Abdominal hernia
Your health expert: Mr Christian Macutkiewicz, Consultant General and Hepato-Pancreatico-Biliary Surgeon
Content editor review by Pippa Coulter, April 2022
Next review due April 2025
An abdominal hernia is when some tissue or part of your bowel pushes through a weakness in your tummy (abdominal) wall. It creates a bulge or swelling in your tummy or groin (top part of your leg). Most hernias can be easily repaired. But they can sometimes cause serious complications.
About abdominal hernia
Your tummy wall is made up of sheets of tough muscles and tendons that run between your ribs and groin. If there’s a weakness in part of the wall, the contents inside can push through, causing an abdominal hernia.
Your hernia may be painful, or you may notice a bulge in your tummy or groin. This may be more noticeable when you cough or strain. Sometimes you might not notice any symptoms at first.
If you have an abdominal hernia, you may need to have surgery to repair it. But this will depend on the type of hernia you have and how likely it is to cause complications.
See a doctor as soon as you can if your hernia suddenly feels very sore or tender, especially if you can’t push it back in. This may mean that some of the hernia contents have become trapped inside. You’ll need surgery as soon as possible.
Types of abdominal hernia
The most common types of abdominal hernia include:
- inguinal hernia
- femoral hernia
- incisional hernia
- umbilical hernia
Abdominal hernias are named according to where the weakness is in your tummy wall. You may also have heard of hiatus hernia. Unlike the hernias above, this isn’t due to a weakness in your tummy wall. It happens when part of your stomach slides up into your chest.
Inguinal hernia
This is when tissue or part of your bowel pushes through a weakness in a passage in your groin called the inguinal canal. It causes a bulge in your groin (a ‘groin hernia’). Inguinal hernias are the most common type of hernia and are more common in men.
Femoral hernia
This is another type of groin hernia that forms a little lower down in your groin. It happens if you have the weakness in another passage in your groin, called the femoral canal. Women are more likely to have a femoral hernia than men.
Incisional hernia
This happens when you have a weakness in your tummy wall caused by previous surgery. Tissue pushes through the weak spot creating a bulge near your old surgical scar. An incisional hernia is more likely after open surgery.
Umbilical hernia
This is when there’s a weakness in the muscle layer in or around your belly button. When tissue pushes through, it creates a bulge in or around your belly button. Umbilical hernias are very common in babies but often disappear by the time children reach the age of five. In adults, they’re most common in people who are pregnant or overweight. They need to be repaired with surgery in adults, due to the risk of complications.
Causes of abdominal hernia
You can be born with some types of abdominal hernia. They happen as a baby develops in the womb. But most hernias develop when you’re an adult. Anything that increases the pressure in your tummy can make you more likely to get an abdominal hernia. This includes:
- coughing, especially if your cough lasts for a long time
- straining when you poo, which may happen if you’re constipated
- lifting heavy objects or weights
- being very overweight
- being pregnant
You’re more likely to have an abdominal hernia as you get older. This is because your tummy wall muscles get weaker as you get older. It’s also more likely after surgery.
Symptoms of abdominal hernia
If you have an abdominal hernia, you may have:
- a lump or swelling somewhere on your tummy or in your groin
- an aching, dragging or burning sensation in your tummy or groin
- a feeling of fullness or heaviness in your tummy or groin
The lump or swelling may disappear when you lie down, or you may be able to push it back in. It may only appear when you strain, for example, if you cough or lift something heavy.
If you have any of these symptoms, contact your GP.
Sometimes the contents of the hernia can get stuck (incarcerated) and you may no longer be able to push the hernia back inside. The blood supply to the hernia can also become cut off (strangulated). These are serious medical conditions that can cause a blockage in your bowel and lead to further complications. See our Complications section for more information. Signs of an incarcerated or strangulated hernia include:
- your hernia pain has got worse
- you’ve usually been able to gently push your hernia back, but now you can’t
- the hernia bulge hurts if you touch it
- the skin over your hernia bulge becomes red or purple
- you feel sick or you are sick
- a decrease in bowel function – you may be unable to poo or pass wind
Seek urgent medical advice if you have any of these symptoms.
