Hernia - What it is, Types, Symptoms, Causes & Treatments

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Signs and Symptoms – What are the Symptoms of a Hernia?

Hernias can present with a range of symptoms, depending on their type, location, and severity. While some hernias may be painless and go unnoticed initially, others can cause significant discomfort or even lead to complications if left untreated. Recognizing the early signs is essential for timely diagnosis and effective treatment. Common Symptoms of a Hernia Include:

Visible Bulge or Lump

A tell-tale sign of a hernia is a noticeable bulge or swelling under the skin, often in the abdomen, groin, or near a surgical scar. This lump may become more prominent when you stand up, cough, or strain and might disappear when you lie down.

Pain or Discomfort

Many people experience pain or a dull ache, especially when lifting heavy objects, bending over, or coughing. The intensity can vary from mild discomfort to sharp, persistent pain in the affected area.

Heaviness or Pressure in the Abdomen

A hernia can create a sensation of fullness, pressure, or dragging in the lower abdomen or groin, particularly after prolonged standing or physical activity.

Burning or Aching Sensation

Some individuals report a burning, gurgling, or aching feeling around the site of the hernia. This can be due to tissue being pushed through the weakened muscle wall.

Swelling and Redness (in some cases)

In more advanced or strangulated hernias, the bulge may become red, swollen, or tender to the touch, signaling a medical emergency.

Nausea, Vomiting, or Bowel Obstruction

In severe or complicated cases, a hernia can block part of the intestine, leading to nausea, vomiting, constipation, or the inability to pass gas. This requires immediate medical attention.

Diagnosis / Investigations – How is a Hernia Diagnosed?

Early and accurate diagnosis is the key to preventing complications and ensuring successful treatment outcomes for hernias.

Thorough Physical Examination

The diagnostic journey often begins with a detailed physical exam.The doctor will check for a visible or palpable bulge, especially when you cough, stand, or strain.Inguinal and abdominal hernias are often detected during routine clinical examinations.In some cases, the bulge may reduce or disappear when lying down, providing further diagnostic clues.

Ultrasound or Doppler Scan

Ultrasound imaging is a non-invasive and effective way to visualize soft tissues and identify hernias, especially in the groin and abdominal wall.Ideal for detecting hernias in children and thin adults.Helpful for differentiating hernias from other masses like lymph nodes or cysts.Doppler ultrasound may be used to assess blood flow if strangulation is suspected.

CT Scan (Computed Tomography)

A CT scan is especially useful for complex or recurrent hernias. It provides detailed cross-sectional images that help:

1. Identify the exact location and contents of the hernia
2. Assess involvement of intestines or surrounding tissues
3. Plan surgical intervention in complicated or post-operative cases

MRI (Magnetic Resonance Imaging)

MRI may be recommended when the diagnosis is uncertain, particularly for deep or hidden hernias (like femoral or obturator hernias). Offers high-contrast images of soft tissue structures. Useful for distinguishing hernias from muscle tears or tumors.

Blood Tests (If Needed)

In emergency cases where bowel obstruction or strangulation is suspected, blood tests may be done to assess:

1. Infection or inflammation (elevated white blood cells)
2. Signs of ischemia (restricted blood supply)

Types of Hernias

We treat all hernia types, including:

Inguinal Hernia – Groin hernia, more common in men
Femoral Hernia – Lower groin/thigh, more common in women
Umbilical Hernia – Belly button area, common in infants
Hiatal Hernia – Upper stomach pushing into chest through diaphragm

Incisional Hernia – Occurs at the site of a previous surgical incision
Epigastric Hernia – Upper abdominal region between belly button and chest
Spigelian Hernia – Rare, occurs along the edge of abdominal muscles

Causes of Hernia

Weakness in Muscles or Connective Tissues: A primary cause of hernias is a natural or acquired weakness in the muscle wall or connective tissues, which can allow internal organs to protrude, especially under pressure.
Chronic Coughing or Constipation: Repeated strain from chronic coughing (due to smoking or lung conditions) or constant straining during bowel movements increases intra-abdominal pressure, placing stress on weak spots in the abdominal wall.
Heavy Lifting Without Proper Technique: Lifting heavy objects without proper support or technique can suddenly increase abdominal pressure, leading to the rupture of weak muscle areas and resulting in herniation.
Obesity or Sudden Weight Gain: Excess body weight puts continual stress on the abdominal muscles and can stretch or weaken the tissue over time, making it easier for a hernia to form.
Aging and Wear and Tear: As people age, muscles naturally lose tone and elasticity. This age-related degeneration can contribute to weakened support structures and increased risk of hernias.
Previous Surgeries: Surgical incisions, especially in the abdominal region, may not fully heal or may leave weak spots in the muscle wall, making them susceptible to incisional hernias later on.
Congenital Defects (Present from Birth):Some individuals are born with a defect in the abdominal wall or diaphragm, which makes them more prone to developing hernias during infancy, childhood, or later in life.

Medical Conditions Linked to Hernias

Chronic Obstructive Pulmonary Disease (COPD): COPD often causes persistent, forceful coughing, which repeatedly strains the abdominal wall and can lead to the development of hernias over time.

Ascites (Fluid in the Abdomen): The buildup of excess fluid in the abdominal cavity increases internal pressure, stretching and weakening the abdominal muscles and raising the risk of hernia formation.

Prostate Issues Causing Straining: Enlarged prostate or related urinary conditions can lead to excessive straining during urination, which puts repeated stress on the lower abdominal muscles and can cause inguinal hernias.

Constipation or Irritable Bowel Syndrome (IBS): Chronic constipation or IBS often involves repeated straining during bowel movements, increasing abdominal pressure and contributing to hernia development.

