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hernia

A hernia is a lump which occurs from a weakness in the wall of the tummy (abdomen). Most hernias need treating by performing an operation. There are now various different types of operation which can be performed to repair hernias. They are usually very successful.


What is a hernia?

A hernia (or 'rupture') occurs where there is a weakness in the wall of the tummy (abdomen). As a result, some of the contents within the abdomen can then push through (bulge) under the skin. Normally, the front of the abdomen has several layers comprising skin, then fat, then muscles, which all keep the guts (intestines) and internal tissues in place. If, for any reason, there is a weak point in the muscles, then part of the intestines can push through. You can then feel a soft lump or swelling under the skin.

What are the types of hernia?

Different types of hernia can occur. The most common types are listed here:


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Inguinal hernia
This is the most common type of hernia. Males are more likely to have inguinal hernias, as they have a small tunnel in the tissues of their groins which occurred when they were developing as a baby. This tunnel allowed the testicles (testes) to come down from the tummy (abdomen) into the scrotum. Tissue from the intestines can also pass into this tunnel, forming an inguinal hernia.

There are two main types: indirect hernias, which are usually congenital and common in boys, and direct hernias, which are more common in adult men. They can occur in both sides of the body.

Femoral hernia
This also occurs when some tissue pushes through in the groin, a little lower down than where an inguinal hernia occurs. They occur more commonly in women. They tend to be smaller than inguinal hernias.

Incisional hernia
This occurs when tissue pushes through a previous scar or wound. They are more common if you have had a scar in the past that has not healed well. For example, if the wound had an infection after the operation. They usually occur within two years of having an operation.


Umbilical and paraumbilical hernias
These occur when some tissue pushes through the abdomen near to the belly button (umbilicus). Umbilical hernias can be present from birth and in most cases the hernia goes back in and the muscles re-seal on their own before the baby is 1 year old. They will generally be repaired if they persist beyond 5 years of age or if they are very large.

Umbilical hernias may develop in adults with being overweight (obesity) and excessive accumulation of fluid within the peritoneum of the abdomen. The peritoneum is a lining of the abdomen and consists of two layers, one which lines the abdominal wall and the other which covers the organs in the abdomen.

Paraumbilical hernias occur in adults and appear above the umbilicus. Although they are generally small, they usually need repairing because there is a risk of intestines contained within them becoming strangulated (see below).

Who gets hernias?

Hernias in adults may arise as a result of the strain which raises the pressure in the tummy (abdomen), causing a weakness or tear in the abdominal wall. This can be caused by:

Persistent coughing
Being overweight or pregnant
Lifting, carrying or pushing heavy loads
Straining on the toilet
Inguinal hernias are more common in males, whereas femoral and umbilical hernias are more likely to occur in females.

What are the symptoms?

Sometimes a hernia is noticed after a strain - for example, after lifting a heavy object. Sometimes one may develop for no good reason and you may simply notice a small lump, usually in the groin area. Usually, at first, the lump can be pushed back, but may pop out after straining again. Coughing is a common strain that brings them out. The swelling often disappears when you lie down.

Hernias are not usually painful, but many people feel an ache over a hernia, which worsens after doing any activity. In time, they might become bigger as t

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