Diseases and Conditions

Inguinal Hernia

What is an inguinal hernia?

An inguinal hernia (pronounced IN-gwuh-nul HER-nee-uh) is when part of your intestine pushes through a weak spot in your lower belly (abdominal) wall. This area is called the groin. The hernia creates a lump in your groin. Over time the hernia may get bigger.

Most inguinal hernias, even large ones, can be made smaller and pushed back into your belly using gentle massage and pressure.

What causes an inguinal hernia?

There are 2 types of inguinal hernias: indirect and direct.

  • Indirect inguinal hernia. This is the most common type. It happens when an opening in your belly (abdominal) wall does not close normally before birth. That leaves a weak spot in the belly wall.
  • Direct inguinal hernia. This type occurs mainly in adult males. It is caused by a weakening of abdominal muscle tissue over time. This happens because of aging and long-term stress on the weakened belly muscles.

Who is at risk for an inguinal hernia?

An inguinal hernia can happen at any age.

You are at greater risk for an inguinal hernia if you:

  • Are male
  • Are obese
  • Are a pregnant woman
  • Have a family history of inguinal hernias
  • Smoke

Some activities may also raise your risk for an inguinal hernia. These include:  

  • Doing a lot of heavy lifting
  • Long-term (chronic) coughing
  • Straining to have a bowel movement

What are the symptoms of an inguinal hernia?

Some inguinal hernias are painful while others don’t cause any pain.

Each person’s symptoms may vary. Symptoms may include:

  • A lump in the groin or in the sac that holds the testicles (the scrotum)
  • Pain or pressure in the groin that gets worse when you cough, strain, lift, or exercise
  • A burning feeling in the lump
  • Steady, growing pain if the blood supply to the bulging part of the intestine is cut off (called a strangulated hernia)

In severe cases the intestine is partly or fully blocked. Symptoms in severe cases may also include:

  • Infection
  • Nausea
  • Vomiting
  • Lack of hunger

The symptoms of an inguinal hernia may look like other health problems. Always see your health care provider to be sure.

How is an inguinal hernia diagnosed?

Your health care provider will likely be able to tell that you have an inguinal hernia by looking at your past health and giving you a physical exam.

During the physical exam he or she will try to push the hernia back into your belly.

You may also have imaging tests including:

  • Ultrasound (sonography). This creates images of blood vessels, tissues, and organs on a computer screen using high-frequency sound waves. It is used to see the intestine and abdominal wall and check blood flow through different vessels.
  • X-ray. This test makes pictures of internal tissues, bones, and organs on large sheets of film. It uses invisible electromagnetic energy beams.  
  • CT scan. This test shows detailed images of any part of the body, such as the bones, muscles, fat, and organs. A CT scan is more detailed than a regular X-ray. It uses a combination of X-rays and computer technology to make horizontal images (often called slices) of the body.

How is an inguinal hernia treated?

A inguinal hernia will not heal on its own. Surgery is needed.

There are 2 types of surgery for an inguinal hernia: traditional open hernia repair (called herniorrhaphy) or laparoscopic hernia repair.

  • Open hernia repair. The skin at the groin is cut open. The bulging intestine is pushed back into your belly and the opening in the muscle wall is sewed shut. Sometimes the weak area is fixed and made stronger with steel mesh or wire (hernioplasty).
  • Laparoscopic hernia repair. A few small cuts (incisions) are made in your lower belly. A thin flexible tube (laparoscope) is put through one of the cuts. The tube has a tiny video camera in it that is attached to a screen. This lets your health care provider see inside your belly. He or she uses long thin tools in the other cuts to repair the hernia with mesh.

Inguinal hernias that are not causing any symptoms can be closely watched. If symptoms occur, the hernia can be repaired through open surgery or laparoscopic surgery.

You will need surgery right away if your small intestine gets stuck in the groin (incarcerated hernia) or if blood supply to your small intestine is blocked (strangulated hernia).

In some cases a hernia may come back after surgery. This is less likely to happen when mesh is used to support the weak belly muscles.

What are the complications of an inguinal hernia?

An inguinal hernia can lead to other problems such as:

  • Incarcerated hernia. This is when part of the small intestine gets stuck in the groin and can’t be pushed back into your belly. Seek emergency medical care.
  • Strangulated hernia. If the incarcerated hernia is not treated, blood supply to the small intestine is blocked. This is a life-threatening condition. Seek emergency medical care.
  • Hole (perforation). The hernia may cause a hole and you may need a bowel resection. This is when the pinched-off part of the intestine, or bowel, is removed.
  • Peritonitis. If the hernia is sore and the skin over it is red and warm, you may have an infection of the lining of your belly (peritonitis).

Key points about inguinal hernias

  • An inguinal hernia happens when part of the intestine pushes through a weak spot in the belly (abdominal) wall. 
  • The hernia creates a soft lump under the skin.
  • Most inguinal hernias can be pushed back into the belly with gentle massage and pressure.
  • An inguinal hernia will not heal on its own. Surgery is needed.
  • You will need surgery right away if your small intestine gets stuck in the groin (incarcerated hernia) or if blood supply to your small intestine is blocked (strangulated hernia).

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

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