Diagnosis of abdominal hernia
A hernia can usually be diagnosed by a GP. The GP will ask about your symptoms and check your tummy or groin area. They may also ask you about your medical history.
Your GP may check your tummy or groin when you're standing up and lying down. They’ll check to see if they can push the bulge back in and may ask you to cough while they put their finger over the hernia. This is to see if the swelling changes.
Sometimes, if the diagnosis isn’t clear, your GP may suggest you have an ultrasound or CT scan.
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Treatment of abdominal hernia
Surgery is the only way to permanently repair an abdominal hernia. But abdominal hernias in adults don’t always need to be repaired.
Your GP can discuss with you whether surgery is the best option for you. This will depend on many things, including the type of hernia you have, how big it is and whether it’s causing symptoms. Your doctor will also assess how likely it is to cause complications. Your doctor may be less likely to recommend surgery if you’re older, or your general health means that surgery is more of a risk.
Umbilical hernias in young children usually get better on their own. If the hernia is very big or hasn’t gone away by the time your child reaches the age of five, your doctor may recommend a surgical repair.
Watchful waiting
If your hernia isn’t causing many symptoms, your GP may suggest monitoring you. This is called ‘watchful waiting’. It means you’ll only have surgery if you need it. Speak to your doctor and make sure you are comfortable with your decision. There may be things you need to consider, such as the risks of having surgery as you get older. Most hernias in adults get bigger over time and are more likely to cause complications.
If your hernia is becoming more painful, or you’re getting any constipation or sickness, it’s important to contact your GP straightaway. This could mean your hernia is getting worse.
Surgery
If your hernia is likely to cause complications your doctor will recommend surgery.
Abdominal hernia surgery involves pulling the hernia back into your tummy and repairing the weakened muscle to prevent it happening again. You may be able to have the surgery as a keyhole (laparoscopic) procedure. This means the operation is done through small cuts in your lower tummy. Or you may be offered open surgery with a single, larger cut. Both types of surgery have pros and cons and your surgeon will discuss the best type of operation for you.
How long it takes to recover from surgery will depend on several things. These include where your hernia is, the type of surgery you’ve had and your general health. In general, it can take up to six weeks to fully recover and get back to normal. You’ll gradually be able to build up your activity during this time. You shouldn’t lift anything heavy while you’re recovering as it can increase the risk of your hernia coming back. If you have keyhole surgery, you’re likely to stay in hospital for less time and recover faster.
Types of abdominal hernia surgery
You can have surgery for umbilical hernia, femoral hernia, inguinal hernia, and incisional hernia, as well as other types of hernia. Below we have videos on open and keyhole surgery for both femoral and inguinal hernia repairs. Your surgeon will explain what your exact surgery will involve and answer any questions you have.
Open femoral hernia repair
This operation may be done under regional or general anaesthesia. Regional anaesthesia is when anaesthetic is injected into your spine, making the lower part of your body numb. Your surgeon will make a single cut in your groin and pull the contents of the hernia back inside. They may insert a synthetic mesh over the weak part of your groin wall to strengthen it. They’ll then close the cut using dissolvable stitches or other methods.
The video below shows one way the surgery may be carried out.
How open femoral hernia surgery is carried out
Femoral hernia surgery | Watch in 2:00 minutes
This animation shows one way open femoral hernia surgery is carried out.
Keyhole femoral hernia repair
This operation is usually done under general anaesthesia. Your surgeon will perform the operation by inserting instruments and a laparoscope (telescopic camera) through several small cuts in your lower tummy and groin. They’ll pull the contents of the hernia back inside and may stitch a synthetic mesh over the weakness in the wall to strengthen it. They’ll then close the cuts with dissolvable stitches, Steri-Strips (narrow strips of sticky plaster) or other methods.
The video below shows one way the surgery may be carried out.
How keyhole femoral hernia surgery is carried out
Keyhole femoral hernia surgery | Watch in 2:03 minutes
This animation shows one way keyhole femoral hernia surgery may be done.
