Hernias occur when an internal part of the body pushes through a weakness in a muscle or tissue, usually causing a lump in the skin. They are fairly common and most cause no pain and many can be left untreated. However, there are certain types of hernia that can become life threatening It is therefore important to understand the different types of hernia and seek specialist help to rectify the problem, ensuring your health is safe.
Hernias – general information
Hernias usually occur between your chest and your hip, with the most common area being the groin.
It may be that your hernia disappears when lying down. However, any strenuous activity may cause your hernia to appear again. Even involuntary actions like coughing can cause an effect.
Most hernias are in fact not painful and could be left untreated. However, if the hernia cuts off the blood supply to a vital organ, known as strangulation, this can be potentially life threatening.
Also, if a part of an organ enters the hernia, known as obstruction, or incarceration, this can also cause complications.
Here are different types of hernia so you can better understand when urgent medical attention is required.
Inguinal hernias – the most common
Inguinal hernias are the most common and affect mainly men. Two thirds of adult hernias will be inguinal and they occur when part of the bowel pushes through the lower abdomen, into the groin. An inguinal hernia will be visible just above the leg crease, in the pubic area and may occur on one side, or both (known as bilateral inguinal hernias).
Inguinal hernias can produce pain in the upper thigh and for men, also pain leading to the scrotum.
Age plays a part, as inguinal hernias affect mainly men over 40 years of age.
There are two types of inguinal hernias:
Direct – caused by a weakness in the floor of the inguinal canal
Indirect – caused by a natural weakness in the internal inguinal ring
The inguinal canal is part of the abdominal wall. Before birth, the inguinal canal is where a man’s testicles must descend from and if not sealed properly, this can result in a natural defect called an internal inguinal ring. It is this opening that can cause a hernia due to weakness.
Fermoral hernias are another type of hernia that affects the groin. These are more common in women, although men can be affected.
A fermoral hernia will be visible below the groin crease and are typically caused from pregnancy or childbirth.
The femoral canal is located next to the femoral vein that transports blood from the leg. A femoral hernia usually occurs from a weakness in the lower groin allowing part of the bowel, or fatty tissue to poke through into the femoral canal.
Early repair is strongly advised for femoral hernias as they are more likely to develop strangulation than inguinal hernias, and therefore can cause complications.
Umbilical hernias affect the area near your belly button. They are caused when part of the bowel pushes into the navel.
If the abdomen though which the umbilical cord passes doesn’t seal properly after birth, babies and infants can experience umbilical hernias, although they are likely to resolve themselves by the time they are three or four years of age. This may result in a lifetime weakness though, which may affect men, women or children.
Adults can also suffer with an umbilical hernia, caused from repeated strain, being overweight, pregnancy or excessive coughing. These hernias are unlikely to improve naturally though, and are more likely to get worse over time.
Hiatus hernias are different to the previous three, as it is the stomach that escapes, rather than the bowel. In this case, the stomach pushes through the diaphragm into the chest.
The diaphragm is the muscle that separates the chest cavity from the abdominal cavity and hiatus hernias are caused due to a weakness, or opening in this muscle.
Hiatus hernias can cause stomach acid to reflux into the oesophagus and mouth, causing symptoms of heartburn. If left untreated the acid wear over time can cause erosion to the wall of the oesophagus, which is potentially dangerous.
Incisional hernias or ventral hernias
Referred to as incisional or ventral hernias, these types of hernias are related to an unhealed wound in the abdomen following surgery. It is possible for the hernia to occur many months, or years after surgery.
It is essential to seek medical attention to ensure the hernia doesn’t worsen and make treatment difficult.
Epigastric hernias occur from a weakness or gap in the muscles located in the upper abdominal wall, between your navel and sternum.
They are less common but affect men more than women.
Spigelian hernias occur when part of the bowel pushes through the abdominal muscle
Muscle hernias often occur as a result of a sports injury, caused when part of the muscle pushes through the abdomen or leg.
Congenital hernias refer to any hernias that is present from birth. To this extent, hernias in children are almost always congenital.
On the contrary, acquired hernias refer to any hernia that occurs as a result of daily activity such as childbirth, sports, muscle strain, excessive coughing and weight gain.
Reducible hernias are generally not an immediate danger to your health. They are determined by being able to flatten the bulge when lying down or by pushing it gently. Reducible hernias may become painful or get worse over time though, so treatment to repair the hernia is often still the best option.
A non-reducible hernia refers to any hernia that does not flatten from gentle pressure. These types of hernia can be painful and medical attention is required because the intestine is likely to be trapped, which can lead to obstruction or strangulation of an organ.