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If you haven’t experienced hernia surgery, you probably know someone who has. Hernias are relatively common and caused by a variety of circumstances that can afflict anyone. The question is, how do you know if you have a hernia?

A hernia occurs when part of an internal organ or tissue bulges through a weak area of muscle. This may be due to natural muscle weakness or straining from heavy lifting. Hernias can also be caused by constipation, aggravating a previous injury, or even persistent coughing or sneezing. There are also a number of lifestyle factors that can lead to hernias. Being overweight, smoking, and an unhealthy diet can weaken the abdominal wall muscles.

There are several types so of hernias, with the majority appearing in the abdomen. Below are the most common.

  • Inguinal hernia: Most commonly appearing in men, this type of hernia occurs when the intestine or bladder extends into the abdominal wall or the groin’s inguinal canal.
  • Incisional hernia: Elderly, overweight or those inactive after an abdominal surgery are most at risk for an incisional hernia. It occurs when the intestine protrudes through the abdominal wall at the site of a previous surgery.
  • Femoral hernia: When part of the intestine causes a bulge in the upper part of the thigh, close to the groin. This is most common in women, particularly those who are pregnant or overweight.
  • Umbilical hernia: When part of the intestine extends into the umbilical opening in the abdominal area. Infants are susceptible to this. These hernias are usually harmless.
  • Hiatal hernia: When the upper part of the stomach squeezes through an opening in the diaphragm. A small one might be harmless, but a larger one can cause symptoms such as heartburn.
  • Congenital diaphragmatic hernia: This is a birth defect needing surgery and occurs when the diaphragm muscle fails to close during prenatal development, and the contents from the abdomen (stomach, intestines and/or liver) migrate into the chest.

There is a misconception that hernias can repair on their own if they are small. However, this is not a wise assumption. It is always important to seek medical attention if you think you may have a hernia; if left untreated, a hernia will grow, become more painful, and can lead to serious health risks. For example, if the wall the intestine is bulging through closes shut, strangulation to the hernia may occur and cut off blood flow to the bowel. This will require emergent surgery.

So, how do you know if you have a hernia? Here are some telltale signs:

  1. A bulge under the skin in the groin or abdomen.
  2. Obvious swelling of the groin or abdomen.
  3. Discomfort or pain when lifting, coughing, sneezing, straining, or performing physical activities.
  4. Heaviness in the groin or abdomen occasionally accompanied by constipation or blood in the stool.
  5. Pain or discomfort during a bowel movement or urination.
  6. Burning, gurgling, or aching sensation at the site of the bulge.
  7. Pain or discomfort toward the end of the day, particularly if you were standing a lot.
  8. Any symptoms of a strangulated hernia, which include fever, vomiting, nausea, and severe cramping.

Occasionally, hernias will have no symptoms and are discovered during a routine physical or medical exam for an unrelated issue.

If you are worried about a possible hernia, be sure to seek medical attention. They can typically be diagnosed by a physical exam, X-ray or endoscopy. Both an X-ray and endoscopy allow the doctor to see the internal location of the hernia. Some hernias can be treated through lifestyle changes or over the counter medications. Others require surgery. Your doctor can help you navigate your options.

It’s important to recognize the early signs of a hernia. When left untreated, hernias will get worse and more painful. With early recognition, you can lessen the effects of a hernia and avoid life-threatening complications.

On Tuesdays in June, Dr. Adam Kramer will be presenting on hernia types and repair options in the Main Surgery Waiting Room in the Main Hospital of St. Mary’s Medical Center at 6 p.m. After the presentation, we will also be providing free hernia screenings. Please join us! Reservations are not required but encouraged. Please contact Alex at or 816-655-5365 to reserve your spot or for more information.