Open inguinal hernia repair
This operation may be done under local, regional or general anaesthesia. Your surgeon will make a single cut in your groin and pull the contents of the hernia back inside. They may stitch a synthetic mesh over the weak part of your groin wall to strengthen it. They’ll then close the cut using dissolvable stitches or other methods.
The video below shows one way the surgery may be carried out.
How open inguinal hernia repair surgery is carried out
Open inguinal hernia repair surgery / Watch in 1:31 minutes
Open inguinal hernia repair may be done under local, regional or general anaesthesia. Our animation shows one way the surgery may be carried out.
Keyhole inguinal hernia repair
This operation is usually done under general anaesthesia. Your surgeon performs the operation by inserting instruments and a laparoscope (telescopic camera) through several small cuts in your lower tummy and groin. They’ll pull the contents of the hernia back inside and may stitch a synthetic mesh over the weak part of your groin wall to strengthen it. They’ll then close the cuts with dissolvable stitches, Steri-Strips (narrow strips of sticky plaster) or other methods.
The video below shows one way the surgery may be carried out.
How keyhole inguinal hernia repair surgery is carried out
Keyhole inguinal hernia repair surgery | Watch in 1:31 minutes
Keyhole inguinal hernia repair surgery is usually done under general anaesthesia. Our animation shows one way the surgery may be done.
Complications of abdominal hernia
If your hernia becomes incarcerated (stuck) or strangulated (the blood supply is cut off), these are serious complications that need urgent surgery.
Hernias are unlikely to rupture (break through the skin). But if not treated, a strangulated hernia can cause a hole in the bowel wall (called bowel perforation) and serious infection. This can be life-threatening without prompt treatment. See the Symptoms section above for signs of an incarcerated or strangulated hernia.
There are also potential complications associated with surgery for abdominal hernia. These include:
- infection
- adhesions (bands of scar tissue that can make tissues inside your body stick together)
- haematomas (a build-up of blood in the space where the hernia used to be)
- seromas (a build-up of clear fluid under your skin, where the hernia used to be)
There is also a chance that your hernia may come back after surgery. Modern surgical techniques reduce the risk of this happening. Your surgeon will go through the risks and benefits of surgery with you before you decide whether to go ahead.
Prevention of abdominal hernia
Anything that increases the pressure inside your tummy or strains your tummy wall can increase your chances of developing an abdominal hernia. You may be able to reduce some of these risk factors.
- Regular coughing. Seek medical help to find out if there’s a cause for your symptoms and get help to treat them. Smoking is a common cause of a persistent cough. If you’d like help to stop smoking, speak to your pharmacist or GP.
- Straining when you poo. To help prevent constipation, eat plenty of fruit and vegetables and gradually increase your fibre intake. Also make sure you’re drinking enough fluids.
- Being overweight. Try to lose excess weight by eating a healthy balanced diet and getting more active.
- Lifting heavy objects. Make sure you’re using a correct lifting technique and, if possible, try to find ways to reduce heavy lifting.
If you have an abdominal hernia, you may notice a lump or swelling somewhere in your tummy or groin. Sometimes you just have a feeling of fullness in the area. It may ache or feel uncomfortable. See our Symptoms section for more information.
Sometimes you may be born with an abdominal hernia. But in adults, they’re usually caused by strain or pressure in your tummy. This can be due to persistent coughing, straining on the toilet, lifting heavy objects and being overweight or pregnant. Read more in our Causes section.
The only way to permanently repair a hernia is to have surgery. This can be with open surgery or keyhole surgery. Not all hernias need to be repaired though. Your doctor will talk you through the options. Read our Treatment section to find out more.
Healthy weight for adults
Weighing too much or too little can increase your risk of several diseases, including heart disease, diabetes and cancer
Umbilical hernia repair
Umbilical hernia repair is an operation to mend a weak area in your abdominal wall that’s in or near your navel (belly button).
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This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals and deemed accurate on the date of review. Photos are only for illustrative purposes and do not reflect every presentation of a condition.
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