The main sign of an abdominal hernia is having a bulge or swelling appear on your abdomen (tummy). Often, the bulge will disappear when you lie down. It may also disappear when you push on it and then reappear when you stand or strain, for example if you cough or sneeze. This is called a reducible hernia.
You may also have slight discomfort and a feeling of heaviness or aching in your abdomen. When you strain or lift something, you may have a sharp pain.
If you have any of these symptoms, see your GP.
To diagnose abdominal hernia, your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history.
Your GP will examine your abdomen (tummy). This will be both when you're standing up and lying down. He or she will check if the bulge can be pushed back in, and may ask you to cough while placing a finger over the hernia. This is to see if there’s a change in the swelling. Depending on your symptoms, your GP may also refer you for an ultrasound scan to confirm a diagnosis.
Umbilical hernias in young children usually get better on their own as the abdominal muscles get stronger. However, most abdominal hernias generally get larger with time and don't go away without treatment. Surgical repair is usually recommended in adults.
If your hernia isn’t causing any symptoms, your GP may suggest monitoring your condition, but not treating your hernia straightaway. This is known as watchful waiting. Watchful waiting means your treatment is delayed until you need it. The idea is that you see your GP if you have any change in your symptoms. He or she will be able to advise you on your treatment options.
An abdominal hernia repair operation involves pushing the hernia back into your abdomen and repairing the weakened muscle. This can be done as a keyhole procedure, where the operation is done through small cuts in your lower abdomen. Alternatively, your operation may be carried out using open surgery, where a single, larger cut is made. Your surgeon will be able to advise you on which operation is the most suitable for you.
Anything that increases the pressure in your abdomen (tummy) can cause an abdominal hernia, including:
- coughing or sneezing
- straining on the toilet (for example, if you have constipation)
- lifting heavy objects (for example, weight training)
- being overweight
- late pregnancy or difficult delivery
The risk of having an abdominal hernia increases with age because the older you get, the weaker your abdominal wall muscles become.
If the hernia grows and becomes impossible to push back in, it’s called an incarcerated or irreducible hernia. When this happens, there’s a risk that the blood supply to the protruding bowel or fatty tissue may be cut off. This is then called a strangulated hernia, which is a serious complication that needs urgent surgery.
It’s vital that you get medical help immediately when you have a hernia and it becomes incarcerated, especially if:
- the affected area is very painful, tender and red
- you feel weak and faint with pale, clammy skin and a fast heart rate
- you feel sick or vomit
The only way to prevent having an abdominal hernia is to limit the problems that make it more likely. Some examples are listed below.
- Recurrent coughing or sneezing. Find out what’s causing your symptoms and get help to treat them. For example, smoking is a common cause of a persistent cough. If you’d like help to stop smoking, speak to your pharmacist or GP.
- Straining on the toilet. To help ease your bowel movement, eat enough fruit and vegetables and increase your fibre intake. Also make sure you drink enough fluids.
- Being overweight. Try to maintain a healthy weight and if you're overweight, get help to lose any excess weight.
- Lifting heavy objects. Make sure you use a correct lifting technique and if possible try to find ways to reduce heavy lifting.
Are there any other symptoms of an abdominal hernia apart from having a bulge?
If you have an abdominal hernia, as well as having a bulge, you might also have a dragging or aching feeling in the area. Your symptoms may get worse when you do anything that puts strain on the area, such as lifting or coughing.
Depending on what type of hernia you have, there’s a chance that the blood supply to your bowel may be temporarily cut off. The medical word for this is strangulation. If your hernia becomes strangulated, you will have more obvious symptoms. Because you can develop complications even from small hernias, it’s important to seek medical help immediately if:
- the affected area is very painful and tender
- you feel weak and faint with pale, clammy skin and a fast heart rate
- you feel sick or vomit
If the hernia is strangulated, you will need to have surgery urgently. Speak to your doctor if you have any questions or would like any more information about this.
What can I do to prevent another hernia from happening in the future?
There’s no sure way of preventing another hernia, but you can take steps to reduce the chances of it happening again. These include managing factors that may put a strain on your abdominal muscles.
After having hernia surgery, there’s a chance that you could have another. The likelihood of this happening will depend on the type and size of the initial hernia, your general health, weight and lifestyle.
Your general health
A chronic cough, violent sneezing or constipation can increase your risk of having another hernia. Some self-help measures to ease these problems are listed below.
- If you smoke, stopping can help to improve your cough. It’s also worth bearing in mind that stopping smoking may also improve the way your wound heals after surgery. If you have a persistent cough for any reason other than smoking, talk to your GP for advice about treatments that can help.
- If you have hay fever, you can be affected by violent sneezing. Talk to your pharmacist or GP about effective treatments for hay fever to control your symptoms.
- Eating a healthy, balanced diet with enough fruit, vegetables and fibre, and drinking enough fluids can help prevent constipation.
Being overweight can put a strain on your abdominal muscles, so it’s important to maintain a healthy weight.
Any physical activity that involves straining your abdominal muscles can increase your risk of getting another hernia. If your job involves heavy lifting, it’s important to look at ways to reduce or not do this type of activity. Regular exercise is good for your general health and wellbeing; although strenuous activity can put pressure on your abdominal muscles. If you have had a hernia before, talk to your GP for advice before starting a new physical activity.
Will I need to have surgery for an abdominal hernia?
Apart from umbilical hernias in small children, abdominal hernias don’t usually go away by themselves and tend to get bigger slowly over time. Because of this, you’re likely to need surgery.
Most people will eventually need to have surgery for an abdominal hernia. How soon you need to have the operation will depend on how severe your hernia is and your individual circumstances.
For example, if your hernia isn’t causing any symptoms, your GP may suggest watchful waiting. This means your GP will monitor your condition, but won’t recommend treatment straightaway. Watchful waiting means your treatment is delayed until you need it. The idea is that you see your GP if you have any change in your symptoms. He or she will be able to advise you on your treatment options.
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