or hernia recurrence, such as obesity or poorly controlled diabetes. Before undergoing surgery, it is advisable to control those conditions. In some cases, patients do not experience symptoms and may decide to postpone surgery after discussing the risks and benefits with their surgeon.
Because ventral hernias come in a variety of shapes and sizes, surgical options and recovery times vary widely. The treatment of a small umbilical or incisional hernia can often be performed as an outpatient procedure. A hospital stay of one to five days may be required for the repair of more complicated hernias.
Q: What are the signs of an emergency hernia?
A: In most cases, the internal tissue that pushes through the muscle gap is fat when a hernia begins. However, it is also possible for part of the bowel to protrude through the opening. It is rare for this to occur, but if it does, it requires emergency repair. You should seek medical attention immediately if you experience any of the following symptoms:
- There is a painful bulge that does not diminish in size when you lie down and rest
- Pain that is becoming worse
- Symptoms of nausea and/or vomiting
- Inability to perform a bowel movement
- There is bloating
- An increase in heart rate
- Having a fever
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