Abdominal hernia

This factsheet is for people who have an abdominal hernia, or who would like information about it.

An abdominal hernia is a bulge or swelling that occurs when a part of your abdomen (tummy), such as your intestine, pushes through a weakness in the muscle of your abdominal wall.

About abdominal hernia

The abdominal wall is a sheet of tough muscles and tendons that run between your ribs and your groin (upper part of your leg). It acts like a natural corset holding all the abdominal organs in place. Sometimes, a weakness in your abdominal wall can open up, so whatever is on the inside (usually part of your gut) pushes through. This causes a bulge or swelling called a hernia.

Types of abdominal hernia

Abdominal hernias are named according to the position of the weakness in the abdominal wall. The most common types of abdominal hernia are listed below.

• Inguinal hernia. This is when a bulge appears in your groin or, if you're a man, in your scrotum. It happens when your gut pushes through a weakness in the inguinal canal (an area in your groin where nerves and blood vessels pass through the muscle layers that supply the genital area). Inguinal hernias are more common in men.
• Femoral hernia. This bulge also appears in your groin. It happens when your gut pushes into the femoral canal (a channel through which large blood vessels travel in and out of your leg). The femoral canal is close to, but separate from, the inguinal canal. Women are more likely to have a femoral hernia than men.
• Incisional hernia. This is when a bulge appears near an old surgical scar. It happens when tissue or part of your gut pushes through a weakness in the muscles, which was caused by a pervious surgery. An incisional hernia can occur months or years after surgery and is more common in adults than children. It can happen after about one in 10 abdominal surgeries.
• Umbilical hernia. This is when a bulge appears around your navel (belly button) because of a weakness in the muscle layer in or around it. Umbilical hernias are very common in young children but often disappear as they get older. In adults, they are most common in women during and after pregnancy, and in people who are overweight.

Symptoms of abdominal hernia

The main sign of an abdominal hernia is having a bulge or swelling appear on a part of your abdomen. Often, the bulge will disappear when you lie down or push on it and then reappear when you stand, cough or sneeze. This is called a reducible hernia.

You may also have symptoms such as burning, 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.

Complications of abdominal hernia

If the hernia grows and becomes impossible to push back in, it’s called an incarcerated hernia. When this happens, there is a risk that the blood supply to the protruding gut may be cut off. This is then called a strangulated hernia, which is a serious complication that requires 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

Causes of abdominal hernia

Anything that increases the pressure in your abdomen can cause an abdominal hernia, including:

• coughing or sneezing
• straining on the toilet (for example, if you have constipation)
• pregnancy 
• lifting heavy objects (for example, weight training)
• being overweight

The risk of having an abdominal hernia increases with age because the older you get, the weaker your abdominal wall muscles become.

Diagnosis of 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 the bulge or swelling. This may be when you're standing up or 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 to see if there is a change in the swelling. Your GP may also refer you for an ultrasound scan to confirm a diagnosis.

Treatment of abdominal hernia

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.

Surgery

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) or open surgery (where a single, larger cut is made).

Prevention of abdominal hernia

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 is causing your symptoms and get help to treat them.
• 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 seek 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.

If you’re a woman and are pregnant, it may be helpful to wear a support belt to ease the pressure on your abdominal muscles. Speak to your GP or obstetrician (a doctor who specialises in pregnancy and childbirth) for more information.

 

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.