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Children's Health System - Alabama

Children's of Alabama
Healthcare as amazing as their potential
www.childrensal.org
1600 7th Avenue South
Birmingham, AL 35233
(205) 638 - 9100


Hernias

What Are Hernias?

A hernia (pronounced: HUR-nee-uh) is when part of an organ or tissue in the body (such as a loop of intestine) pushes through an opening or weak spot in a muscle wall. It can push into a space where it doesn't belong. This causes a bulge or lump.

Hernias are most common in areas like the belly, groin and upper thigh area, and belly button area. They also can happen in any area where you may have had an incision from surgery.

How Do People Get Hernias?

It might take a long time for a hernia to develop or it might develop suddenly. Hernias are caused by a combination of muscle weakness and strain, although the cause of the weakness and the type of strain may vary.

Hernias are actually most common in babies and toddlers. And most teens who are diagnosed with a hernia actually have had a weakness of the muscles or other abdominal tissues from birth (called a congenital defect). In these cases, straining your muscles doesn't cause the hernia; it only makes the hernia more apparent (and painful!).

Here are some types of strain on the body that may induce hernias:

  • obesity or sudden weight gain
  • lifting heavy objects
  • diarrhea or constipation
  • persistent coughing or sneezing
  • pregnancy

These types of strain on their own probably won't give you a hernia. But if there's also a weak muscle, a hernia is more likely to result.

Many hernias are discovered during routine physical exams. If you're a guy, you may have had a physical exam where your doctor gave you a testicular exam and checked your testicles for a hernia. By placing a finger at the top of your scrotum and asking you to cough, the doctor can feel if you have a hernia.

Females can get hernias, too, especially if they've been pregnant or are obese. A doctor can check for any possible hernias in girls by gently pressing on the organs or looking for possible signs during an examination.

What Are the Types of Hernias?

Teens can get:

Inguinal Hernias

Inguinal (pronounced: IN-gwuh-nul) hernias are more common in guys than girls. In an inguinal hernia, part of the intestines protrudes through an opening in the lower part of the abdomen, near the groin, called the inguinal canal.

In guys, the inguinal canal is a passageway between the abdomen and the scrotum through which the spermatic cord passes (the testicles hang from the spermatic cord). In girls, the inguinal canal is the passageway for a ligament that holds the uterus in place. Nearly all cases of inguinal hernias in teens are due to a congenital defect of the inguinal canal. Instead of closing tightly, the canal leaves a space for the intestines to slide into.

If you have an inguinal hernia, you might be able to see a bulge where your thigh and your groin meet. In guys, the protruding piece of intestine may enter the scrotum, which can cause swelling and pain. Other symptoms of an inguinal hernia might include pain when you cough, lift something heavy, or bend over. These types of hernias are fixed with surgery. In fact, inguinal hernia operations are the most common type of surgery done on kids and teens.

Epigastric Hernias

In an epigastric (pronounced: eh-pih-GAS-trik) hernia, which is also called a ventral hernia, part of the intestines protrudes through the abdominal muscles located between the belly button and the chest.

It's mostly guys who have to worry about this type of hernia — about 75% of epigastric hernias are in males. People with this type of hernia may notice a lump. Surgery is a common way to fix this problem.

Incisional Hernias

People who had surgery in the abdominal area might get this type of hernia. In incisional hernias, part of the intestines bulges through the abdomen around a surgical incision. In this case, surgery weakened the muscle tissue in the abdomen. This type of hernia requires another surgery to repair it.

Hiatal Hernias

This type of hernia happens at the opening of the diaphragm where the esophagus (the pipe that food travels down) joins the stomach. If the muscle around the opening to the diaphragm becomes weak, the top part of a person's stomach can bulge through the diaphragm.

Hiatal (pronounced: hy-AY-tul) hernias are common, although small ones don't usually cause any symptoms. Unlike the other types of hernia, you can't see a bulge on the outside of your body, but you might feel heartburn, indigestion, and chest pain. Hiatal hernias can be treated with medicine and diet changes, but sometimes need surgery.

What Do Doctors Do?

If you notice a bulge or swelling in your groin, abdomen, scrotum, or thigh, talk to your doctor. Sometimes a hernia may also cause sharp or dull pain, which can get worse upon standing.

With most types of hernias, the doctor can see and feel the bulge and diagnose someone with a hernia.

Over time, a hernia may become larger and more painful. In some cases of hiatal hernia, a piece of the intestine could become trapped (this is known as incarceration). In a true surgical emergency, the blood supply could be cut off to the incarcerated intestine (this is known as strangulation). This situation is painful and dangerous because it can cause infection and may cause the strangulated tissue to die.

If you've had a hernia operation and you notice redness or discomfort around your incision (the area where the cut was made for the operation), be sure to let your doctor know. It could be a sign of infection that needs further treatment.

Can Hernias Be Prevented?

Here are a few tips that can help prevent hernias:

  • Stay at a healthy weight for your height and body type. Talk to your doctor or a dietitian about a healthy eating and exercise program if you think you are overweight or obese.
  • Make fruits, veggies, and whole grains part of your diet. Not only are these foods good for you, they're also packed with lots of fiber that will prevent constipation and straining.
  • Be careful when weight lifting or lifting heavy objects. Make sure you lift weights safely by never lifting anything that's too heavy. If you have to lift something that's heavy, bend from your knees, not at your waist.
  • See your doctor when you're sick. If you have a lasting cough from a cold or you sneeze a lot because of allergies, see your doctor about cough or allergy medicines.
  • Quit smoking.Smoking can cause a nagging cough, and this can strain your abdominal muscles. The risk of getting hernias is just one more reason to kick the habit!
Reviewed by: T. Ernesto Figueroa, MD
Date reviewed: October 2021