Hernia: A Bulge in the Groin or Belly, Types and When to Be Seen

What it involves

MedlinePlus describes a hernia as a sac formed by the lining of the abdominal cavity that pushes through a hole or weak spot in the strong layer of the belly wall. The type depends on where it is: groin, upper thigh, belly button, an old surgical scar, or the diaphragm.

Who this is for

• Patients who notice a bulge in the groin or around the belly button
• Patients with discomfort when standing, straining, or lifting heavy objects
• Patients with chronic cough, constipation, or straining to urinate who worry about a hernia
• Patients who had abdominal surgery and now feel a bulge near the scar

What to expect

• Questions about when the bulge appears, whether it goes away on lying down, and any pain
• An exam while you stand, cough, or bend, since MedlinePlus says a provider can usually see or feel a hernia
• A review of conditions that raise belly pressure, such as constipation, cough, or an enlarged prostate
• A plan that may include imaging, advice about lifting, and a referral to a surgeon, who performs hernia repairs

The common types

MedlinePlus separates hernias by location:

• Inguinal hernia, a bulge in the groin, which is more common in men
• Femoral hernia, a bulge in the upper thigh just below the groin, more common in women
• Umbilical hernia, a bulge around the belly button
• Incisional hernia, which can push through the scar of earlier abdominal surgery
• Hiatal hernia, where part of the upper stomach pushes into the chest

What brings one on

MedlinePlus says there is often no clear cause, but heavy lifting, straining on the toilet, and anything that raises pressure inside the belly can contribute. Chronic coughing, extra weight, smoking, poor nutrition, fluid in the abdomen, and an enlarged prostate that makes you strain to urinate all add pressure. The persistent cough guide and the constipation guide explain two of the biggest triggers.

What you feel

MedlinePlus says there are usually no symptoms other than a visible bulge, though some people have discomfort or pain that is worse when standing, straining, or lifting. Over time the most common complaint is a bump that is sore and growing. Pain in the belly with no visible bulge is covered by the abdominal pain guide, and heartburn from a hiatal hernia by the heartburn guide.

The warning sign not to wait on

When a hernia gets bigger, MedlinePlus says the small intestine can get stuck in the hole and lose its blood supply, which is called strangulation. Pain and swelling at the site, nausea and vomiting, and not being able to pass gas or have a bowel movement are the signs, and surgery is needed right away. A painful hernia that cannot be pushed back, a hernia that turns red, purple, or dark, or fever with a painful hernia means contacting a provider immediately.

How it is treated

MedlinePlus states that surgery is the only treatment that can permanently fix a hernia. It repairs the weakened abdominal wall and closes the hole, often with stitches and sometimes a mesh patch. Surgery can be riskier for people with serious medical conditions, so a provider reviews your overall health. Repair is done by a surgeon, and a primary care provider arranges the referral and manages the rest of your health around it.

Lowering the odds

To help prevent a hernia, MedlinePlus lists using proper lifting techniques, losing weight if needed, avoiding constipation with fiber, fluids, and regular exercise, and, for men, seeing a provider about straining to urinate, which can be a symptom of an enlarged prostate. These steps also help after repair.

Sources

• MedlinePlus — Hernia
• MedlinePlus — Hernia health topic