Do you remember a time when your toe was poking through a worn area at the tip of your sock? An inguinal hernia is similar—except the sock is the layer of muscle across your abdomen, and what’s poking through it is an inner organ. That may sound a bit unsettling. And the fact that you often can press the bulge back into place might make it more so.
Inguinal hernias aren’t usually a medical emergency. Treatment can depend on the hernia’s size, your symptoms and even your age. However, Joseph Talarico, MD, one of four general surgeons with Thompson Health, says hernias do not heal by themselves and will continue to worsen if ignored.
WHAT IS AN INGUINAL HERNIA?
Inguinal hernias occur when a section of intestine or abdominal fat pops out of a weak area in the abdominal wall.
There are two types of inguinal hernias: direct and indirect.
- An indirect inguinal hernia is caused by a defect in the abdominal wall that is present at birth. It happens more often in boys than girls. Premature infants are also more likely to be born with this type of hernia. Although rarely an emergency, an indirect inguinal hernia should be fixed with surgery as soon as possible.
- A direct inguinal hernia usually occurs in adult men. It develops slowly after years of continuous pressure or stress on the abdominal wall.
SIGNS, SYMPTOMS AND RISK FACTORS
The first sign of an inguinal hernia usually is a small bulge under the skin on one side of the groin. Other symptoms can include pain or pressure at the hernia site.
Risk factors for an inguinal hernia include:
- Chronic constipation and straining during bowel movements
- Being older than 40
- Having a family history of hernia
- Being overweight
- Lifting heavy objects
- Smoking
WHY SEE YOUR DOCTOR?
Inguinal hernias may grow larger over time, and that can lead to more serious problems. Dr. Talarico says it’s important to see the doctor once a hernia is symptomatic, with pain, tenderness or swelling, for example.
If a hernia is ignored, one serious condition that can occur is known as incarceration, in which the hernia gets trapped and can’t be pushed back in. If an incarcerated hernia becomes strangulated, Dr. Talarico says, “what was an easy operation now becomes an emergency.” Yet hernia surgery usually is a one-day event. Dr. Talarico says the operation is an outpatient procedure involving three small incisions. The patient spends approximately 35 minutes in the operating room, under anesthesia, and is able to return home the same day. Over-the-counter medications and icing are then typically used during recovery.