How to identify, diagnose and treat hernias

What is a hernia?

A hernia occurs when there is a weakness or opening in the wall of a muscle, tissue or membrane. This can allow an internal organ or fatty tissue to squeeze through into another area where it should not be located. Hernias usually cause only a bulge under the skin. But sometimes there also may be discomfort and pain that may worsen when standing, straining or lifting heavy objects.

What are the causes and types of hernias?

Hernias can stay the same or slowly increase in size over time. Common activities or medical problems that increase pressure on the abdominal wall tissue and muscles and could contribute to a hernia include straining to have bowel movements, chronic cough, cystic fibrosis, additional weight, heavy lifting, poor nutrition, pregnancy, smoking, overexertion, enlarged prostate and undescended testicles.

Hernias can be present at birth or they develop during adulthood. The different types and causes of hernias include the following:

  • Inguinal hernias occur when part of the intestine or bladder protrudes through a weakness in the inguinal canal, which is a natural passageway through the abdominal wall in the groin. Inguinal hernias account for approximately 75 percent of all hernias and are more common in men.
  • Femoral hernias appear more often in women. In femoral hernias, the intestine enters the canal that carries the femoral artery into the upper thigh.
  • Epigastric hernias happen when a small amount of fat bulges through a weakness in the abdominal muscles between the navel and breastbone.
  • Incisional hernias occur when intestine comes through a weakness in the abdominal wall where there has been previous surgery.
  • Hiatal hernias happen when the stomach slips upward through an opening in the diaphragm and goes into the chest.
  • Umbilical hernias are bulges of fat or intestine that come through the abdominal wall under the navel. They are common in newborns and may disappear gradually over time.

How can I tell if it’s a hernia?

Hernias are often discovered by people when they notice a bulge or swelling in their groin, abdomen, scrotum or thigh. A doctor can confirm the presence of a hernia during a physical examination. Smaller hernias may not require treatment except to be watched. Hernias that are getting larger or causing pain could require surgery, which is the only treatment that can permanently fix a hernia.

How do I treat my hernia? 

The kind of surgery necessary to repair a hernia will depend on the type, size and location of the hernia. Options include standard surgery, which involves making an incision over the hernia site and closing the hole with sutures, or a combination of sutures and a plastic mesh. The hernia also can be repaired laparoscopically using a tiny camera and special surgical instruments that are inserted through small incisions.

“Most hernia surgeries are performed on an outpatient, non-emergency basis,” David Ritter, MD, general surgeon on staff at Lake Pointe Medical Center, said.  “However, urgent surgery may be necessary if part of the intestine becomes trapped in the hernia and cannot slide back into the abdomen (an incarcerated hernia) or the contained intestine dies because its blood supply has been cut off (a strangulated hernia).”

For more information about hernias, talk with your doctor or call 1-866-525-LPMC(5762) for a free referral to a general surgeon on staff at Lake Pointe Medical Center.  Or visit Lake Pointe’s website at  While there, download a mobile app for your smart phone – Mobile Health for Mobile Families.

This educational article was contributed on behalf of Dr. David Ritter, general surgeon on staff at Lake Pointe Medical Center in Rowlett, and the Lake Pointe Health Network.

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