Inguinal hernia: symptoms and treatments

Inguinal hernias are a common condition, that can be extremely painful and require emergency surgery if not treated. In his latest article, renowned colorectal surgeon Professor Lee Dvorkin gives a comprehensive explanation of this condition. He explains the symptoms and treatment options, as well as whether or not they are a serious condition. 

What are the first signs of a hernia?

The first sign or symptom of a hernia is a small bulge that appears in the groin which often appears when standing upright but may go away when lying down. As they get bigger, they may start to cause an ache or pain in the area. Small hernias are rarely a cause of severe groin pain.

How serious is a hernia?

Usually, a hernia is a problem because of how it looks and how it prevents patients from doing their usual activities or exercise. Over time, hernias can get bigger and cause more symptoms. Occasionally the hernia becomes strangulated. This means it becomes hard and painful and won’t go away. This is an emergency and requires urgent surgery.

 If the bowel has become trapped in the hernia patients can become very ill and surgery is even more urgent. Symptoms of this include a painful lump in the groin associated with abdominal pain and vomiting. Surgeons often recommend surgery in order to prevent this problem.

What can happen if an inguinal hernia doesn’t get treated?

If not treated a hernia can become larger and more symptomatic and with that, the chance of needing surgery becomes greater. For patients who are fit for treatment, surgeons would usually recommend surgery for all but the smallest of hernias.

How are they treated? Is surgery the only option?

For very small inguinal hernias that are not causing any symptoms, it may be reasonable to avoid surgery as the risk of strangulation is low, at about 3% over the next 2 years. If patients choose this option, they need to have the risks explained to them as 70% of these patients will need surgery at some point over the next 10 years.

For patients who are symptomatic, and those for whom the hernia is affecting their quality of life, surgery is usually recommended. 

The use of a hernia truss (or belt) can be helpful in some patients, especially those who are unfit for surgery, but its general use is controversial.

What’s involved in hernia surgery?

A groin hernia can be fixed by a variety of methods which the surgeon will discuss. This will usually (but not always) involve a general anaesthetic and the placement of a mesh to strengthen the area. These operations can be done by keyhole surgery under some circumstances but otherwise, there will be a small cut in the groin. The complication rate of hernia surgery is generally low and can often be done as a day case.

Professor Lee Dvorkin is a highly revered colorectal surgeon based in London, with over 25 years of experience. If you would like to book a consultation with Professor Dvorkin you can do so today via his Top Doctors profile.