Inguinal Hernia

Inguinal Hernia

Description

A hernia is a condition in which part of the intestine (bowel) bulges through a weak area or gap in the abdominal muscles. A groin, or inguinal, hernia occurs in the groin. The groin is the lower abdominal area where the legs join the body. A groin hernia happens when the bowel pushes through a weak spot in the inguinal canal. The inguinal canal is an opening between layers of muscle in the groin.

Cause

Some people, especially men, are born with a weakness in their groin muscles. With or without this weakness, a hernia may be caused by anything that causes the intestine to push against the inguinal canal (image below). Activities or conditions that might cause this pressure are:

  • Lifting heavy objects

  • Coughing or sneezing a lot

  • Being constipated or pushing too hard when having a bowel movement

  • Being overweight

  • Pregnancy

Symptoms

Symptoms of a groin hernia may include:

A lump in the groin that you can push back in

Pain or discomfort in the lower belly or groin, especially with physical activity

A lump in the groin that CANNOT be pushed back in

Examination

Your healthcare provider will ask about your symptoms and examine you. A visual inspection will take place to see if there are any lumps or swelling in the problem area. They will palpate (press) the area to see if there is a lump and determine if it is a hernia or other condition. They may ask you to cough to see if the area expands or becomes tense. If it is a hernia, they will also try to determine if it is reducible or irreducible (the lump can be be pressed back in or not). If it is reducible, they will have you perform the cough test again. If the lump stays reduced, it is likely to be a direct hernia vs an indirect hernia.

Treatment

The main treatment for a painful groin hernia is surgery to repair the opening in the muscle wall. Sometimes the weak area is reinforced with mesh during the surgery. Your physician will generally suggest that you have the surgery as soon as possible to avoid complications. If your hernia is causing few or no symptoms, you may choose not to have surgery. You may need to use a groin support. You will need to discuss with your physician what symptoms to watch for and when you should seek medical care for possible problems resulting from your hernia, such as bowel blockage.

The hernia will not get better on its' own, but it may not get worse for months or even years. A complication of a groin hernia is that after the bowel has pushed through the muscle wall, its contents may become trapped. A dangerous complication of this trapping is that the blood supply to the bowel may be cut off and the tissue may die, resulting in gangrene. This is a medical emergency!