Inguinal hernia: Your questions answered

An inguinal hernia, which is the most common type of hernia, typically appears as a swelling or a lump in the groin.

Here to provide an expert insight into inguinal hernias, including their causes, symptoms and treatment, is Ms Cinzia Sammartino, renowned consultant general surgeon.

What are the symptoms of an inguinal hernia?

Many people don’t have symptoms when they have an inguinal hernia, especially if the hernia is small.

An inguinal hernia, however, may cause pain and discomfort if it becomes very large. If complications start to appear - which tend to happen when the hernia grows bigger - the inguinal hernia can then become strangulated or incarcerated, especially if there is a loop of bowels inside of the hernia. This can cause a lot of pain, nausea, and vomiting.

When symptoms appear, people will go to the emergency department for urgent assessment, and this is when the inguinal hernia will be identified. In most cases, however, people will go to see a GP after they start noticing a small swelling or lump coming at the level of the groin.

How is an inguinal hernia diagnosed?

The diagnosis of an inguinal hernia is clinical.

If a hernia is suspected, the first thing to look for is the presence of a hole in the abdominal wall. The abdominal wall is made of different layers: the layer seen on the outside (skin) and the layer found underneath the skin and the subcutaneous tissue which is made by fascia and muscles. Where there is a hole in the fascia and muscles, this is where a hernia can protrude through.

There are times, however, when it’s not obvious if we are dealing with an inguinal hernia. If this happens, an ultrasound scan is then normally requested.

In specific situations, a CT scan may also be required to better assess the size and site of a hernia.

What causes an inguinal hernia?

An inguinal hernia can be something which is acquired. It’s not unusual that hernias are more likely to appear on people who put a lot of pressure on the abdominal wall. These are people who, for example, exercise very frequently or do a lot of heavy lifting either at the gym or because they have a physical manual job.

Some people can also be born with a defect in the abdominal wall. When there is a lot of pressure put on the fascia and muscles, this defect can become larger and cause the contents of the abdomen to come through, resulting in a hernia.

What are the treatment options for an inguinal hernia?

The treatment for an inguinal hernia is always surgical, especially for small-sized and medium-sized hernias. Hernia repair is normally performed under general anaesthetic and, most of the time, people go home on the same day.

If a hernia is very small and doesn’t cause any symptoms, it can be left alone without planning for surgery. Eventually, however, only surgery will be able to close the hole and stop the hernia from growing bigger.

Additionally, unless there is a major medical contraindication, it’s always better to treat a hernia when it's small. This is because the surgical procedure required to treat the hernia will be less invasive and more straightforward. If a hernia is left to grow bigger, the risk of complications can increase, adding complexity to the surgery.

How can I prevent an inguinal hernia from recurring?

Unfortunately, there is little that can be done in terms of prevention. Having points of weaknesses in the abdomen can be a congenital condition and if someone does heavy lifting for sports or for work, it is very likely that a hernia will come through.

What are the potential complications of an inguinal hernia?

Many people are able to live with small inguinal hernias for a long period of time without ever needing surgery if these hernias don’t cause symptoms.

If a hernia grows, however, it can cause the loop of bowels inside of the hernia to twist. This can result in occlusion by hernia, which is a medical emergency that requires a very complex surgical procedure that is much more complicated to perform than a simple repair of a small hernia.

Ms Cinzia Sammartino is a leading consultant general surgeon with over 15 years' experience.

If you require hernia repair for an inguinal hernia and you would like to consult your options, don’t hesitate to book an appointment with Ms Sammartino via her Top Doctors profile today.