What is a hernia?

A hernia is when tissues or organs bulge through a weak point in the surrounding muscle or tissue wall.

Many hernias occur in the abdomen (tummy) — the area between your chest and pelvis. If you have an abdominal hernia, tissue from inside your abdomen (such as fatty tissue or part of your bowel) can move into a space where it doesn’t normally sit.

The main symptom of many hernias is a bulge that you notice more when:

• exercising
• straining
• coughing
• heavy lifting

The bulge may disappear when you lie down.

Types of hernias

There are a number of different types of hernias that can occur in your abdomen:

• inguinal hernias
• femoral hernias
• umbilical hernias
• incisional hernias
• epigastric hernias
• hiatus hernias

Inguinal hernia

An inguinal hernia can cause a bulge in your groin, at the top of your inner thigh.

Inguinal hernias are the most common type of hernia, and mostly affect males. They happen when there is a weakness in the lower wall of your abdomen.

Femoral hernia

A femoral hernia can also cause a bulge in your groin, at the top of your inner thigh. Femoral hernias are more common in females.

Umbilical hernia

An umbilical hernia is when abdominal tissue pushes through a weakness in the abdominal wall near your umbilicus (belly button). It forms a bulge around your belly button.

Umbilical hernias are more common in babies and toddlers.

Incisional hernia

An incisional hernia is when you have a hernia in a place where you previously had abdominal surgery.

Abdominal tissue pushes through the weakness in your abdominal wall where there is scar tissue.

Epigastric hernias

In this type of hernia, tissue pushes through your abdominal wall in the area between your belly button and your breastbone. Epigastric hernias can affect children and usually cause no symptoms.

Hiatus hernia

A hiatus hernia is when part of your stomach pushes up into your chest cavity.

Your stomach pushes through the opening in your diaphragm where the oesophagus (food pipe) passes through. Your diaphragm is the muscle separating your chest from your abdomen.

What are the symptoms of a hernia?

The symptoms of a hernia depend on the size of the hernia and where it is in your body.

The main symptom of most abdominal hernias is a bulge or soft lump in your groin or abdomen. Usually, the bulge can be gently pushed back, and may disappear when you lie down. Males with an inguinal hernia may notice a bulge in the scrotum.

You may notice the bulge more when you cough or strain. Umbilical hernias in babies are often more noticeable when they are crying.

You may also have:

• a feeling of heaviness or discomfort around the bulge
• a pulling or dragging sensation where the bulge is

You may notice these symptoms when coughing, straining, exercising or lifting.

What causes a hernia?

Hernias are due to a weakness in your abdominal wall. This weakness may:

• be there from birth
• happen after abdominal surgery
• develop over time

The causes and risk factors for hernias depend on the type of hernia you have.

Hernias are more likely to develop when you have increased pressure in your abdomen. This can be from:

• being overweight or obese
• pregnancy
• having a chronic cough
• constipation and straining on the toilet

Other risk factors for some types of hernias include older age and smoking.

When should I see my doctor?

If you or your child have symptoms or signs of a hernia, see your doctor.

Seek emergency medical treatment if:

• you cannot push your hernia back in
• your hernia becomes sore or firm
• your hernia changes colour to be red purple or dark
• you have sudden abdominal pain that quickly gets worse
• you have nausea, vomiting or bloating
• you have difficulty opening your bowels (pooing) or passing wind

How is a hernia diagnosed?

Your doctor will ask about your symptoms and examine you. Your doctor may ask you to cough, strain or stand while pressing on the hernia.

Hernias can be diagnosed without tests, but your doctor may sometimes recommend tests such as:

• an ultrasound scan
• a CT scan
• an MRI scan

How is a hernia treated?

Treatment for a hernia depends on:

• the type of hernia you have
• the size of your hernia
• your symptoms
• your health in general

If you have a hernia, your doctor may recommend avoiding straining and heavy lifting.

Surgical repair of hernias

Surgery to repair a hernia can be done with an open or laparoscopic (keyhole) procedure.

With open surgery, your surgeon makes a cut near the hernia to repair it with stitches. They may lay down a piece of mesh to help strengthen the area.

Laparoscopic surgery involves several small cuts in your abdominal wall. Long tools and a small camera (called a laparoscope) are put into the cuts. The images from the camera guide your surgeon to repair the hernia.

Talk to your doctor about the treatment options and the risks and benefits of the different procedures. Here’s a list of questions to ask before surgery.

You will need to avoid heavy lifting or straining for several weeks after a hernia repair.

If surgery is risky because you have other medical problems, your doctor may recommend a watch-and-wait approach. For more information, speak to your doctor.

Inguinal hernia treatment

Surgery is usually recommended to repair an inguinal (groin) hernia.

Types of inguinal hernia repair include:

• open surgery (for males or females)
• inguinal hernia repair for a child
• laparoscopic (keyhole) inguinal hernia repair (TEP)
• laparoscopic (keyhole) inguinal hernia repair (TAPP)

A watch-and-wait approach may be used in some people with few symptoms. But even if you don’t have symptoms, surgery is often recommended as there is a risk of complications.

Femoral hernia repair

If you have a femoral hernia, surgery can be done to repair it. Surgery is usually recommended even if you don’t have symptoms, as there is a risk of complications.

Umbilical hernia treatment

Umbilical hernias usually close naturally when children are around 2 to 5 years old.

If an umbilical hernia hasn’t closed by this time, or if the hernia is large, then surgery is usually needed. This type of surgery is called an umbilical hernia repair.

Incisional hernia repair

If you have an incisional hernia, you will probably need surgery to repair it. The hernia won’t get better by itself.

The operation can be done as:

• open surgery
• a laparoscopic (keyhole) procedure

Can a hernia be prevented?

You can reduce your chances of getting some types of hernias by:

• losing weight if you are overweight or obese
• quitting smoking

Complications of a hernia

Occasionally, the tissue from inside your abdomen can get trapped in a hernia. This is called a strangulated hernia when the blood supply to the tissues inside the hernia is blocked.

If part of your bowel is trapped in your hernia, it can cause a bowel obstruction.

Emergency surgery is needed to treat these hernia complications.

Resources and support

You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.