Inguinal hernia What is it?

An inguinal hernia occurs when a portion of intestine pushes through a weak spot in the muscle of the abdominal wall.

It can descend into the scrotum and is painful, particularly when you lift something heavy or when you cough.

What are the symptoms?

A bulge in one side of your lower abdomen – it’s more visible when you’re standing up. You may feel a burning or aching sensation in the area and pain when you cough, lift something or bend down. A dragging sensation in your groin is common, as is pain and swelling around your testicles when the protruding intestine descends into the scrotum.

When is an inguinal hernia serious?

If you can’t push the hernia back in, it may be trapped in the abdominal wall. It becomes an incarcerated hernia and is then in danger of becoming strangulated, cutting off the blood flow to the tissue that’s trapped. If you have a fever, nausea, sudden pain and you’re vomiting, see your doctor urgently.

What causes it?

Commonly an inguinal hernia can begin with a weak spot in the muscles of the abdominal wall. Any increase in abdominal pressure, such as straining during bowel movements or urination, chronic coughing or vigorous activity, can worsen the hernia.

What’s the treatment?

„ Watch and wait if the hernia is small and isn’t causing you any problems.

„ A truss can help relieve symptoms, but it needs to be properly fitted, so consult your doctor.

„ Open or laparoscopic surgical repair if the hernia is large and painful. Try to be as mobile as possible after surgery, but it can take weeks before you’re fully back to normal.

Understanding inguinal hernia

HERNIA is a condition where part of the abdominal content bulges through a weak point on the abdominal wall. It can occur near the groin, around the belly button, or through a past surgical scar.

Inguinal hernia is a condition where abdominal fat (omentum) or part of the intestines bulges through a weak point on the abdominal wall near the groin area.

According to MSU Medical Centre medical consultant general and colorectal surgeon Dr Mohd Zailani Mat Hassan, “Men are 25 times more likely than women to be present with inguinal hernia. Adult males over 40 are much more likely than females to develop direct inguinal hernias.”

There are two types of inguinal hernias:

Indirect inguinal hernia, which is caused by a defect in the abdominal wall through an inguinal ring relating to a birth defect Direct inguinal hernia, which occurs in adult males and is owed to a weakness in the abdominal wall muscles; it may develop over time or be caused by straining or heavy weight lifting over time

Signs and symptoms

Usually patients have bulges in the groin area. At an early stage, bulging occurs only during coughing or straining, and spontaneously disappears. This condition is called reducible inguinal hernia.

As the hernia advances, an intestinal content of fat is trapped inside the “hernial sac” or the scrotum. This is called irreducible, obstructed, or even strangulated inguinal hernia, in which stage the patient will experience persistent bulging in the groin or scrotal area, severe pain and vomiting.

Causes and risk factors of inguinal hernia

A weakened abdominal muscle at the affected areas may be a major predisposing factor. Some risk factors that can increase the chances of getting inguinal hernia include:

  • Gender (men are more predisposed than women) Obesity
  • Chronic constipation Chronic cough
  • Chronic urinary bladder outlet obstruction, e.g., benign prostate hyperplasia
  • Premature birth Previous history of inguinal hernia
  • Occupation-related – heavy weight lifting

Two possible serious complications if hernia is left untreated are:

Incarcerated inguinal hernia, which happens when tissue becomes stuck in the groin and is not reducible – it cannot be pushed back into place

Strangulated inguinal hernia, a life-threatening condition that requires emergency medical care; this is when the intestine in an incarcerated hernia has its blood flow cut off, which may lead to intestinal gangrene (“dead” tissue).

Diagnosis and treatment

In most cases, diagnosis is made from history and clinical examinations. When the diagnosis is doubtful, then medical imaging is required, with ultrasonography being the first choice.

Surgery is the primary treatment for inguinal hernias.

It is a common operation and a highly successful procedure when performed by a well-trained surgeon.

Surgical options are either an open inguinal herniorrhaphy or a laparoscopic inguinal herniorrhaphy. In open inguinal herniorrhaphy, a 5cm-long incision is made over the abdomen near the groin. In laparoscopic inguinal herniorrhaphy, multiple smaller abdominal incisions are made (at least three, approximately 1cm each).

The goal of either surgical approach is to return the internal abdominal tissue(s) back into the abdominal cavity and repair the abdominal wall defect. Mesh is commonly placed to reinforce the abdominal wall.

There are advantages and disadvantages of both techniques. Patient factors, surgical expertise, and cost incurred will determine the selection criteria.

