A hernia occurs when an internal organ or other body part protrudes through the wall of muscle or tissue that normally contains it. Most hernias occur within the abdominal cavity, between the chest and the hips.
The most common forms of hernia are:
Inguinal hernia: In men, the inguinal canal is a passageway for the spermatic cord and blood vessels leading to the testicles. In women, the inguinal canal contains the round ligament that gives support for the womb. In an inguinal hernia, fatty tissue or a part of the intestine pokes into the groin at the top of the inner thigh. This is the most common type of hernia, and affects men more often than women.
Femoral hernia: Fatty tissue or part of the intestine protrudes into the groin at the top of the inner thigh. Femoral hernias are much less common than inguinal hernias and mainly affect older women.
Umbilical hernia: Fatty tissue or part of the intestine pushes through the abdomen near the navel (belly button).
Hiatal (hiatus) hernia: Part of the stomach pushes up into the chest cavity through an opening in the diaphragm (the horizontal sheet of muscle that separates the chest from the abdomen).
Other types of hernias include:
Incisional hernia: Tissue protrudes through the site of an abdominal scar from a remote abdominal or pelvic operation.
Epigastric hernia: Fatty tissue protrudes through the abdominal area between the navel and lower part of the sternum (breastbone).
Spigelian hernia: The intestine pushes through the abdomen at the side of the abdominal muscle, below the navel.
Diaphragmatic hernia: Organs in the abdomen move into the chest through an opening in the diaphragm.
Causes of Hernia
Hernias are caused by a combination of muscle weakness and strain. Depending on its cause, a hernia can develop quickly or over a long period of time.
Some common causes of muscle weakness or strain that can lead to a hernia include:
- a congenital condition that occurs during development in the womb and is present from birth
- damage from an injury or surgery
- chronic coughing or chronic obstructive pulmonary disorder (COPD)
- strenuous exercise or lifting heavy weights
- pregnancy, especially having multiple pregnancies
- constipation, which causes you to strain when having a bowel movement
- being overweight or obese
- fluid in the abdomen, or ascites
There are also certain things that can increase your risk of developing a hernia. They include:
- a personal or family history of hernias
- being older
- being overweight or obese
- chronic constipation
- chronic cough (likely due to the repetitive increase in abdominal pressure)
- cystic fibrosis
- smoking (leading to weakening of connective tissue)
- being born prematurely or with a low birth weight
Diagnosis of Hernia
To diagnose your condition, your doctor will first perform a physical examination. During this examination, your doctor may feel for a bulge in your abdominal or groin area that gets larger when you stand, cough, or strain.
Your doctor will then take your medical history. They may ask you a variety of questions, including things like:
- When did you first notice the bulge?
- Have you experienced any other symptoms?
- Do you think that there was something in particular that may have caused it to occur?
- Tell me a little bit about your lifestyle. Does your occupation involve heavy lifting? Do you exercise rigorously? Do you have a history of smoking?
- Do you have a personal or family history of hernias?
- Have you had any surgeries in the area of your abdomen or groin?
Your doctor will also likely use imaging tests to aid in their diagnosis. These can include things like:
abdominal ultrasound, which uses high-frequency sound waves to create an image of the structures inside the body
CT scan, which combines X-rays with computer technology to produce an image
MRI scan, which uses a combination of strong magnets and radio waves to make an image
If a hiatal hernia is suspected, your doctor may use other tests that allow them to assess the internal location of your stomach:
Gastrografin or barium X-ray, which is a series of X-ray pictures of your digestive tract. The pictures are recorded after you’ve finished drinking a liquid containing diatrizoate meglumine and diatrizoate sodium (Gastrografin) or a liquid barium solution. Both show up well on the X-ray images.
Endoscopy, which involves threading a small camera attached to a tube down your throat and into your esophagus and stomach.