All About Inguinal Hernias: Symptoms and Causes


by Charles H. Booras, M.D.

5/16/98

A Hernia is a defect in a wall or lining that allows the extrusion
of tissues normally contained by that wall.

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Inguinal hernias are protrusions of soft tissue, such as a portion of the intestine, through a weak spot in a muscle, usually in the abdominal wall. Inguinal hernias occur where the abdomen meets the thigh in the groin region.

Anyone can have an inguinal hernia. Men, women and even children of all ages experience hernias. Hernias are weaknesses or tears in the wall of the abdomen;sometimes they are referred to as ruptures. They typically occur two ways: first, by wear and tear over time (acquired hernias) and secondly from a weakness in the abdominal wall that is present at birth (congenital hernias).

Although many people "live" with hernias for years before they even know it or they become a problem, over time they often get worse due to physical stress or aging. Children's hernias usually are congenital and are present from the time they're born.

Hernias produce different symptoms or feelings. Sometimes you'll notice a protrusion in your groin area between the pubis and the top of the leg or feel pain when you strain during urination or a bowel movement or when you lift a heavy object. The pain can be sharp and immediate. Other times you'll just feel a dull aching sensation, a vague feeling of fullness, nausea or constipation; these feelings typically get worse toward the end of the day or after standing for long periods of time and may disappear when you lie down. And, while persons certainly can live for years with hernias, without treatment they will not disappear.

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If the hernia can be pushed back into the abdominal cavity, it is referred to as a reducible hernia, which while not an immediate health threat, will require surgery to disappear. If it cannot be pushed back, it is nonreducible. This is a condition that may lead to dangerous complications such as the obstruction of the flow of the intestinal contents or intestinal blood supply (strangulation), leading to tissue death. Intestinal obstruction produces nausea, vomiting, loss of appetite, and abdominal pain and usually requires immediate surgery. A strangulated hernia is very painful and requires immediate surgery.

Over 70% of all hernias occur in the groin area between the pubis and the top of the leg known as the inguinal region of the abdomen, that's why they are called Inguinal Hernias. Here, an abnormal opening occurs in the large sac containing the internal organs, causing some of the organs to protrude. When an abnormal opening or defect occurs on both sides of the groin, it is called a bilateral inguinal hernia. While most hernias are easily treated, in about one in ten people, even after treatment they may return and need to be repaired again. These are called recurrent inguinal hernias. Recurrent hernias are not an indication of your surgeon's ability, but indicate poor tissue healing or trauma to the site of the repair.

Who's Likely to Have This Type of Problem?

Every year, more than half a million American men, almost one in twenty, will have a hernia that needs surgery. And while the number of women who have problematic inguinal hernias is much less, they are on the rise. Typically men are about 10 times more likely to get an inguinal hernia than women.

What Causes Hernias?

Hernias are caused by congenital (defects at birth) or age-related weaknesses in the abdominal walls. In males, they are caused by an improper closure of the abdominal cavity during the body's development in the womb. They can also be caused by an increase in pressure within the abdominal cavity due to heavy lifting, straining, violent coughing, obesity or pregnancy.

Signs and Symptoms

  • Lump in groin area when standing/straining & disappears when reclining.
  • Pain at the site of the lump, especially when lifting a heavy object.
  • Swelling of the scrotum Excruciating abdominal pain (if you have strangulation).
  • Nausea, vomiting, loss of appetite & pain (if intestinal obstruction occurs)

What If I Need Surgery?

New surgical techniques are being used today to treat inguinal hernias. The method most frequently used these days is an outpatient procedure called a Laparoscopic Hernia Repair. This type of surgery is frequently done in an Outpatient or Ambulatory Surgery Center.

 

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