Prevention of inguinal hernia

As inguinal hernia relates to abdominal wall muscles and inguinal ring birth defect, reducing abdominal pressure may substantially prevent inguinal hernia from occurring.

Maintain a healthy body weight:

Inguinal hernia is a condition where abdominal fat (omentum) or part of the intestines bulges through a weak point on the abdominal wall near the groin area.

Obesity is a potential hazard as it can impose extra pressure on the abdomen. Regular exercise and a good healthy lifestyle are important to maintaining good body weight.

Be careful while exercising: Some exercises such as squats can put undue strain on the abdominal wall. Exercises involving fast movements or high-intensity workouts also increase your risk of developing hernia. Use proper gear and attire during abdominal exercises.

l Avoid lifting heavy weights: Heavy weight lifting puts unneeded pressure on the abdominal muscles. If it is still required, consider bending down at the knees rather than lifting from the waist up to distribute the weight.

l Eat fibre-rich foods: Constipation can put undue strain on the abdomen during bowel movement and thus increase hernia risk. Eating fibrous foods such as whole grains, fresh fruits (bananas, apples, oranges), vegetables, and nuts can help regulate bowel movements. Staying well-hydrated is essential to preventing constipation.

Consult your doctor if you experience difficulty when urinating:

Urination difficulties, increased urination frequency especially at night, or feelings of incomplete emptying may indicate an enlarged prostate, particularly among men aged 50 years and above. These symptoms can increase pressure on the abdomen by causing strain during urination.

All about that pain in your groin - inguinal hernia symptoms


You’re not very fit but you play football on the weekends and you’ve developed pain in your groin, making walking difficult. It’s stopping you from playing.

It could be Muscle, tendon or ligament strain of the hip. This is particularly common in men who play hockey and football. Cure Take painkillers for the pain, ditch the weekend football and see your doctor to arrange a physio. The strain may take a month or so to heal itself.


You’re in your 60s and have developed an increasingly severe pain in your groin. It’s worse on walking but disappears with rest.

You’re overweight and take little exercise.

It could be Osteoarthritis of the hip, where the cartilage cushions within the joint have worn away due to wear and tear, made worse by carrying excess weight.

Cure See your doctor for scans of the hip to confirm the diagnosis and take painkillers for the pain. If your condition deteriorates, you may be a candidate for a hip replacement.


You’ve got pain and swelling in your groin and the pain is worse when you cough, bend over or lift a heavy object.

It could be Inguinal hernia, when a weakness of the abdominal muscles develops and allows part of the intestine to protrude through the weak spot. The resulting bulge can be painful.


Cure An inguinal hernia needs surgical repair



What is Hernia?

Hernia occurs when a tissue or a part of an organ, usually the intestines, protrudes through a weak point or tear in the abdominal wall, forming a ‘Sac.’ The protruding tissue may not have proper supply of blood. This condition can further result into various health problems as serious as life –threatening gangrene.

Causes and Risk factors of Hernia

‘Hernia’ develops due to weakness in the abdominal muscles or ‘groin.’ The ‘Sac’ is usually a part of the intestine. The exact cause of the disease is still unknown. The risk factors for developing a hernia seem to include:

  •     If an individual has a Family history of the disease
  •     In a condition of Cystic fibrosis
  •     If a person is obese, the risk increases
  •     If one suffers from chronic cough
  •     If an individual experiences chronic constipation
  •     In a condition of enlarged prostate
  •     Due to Un-descended testicles


Most hernias occur in the abdominal wall, both in the groin (inguinal, femoral) or navel (umbilical) and at the point where one has had the surgical incision. The most common type of Hernia is called an ‘Inguinal Hernia.’ It can be present in a child during the time of birth or develop over the years.


The individual might feel development of a ‘lump’ or can also experience ‘swelling’ in the abdomen. If the swelling disappears while lying down, there is a possibility that the person suffers from Hernia. Also the person might feel discomfort and pain in the area. The pain gets acute due to prolonged standing or if the person is engaged in some strenuous work. If a person experiences pain while lifting heavy objects, he/she might go for the test or consult a General Surgeon or Surgical Gastroenterologist.

Get tested

Hernia can be diagnosed after the doctor conducts a medical examination of an individual. The ‘lump’ may not be obvious in children, except when the child is crying or coughing.

Treating time

Surgery is the only way to treat Hernia and neglecting it can have serious consequences.

Reference :

Inguinal Hernia Surgery in India