What to Do About a Hernia
Most don’t go away on their own. Here’s what to consider.
Hernias occur when a gap or weakness in a muscle or tissue allows part of an organ or other tissue to push through. They can cause pain, constipation, a heavy feeling in the abdomen, and potentially serious complications. Some cause a noticeable lump or bulge. But others have no obvious symptoms at all.
People may be reluctant to bring up a potential hernia with their physician, even when experiencing pain or discomfort. But don’t ignore what may be symptoms, says Robert J. Fitzgibbons Jr., MD, chairman of the department of surgery at the Creighton University School of Medicine in Omaha, Neb., who specializes in hernias.
That’s because in some cases, an untreated hernia could lead to an emergency. And if you suddenly develop a large bulge, redness in the area, or a fever, or start vomiting or feeling severe pain, get medical help right away.
4 Common Types of Hernias
Hernias usually develop in the abdomen or groin. In the U.S., 1.6 million groin hernias are diagnosed annually, and about 700,000 are repaired surgically. A few common types include:
Finding and Fixing Hernias
Healthcare providers often diagnose groin or abdominal hernias with a physical exam. A telltale symptom is typically a big bulge, Fitzgibbons says. To confirm the diagnosis, providers also might use imaging tests such as CT scans.
With certain male patients, watchful waiting may be an option for a hernia that isn’t causing any serious symptoms. But most hernias don’t resolve on their own. Treatment for groin and abdominal hernias generally involves surgery, Fitzgibbons says, which is sometimes but not always the minimally invasive type.
There may be some risk to putting off treatment. A hernia is “a hole in the abdominal wall,” Fitzgibbons says, which can lead to life-threatening complications like bowel obstruction. The success rate for a repair in an emergency situation is much lower than with surgery that’s planned, he says, so it’s better to try to get treated before the condition becomes dire.
Prevent Future Problems
Straining during a bowel movement or laughing, crying, coughing, or exercising can make the lump from a hernia reappear after it has been pushed in. A few strategies can help avoid a reemergence.
In general, eating enough fruits, vegetables, and grains can help prevent constipation and straining. Don’t smoke, and talk with your provider if you have frequent fits of coughing or sneezing. Avoid lifting anything too heavy, and use the correct form if you lift. Different types of supportive undergarments are available but may not be right for everyone. Check with your doctor before using one.
What About Hiatal Hernias?
Hiatal hernias, which occur when part of the stomach pushes into the chest cavity through an opening in the diaphragm, generally don’t need surgery to fix, says James P. Callaway, MD, of the University of Alabama at Birmingham. Instead, to relieve symptoms such as problems swallowing, acid reflux, pain, and regurgitation, your doctor may suggest dietary changes, medication, or simply remaining upright for 2 to 3 hours after eating. Losing weight can help, too.
If there’s no improvement, a surgeon can perform a hiatal hernia repair. In rare cases, these hernias allow other organs to enter the chest, which can result in chest pain and may require emergency treatment.
Editor’s Note: This article also appeared in the August 2022 issue of Consumer Reports On Health.
