A complete guide to hernias

Written in association with: Mr Dominic Coull
Published: | Updated: 07/01/2025
Edited by: Aoife Maguire

A hernia is a prevalent medical condition where an organ or fatty tissue protrudes through a weak area or tear in the surrounding muscle or connective tissue. Although often harmless, hernias can lead to discomfort and may need medical attention if not addressed.

 

We speak to experienced colorectal surgeon Mr Dominic Coull who delves into the nature of hernias, their causes, symptoms, and the treatment options available.

 

 

What causes a hernia?

 

Hernias occur when there is an opening or weakness in the muscles or tissues that normally hold internal organs in place. This allows a portion of the intestine, fat, or another organ to protrude through that weakened area. There are various types of hernias, each with its own causes and risk factors.

 

The most common type is an inguinal hernia, where tissue pushes through the abdominal wall in the groin area. Other types include femoral hernias, which occur in the upper thigh, and hiatal hernias, where part of the stomach protrudes into the chest through the diaphragm.

 

In some cases, hernias can develop from congenital defects, while others are the result of increased pressure on the abdominal muscles due to factors such as obesity, heavy lifting, pregnancy, or chronic coughing.

 

What are the symptoms of a hernia?

 

The symptoms of a hernia can vary depending on its size and location. Common symptoms may include:

 

  • A visible lump or bulge, particularly noticeable when standing or straining.
  • Pain or discomfort in the affected area.
  • A sensation of heaviness or dragging in the abdomen or groin.
  • Pain that intensifies with activities like movement, lifting, or bending.

 

In some cases, hernias may be asymptomatic and only discovered during routine medical examinations. However, if the hernia becomes incarcerated or strangulated—where the blood supply is cut off—it can become a medical emergency requiring immediate surgical intervention.

 

How is a hernia diagnosed?

 

Diagnosis of a hernia typically begins with a physical examination by a doctor. In some cases, additional imaging tests, such as ultrasound or MRI, may be required for a more accurate assessment. These tests help to determine the severity and exact location of the hernia.

 

What are the treatment options for a hernia?

 

The primary treatment for most hernias is surgical repair. In many cases, the goal of surgery is to return the protruding tissue or organ back into its proper place and strengthen the weakened muscles to prevent recurrence.

 

For smaller, non-complicated hernias, a watchful waiting approach may be appropriate, especially in cases where surgery carries higher risk, such as in elderly patients or those with other health conditions. Non-surgical options like hernia trusses or supportive garments may offer temporary relief, but these are not a cure.

 

Surgical techniques for hernia repair vary depending on the type and location. Common methods include open hernia repair and laparoscopic surgery. Laparoscopic procedures often lead to faster recovery times and less post-operative discomfort, though they may not be suitable for all cases.

 

Are there any risks associated with hernia surgery?

 

As with any surgical procedure, hernia repair carries some risks, including infection, bleeding, and recurrence of the hernia. However, with advances in medical techniques and post-operative care, the success rates are generally high, and complications are uncommon.

 

If you suspect a hernia, it is important to consult with a doctor promptly for diagnosis and to discuss the most appropriate treatment options tailored to your specific needs.

 

If you would like to book a consultation with Mr Coull, do not hesitate to do so by visiting his Top Doctors profile today. 

By Mr Dominic Coull
Colorectal surgery

Mr Dominic Coull is a leading consultant laparoscopic general and colorectal surgeon whose main specialty is hernia surgery. He is based in Reading and is an examiner for The Royal College of Surgeons. Mr Coull's areas of expertise further lie in minimally-invasive hernia surgery, modern minimally-invasive management of haemorrhoids and colonoscopy alongside laparoscopic colorectal surgery, colorectal cancer and investigation of rectal bleeding. Mr Coull also specialises in altered bowel habits (diarrhoea, constipation), ulcerative colitis and Crohn's disease as well as pilonidal sinus surgery, anal fistula and anal fissure treatment and skin lesion removal.

He qualified in 1995 from the University of London and obtained a subsequent Masters of Surgery degree in Inflammatory Bowel Disease. After further training, he obtained a prestigious laparoscopic surgical fellowship in colorectal and general surgery jointly at two world-renowned surgical units in Basingstoke and Frimley, before being appointed as a consultant at the Royal Berkshire Hospital. Here, he initiated the provision of laparoscopic TEP hernia repairs and laparoscopic colorectal surgery there.

Mr Coull has acquired a vast amount of training and experience in his field and is considered an expert in laparoscopic surgery across Europe. Alongside his consultancy work, he is on the teaching faculty to train other European consultants at surgical training facilities in Paris, Hamburg and the UK.

He currently practices privately at the Circle Reading Hospital and Spire Dunedin Hospital. He prides himself on delivering first-rate, reassuring and honest consultations with his patients to support and guide them through their surgical procedures.

His average length of stay for patients following colorectal cancer surgery is three days contrasted with the national average of eight days. Additionally, his successful colonoscopy completion rate stands at 99 per cent - well above the national requirement of 90 per cent.

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