Connective Tissue Disorders (e.g., Marfan Syndrome): Genetic conditions like Marfan syndrome affect the strength and integrity of connective tissues, making muscle walls more prone to stretching or tearing and increasing hernia susceptibility.

Surgical Conditions Linked to Hernias

Previous surgeries or abdominal interventions can weaken muscle layers and increase the likelihood of hernia formation, especially near incision sites:

Previous Abdominal Surgeries: Surgeries involving the abdomen—such as appendectomies, C-sections, or bowel surgeries—can leave weakened spots in the abdominal wall where hernias may later develop, especially if healing was delayed.

Poor Wound Healing or Post-Surgical Infections: Infections or complications during healing can compromise the strength of surgical sites, leading to incisional hernias where tissue pushes through the weakened scar.

Repeated Surgeries in the Same Area: Multiple surgeries in the same location can repeatedly strain and damage muscle layers, compounding the risk of developing a hernia at or near the surgical site.

Use of Drains or Mesh Without Proper Reinforcement: In some cases, improper placement or complications from surgical mesh or drains can contribute to tissue weakness, predisposing patients to hernias.

Laparoscopic Surgeries with Port Sites: Although minimally invasive, laparoscopic procedures can still result in hernias at port or trocar insertion sites if proper closure techniques aren’t used or if post-operative strain occurs.

Treatments & Procedures for Hernia at Royal Care Hospital

Watchful Waiting Open Hernia Repair Laparoscopic Hernia Repair Robotic-Assisted Hernia Surgery Emergency Surgery Mesh vs. Non-Mesh Repair Options Postoperative Care and Rehabilitation

Watchful Waiting (for Minor, Asymptomatic Hernias)

In some cases—especially when hernias are small and not causing pain—doctors may recommend monitoring the condition over time. Patients are advised on lifestyle changes and activity modification to reduce strain.

Open Hernia Repair (Herniorrhaphy or Hernioplasty)

This traditional surgical approach involves making an incision directly over the hernia site, pushing the bulging tissue back into place, and reinforcing the weakened muscle wall. A mesh may be used to provide additional support and prevent recurrence.

Laparoscopic Hernia Repair

Minimally invasive and performed through small incisions, this technique uses a camera (laparoscope) and specialized instruments to repair the hernia. Benefits include less post-operative pain, shorter hospital stay, faster recovery, and smaller scars.

Robotic-Assisted Hernia Surgery

For suitable cases, we offer robotic-assisted procedures that provide greater precision and flexibility for complex or recurrent hernias. The robotic system allows for enhanced visualization and meticulous dissection, ensuring optimal results.

Emergency Surgery (for Strangulated or Incarcerated Hernias)

If a hernia becomes strangulated (cutting off blood supply) or incarcerated (trapped tissue), emergency surgery is needed to prevent life-threatening complications. Our surgical team is trained to handle these urgent scenarios with speed and efficiency.

Mesh vs. Non-Mesh Repair Options

Depending on the patient’s condition and preferences, we offer both mesh-based and non-mesh repair techniques. Mesh helps reinforce the abdominal wall and is commonly used in most modern repairs, but non-mesh repairs may be chosen for specific cases.

Postoperative Care and Rehabilitation

After surgery, patients receive detailed guidance on wound care, physical activity, and follow-ups. Our team ensures recovery is closely monitored to reduce complications and support a quicker return to normal life.

3D Mesh Repair Systems: Our advanced 3D mesh implants provide a stronger, more secure repair for hernias, reducing recurrence and promoting faster healing.
Laparoscopic & Robotic Surgery Units: Minimally invasive laparoscopic and robotic-assisted surgeries ensure smaller incisions, less pain, and quicker recovery times for our patients.
High-Definition Imaging & Diagnostic Tools: State-of-the-art imaging equipment allows for precise diagnosis and surgical planning, leading to better treatment outcomes.
Enhanced Recovery After Surgery (ERAS) Protocols: We follow ERAS protocols to help patients regain mobility and return home sooner, with less discomfort and fewer complications.
Zero-Touch Sterile Environment for Infection Control: Our ultra-sterile surgical suites are designed to minimize infection risk, ensuring a safe and clean environment for every procedure.

Prevention and Awareness

Gastroenterology team

Dr. S. Paulvannan

MS, DNB, FRCS (Glasg), FRCS (Gen.Surg), CSST, HPB Fellow (Cambridge, UK).,

Consultant Surgical Gastro, Advanced Laparoscopic, HPB and GI Onco & Bariatric Surgeon

Dr. A. Sandip Chandrasekar

MS, M.Ch (SGE), DNB (GI.Surgery), FALS (Bariatric).,

Consultant Surgical Gastro, Advanced Laparoscopic, HPB,GI Oncology and Bariatric Surgeon

Dr. S. Soundappan

MBBS(MMC), MS(KEM, Mum), MRCS(UK), DNB - Surg Gastro (AIG, Hyd), FALS-Robotic, Fellowship-Hepatobiliary Surgery(AIG,Hyd), Fellowship-Liver transplant(CLBS,Delhi).,

Consultant - Gastro, Minimally invasive, and Liver transplantation surgery

Frequently Asked Questions

1. Is hernia surgery painful?

Modern hernia surgery is performed under anesthesia. Post-operative discomfort is usually minimal and well-managed with medication.

2. Can a hernia heal on its own?

No, hernias typically do not heal without surgery. Left untreated, they may worsen or become life-threatening.

3. How long does recovery take after hernia surgery?

Recovery depends on the type of surgery. Laparoscopic patients often return to normal activity within 1–2 weeks.

4.Are hernias preventable?

While not all hernias are preventable, but healthy lifestyle habits can reduce risk.

5. What are the risks of untreated hernias?

Risks include obstruction, strangulation, and severe infection requiring emergency surgery.

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