A hernia occurs when a part of internal organ bulges out through an opening or weakness in the muscle or tissue. Most hernias involves only one of the abdominal organs pushing through the walls of abdominal cavity. Generally it occurs in the abdomen or groin . It bulges out and goes back during different activities or positions. It may or may not show symptoms .

  The lump that can be pushed back through the abdominal wall is reducible hernia , if not it’s irreducible hernia .

Types of hernia

• Inguinal hernia: occurs when the intestine push through a weakness in lower abdomen. This causes a bulges in an area of the groin called inguinal canal. This is the most common  groin hernias and is prevalent in men than women. Two forms of inguinal hernia are :

Indirect hernia: the intestine enters the inguinal canal.

Direct hernia: the intestine does not enter inguinal canal but goes through the abdominal wall.

• Femoral hernia: it bulges into a different area of groin called the femoral canal.
• Umbilical hernia: happens when fat or part of the intestine pushes through muscle near the umbilicus. This contributes to 15% of congenital hernia.
• Incisional hernia: common in people with history of surgery leading to weakened abdominal muscles.
• Hiatal hernia: occurs when a part of stomach bulges up through the opening in the diaphragm into the chest.
• Epigastric hernia: forms at the midpoint between sternum and umbilicus.
• Congenital diaphragmatic hernia: as a birth defect due to an opening in the diaphragm.

Signs and symptoms

• A visible lump or bulge during activities like coughing, exercising,  straining,  lifting,  laughing or certain physical positions.
• Dull ache or shooting pain
• Weakness or pressure in groin
• Vomiting
• Constipation
• Burning sensation at the bulges
• Chronic acid reflux , heartburn , indigestion in hiatal hernia.

Severity increases with time. If the hernia has slipped out and is stuck in the hole , it is an incarcerated hernia. It is painful and causes bowel obstruction and becomes strangulated. Lack of blood supply leads to necrosis and gangrene formation.

Causes and risk factors

• Hernia occur due to pressure, weakness or pre existing opening in the muscle or tissue. It may be present at birth or acquired later.
• Obesity
• History of abdominal or pelvic surgery
• Chronic Constipation
• Repeated pregnancy
• Chronic cough, sneezing
• Weight lifting
• Standing for long hours
• Tissue wear down
• Congenital hernia if born premature, cystic fibrosis , hip dysplasia, undescended testicle.

Diagnosis and management

Most bulging hernias can be diagnosed with physical examinations and also by CT scan and other imaging tests.

Non surgical treatment includes wearing corset , binders or supporting undergarments that apply gentle pressure to keep the hernia in place and ease the pain . Also medications to relieve pain and inflammation.

Surgical repair is suggested in case of  irreducible hernia with severe complications.