Q&A: How to Tell If You Have a Hernia

If you have pain or a bulge in your abdomen or groin, you could have a hernia. But sometimes it can be hard to tell.

Seth Weinreb, MD, a UNC Health surgeon, explains what a hernia feels like, what to do if you might have one and what treatments are available.

What is a hernia?

A hernia occurs when organs or tissue start to push through a hole in the body’s muscle or fascia (connective tissue), Dr. Weinreb says. Hernias commonly occur in the abdomen or groin, especially in places you’ve previously had surgery.

Should I worry about having a hernia?

Most hernias aren’t serious, but some are. Don’t let them go untreated.

“If you notice any hernia symptoms, the best thing to do is to remain calm and contact your primary care provider,” Dr. Weinreb says. “This is something we can usually take care of and get you back to your normal routine and way of life.”

Where do hernias occur?

Hernias appear in various locations. Here are a few types:

  • Inguinal hernias are groin hernias that occur when an organ or tissue, such as part of the intestines or bowel, pushes through a hole in the inguinal canal, which is where the abdomen meets the upper thigh. They are more common in men, Dr. Weinreb says.
  • Femoral hernias are like inguinal hernias but occur in the femoral canal, which is lower than the inguinal canal, closer to the thigh. They are more common in women.
  • Umbilical hernias are a type of ventral hernia that occur when part of an organ pushes through the abdominal wall at the bellybutton.
  • Incisional hernias are ventral (abdominal) hernias that occur at the site of a previous surgical incision.
  • Hiatal hernias occur when the stomach pushes up through the diaphragm into the chest. Hiatal hernias can cause reflux.

What are the symptoms of a hernia?

Not all hernias cause symptoms. However, the two most common early symptoms of a hernia include:

  • A bulge or swelling—something you can see or feel. It might only be seen or felt at certain times, such as during exercise.
  • Pain or discomfort.

“Pain from a hernia can vary,” Dr. Weinreb says. “It can be dull or sharp pain, constant or intermittent.”

If you notice a bulge or pain that doesn’t go away or that comes and goes predictably, contact your doctor.

Can having a hernia cause complications?

In rare cases, the hernia can become incarcerated, or stuck, and start to lose blood supply, which can lead to strangulation, or tissue death. If a hernia becomes strangulated, you might notice the following symptoms:

  • Increasing and constant pain.
  • A bulge that might have previously easily reduced but is now stuck out (or incarcerated), firm and tender to touch.
  • Overlying skin that is discolored (first red, then purple, then black).

If your bowel is the organ that is stuck, you could experience symptoms of bowel obstruction, including nausea, constipation and vomiting.

Seek medical attention immediately if you notice any strangulation symptoms.

How are hernias treated?

In general, hernias don’t go away on their own. Most people have surgery to repair them.

“If you don’t have surgery, the hernia will continue to get bigger and more bothersome,” Dr. Weinreb says. “However, in most cases the need for surgery is not urgent, and we can plan around your schedule.”

Depending on the type of hernia you have, your surgeon will try to either close the hole or reinforce it with mesh, or both. Most of the surgeries are outpatient. If your hernia is complicated, you could have to stay in the hospital a few nights.

There are a few factors that increase the risk for complications with hernia surgery, including if you:

  • Have obesity
  • Smoke
  • Have diabetes
  • Are immunocompromised

Your surgeon may ask you to address these risk factors prior to surgery, such as recommending you quit smoking or lose weight.

“There is a new focus on what’s called ‘prehabilitation,’ correcting risk factors before operating,” Dr. Weinreb says. “Sometimes those conversations with patients can be difficult. Our recommendations might trigger negative feelings, but it’s important to set patients up for a successful surgery.”

What other conditions cause hernia-like symptoms?

The most common condition that is confused with a hernia is diastasis recti, where the abdominal muscles in the midline don’t meet in the middle and the separation can cause a bulge. Women often develop diastasis recti after pregnancy, and men can experience it as they age or gain weight, Dr. Weinreb says.

Also, while groin pain can be the symptom of a hernia, pain could also be the result of a groin strain, testicular problems, urological issues or a hip labral tear, among other causes.

Groin pain could also be a sign you have a sports hernia, which is an injury that causes pain generally only while working out. It is not a true hernia, as there’s no hole for organs to push through. It is frequently caused by small tears where muscles attach to the pubic bone, usually by repetitive explosive movements in certain sports.

Can I prevent myself from getting a hernia?

Unfortunately, no. Anyone could be at risk for a hernia. There are some situations, however, that put you at a higher risk, including:

  • Intense coughing or sneezing fits.
  • Straining to have a bowel movement, especially along with chronic constipation.
  • Extreme physical activity, such as lifting a 200-pound object or doing heavy weightlifting that you haven’t lifted previously.
  • Having surgery on your belly. Between 10 and 20 percent of people who’ve had surgery on their belly, including cesarean sections, will get a hernia at the surgical site, Dr. Weinreb says.
  • Obesity.
  • Pregnancy.

If you think you have a hernia and want to have it checked, talk to your doctor. Need a doctor? Find one near you.