An inguinal hernia is a condition in which intra-abdominal fat or part of the small intestine, also called the small bowel, bulges through a weak area in the lower abdominal muscles. An inguinal hernia occurs in the groin; the area between the abdomen and thigh. This type of hernia is called inguinal because fat or part of the intestine slides through a weak area at the inguinal ring, the opening to the inguinal canal. An inguinal hernia appears as a bulge on one or both sides of the groin. An inguinal hernia can occur any time from infancy to adulthood and is much more common in males than females. Inguinal hernias tend to become larger with time.
The two types of inguinal hernia have different causes.
- Indirect inguinal hernia. Congenital hernias that are much more common in males because of the way they develop in the womb. Sometimes the entrance of the inguinal canal at the inguinal ring does not close as it should just after birth, leaving a weakness in the abdominal wall. In females, an indirect inguinal hernia is caused by the female organs or the small intestine sliding into the groin through a weakness in the abdominal wall. Indirect hernias are the most common type of inguinal hernia. Premature infants are especially at risk for indirect inguinal hernias because there is less time for the inguinal canal to close.
- Direct inguinal hernia. Direct inguinal hernias are caused by connective tissue degeneration of the abdominal muscles, which causes weakening of the muscles during the adult years. Direct inguinal hernias occur only in males and develop gradually because of continuous stress on the muscles. Various factors can cause pressure on the abdominal muscles and may worsen the hernia, such as sudden twists, pulls, or muscle strains, lifting heavy objects, straining on the toilet because of constipation, weight gain and chronic coughing.
An incarcerated inguinal hernia is a hernia that becomes stuck in the groin or scrotum and cannot be massaged back into the abdomen. An incarcerated hernia is caused by swelling and can lead to a strangulated hernia, in which the blood supply to the incarcerated small intestine is jeopardized. A strangulated hernia is a serious condition and requires immediate medical attention. Left untreated, nausea, vomiting, and severe infection can occur. If surgery is not performed right away, the condition can become life threatening, and the affected intestine may die and need to be removed.
- A small bulge in one or both sides of the groin that may increase in size and disappear when lying down; in males, it can present as a swollen or enlarged scrotum
- Discomfort or sharp pain that goes away when resting, especially when straining, lifting, or exercising
- A feeling of weakness or pressure in the groin
- A burning, gurgling, or aching feeling at the bulge
Strangulated hernia symptoms
- extreme tenderness and redness in the area of the bulge
- sudden pain that worsens in a short period of time
- rapid heart rate
In adults, inguinal hernias that enlarge, cause symptoms, or become incarcerated are treated surgically. Surgery is usually done on an outpatient basis. Recovery time varies depending on the size of the hernia, the technique used, and the age and health of the patient. The two main types of surgery for hernias are traditional hernia repair and laparoscopy.