What is a Hernia?

A hernia occurs when your muscle wall or tissue becomes weak or tears, allowing your internal organs and other body tissues to push through the weakened area.

A hernia will often cause a visible bulge or swelling, and you may feel discomfort, aching or pain or experience a functional impairment from their hernia. While the most common location for a hernia is in the abdomen, they can occur in other areas, including the upper thigh, belly button and groin. Penn Hernia Center specialists provide personalized evaluations to develop a unique plan to treat and manage your specific hernia.

What Causes a Hernia?

All hernias are caused by pressure combined with an opening or weakness of muscle or tissue in your abdomen.

You can be born with muscle weakness, but more commonly it happens later in life. The most common causes of muscle weakness include:
  • a congenital defect
  • advanced age
  • chronic coughing
  • damage from a previous injury or surgery

Factors that place strain on your body and lead to an increase in pressure can cause a hernia, including:

  • Lifting heavy objects 
  • Constipation
  • Pregnancy
  • Coughing or sneezing
  • Sudden weight gain
  • Fluid buildup in your abdomen

If you are obese, have a poor diet or smoke, your muscles may be weakened, making hernias more likely.

What Are the Signs and Symptoms of a Hernia?

The signs and symptoms of hernias can range from a painless lump to a swollen and tender protrusion accompanied by severe abdominal or pelvic pain. Some common signs include:

  • A lump in the groin or abdomen that grows in size while standing or during times of increased pressure, such as while coughing
  • A lump in the abdominal area that grows over time without pain 
  • A lump that aches, but does not cause increased pain when touched
  • Nausea and vomiting
  • Persistent pain in the abdomen accompanied by nausea and vomiting

If you suspect you have a new hernia, schedule a visit with your doctor as soon as possible. Hernias are not necessarily surgical emergencies, but can potentially become serious. 

What Are the Different Types of Hernias?

  • Inner Groin (inguinal) hernia – Often caused by lifting or straining and represents the most common hernia type in men.
  • Upper thigh (femoral) hernia – Older women are more likely to have this type of hernia, in which tissue or part of the intestine protrudes into the groin.
  • Upper Stomach (hiatal) hernia – This condition results in the stomach pushing through an opening in the diaphragm. If small, the hernia may cause no trouble. If larger, it can create heartburn, difficulty swallowing or chest pain and may need surgical repair.
  • Navel (umbilical) hernia – When part of the intestine or other tissue pushes through the navel or belly button, it causes this hernia type. In children, this usually disappears by the preschool years. If it occurs in adults, surgery is needed.
  • Abdominal (ventral) hernia – These develop in various areas of the abdomen. Incisional hernia happens at the site of previous surgery, such as a cesarean section or appendectomy. Diaphragmatic hernia, epigastric hernia, lumbar hernia and Spigelian hernia are other, rarer types of abdominal hernias.

How Are Hernias Diagnosed?

The Penn Hernia Center offers advanced diagnostic and imaging services. Diagnosis is made through a comprehensive clinical examination by one of our specialists and is also based on your history of symptoms.

If you are being evaluated for a hernia, you may have one of more of the following diagnostic tests:

  • High resolution CT scan
  • MRI
  • GI contrast study (for those with a more complex intra-abdominal pathology that accompanies their hernia, such as intestinal fistula)

How Are Hernias Treated?

Hernias in adults do not go away without treatment. They may grow larger and symptoms may worsen. Certain hernias may become obstructed, causing nausea and stomach pain. They also can become strangulated, when blood flow is cut off, a condition needing immediate emergency surgery.

Hernias that have grown and are causing discomfort or pain will likely need surgery. Your hernia repair team may include specialists in gastrointestinal and plastic surgery who collaborate to repair your specific hernia.

Penn Hernia Center physicians excel in all types of hernia procedures, including:

  • Open repair – Through traditional surgical incisions, the surgeon reaches the hernia, replaces the protruding tissue and sews up the torn muscle or tissue. Synthetic mesh is added to support the area and prevent a repeat hernia. Recovery may take a month or more.
  • Laparoscopic repair – This approach uses a few very small incisions. A tiny camera in a tube is placed through one incision to guide the surgeon. Small instruments inserted through another incision repair the hernia, also using mesh for strength. Laparoscopic surgery has a faster recovery time than open repair, but is not appropriate for all conditions or patients.
  • Plastic surgery – Some hernia patients also require soft tissue reconstruction, repair of other internal structures or the removal of excess skin. This may be needed to prevent infection or improve function and appearance. Penn gastrointestinal surgeons and plastic surgeons collaborate to provide the best results.

Learn more about hernias and how we treat them from John Fischer, MD:

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