The abdominal wall is a sheet of tough muscles and tendons that run between your ribs and your groin (upper part of your leg). It acts like a natural corset holding all the abdominal organs in place. Sometimes, a weakness in your abdominal wall can open up, so whatever is on the inside (usually part of your gut) pushes through. This causes a bulge or swelling called a hernia.
Abdominal hernias are named according to the position of the weakness in the abdominal wall. The most common types of abdominal hernia are listed below.
The main sign of an abdominal hernia is having a bulge or swelling appear on a part of your abdomen. Often, the bulge will disappear when you lie down or push on it and then reappear when you stand, cough or sneeze. This is called a reducible hernia.
You may also have symptoms such as burning, slight discomfort and a feeling of heaviness or aching in your abdomen. When you strain or lift something, you may have a sharp pain.
If you have any of these symptoms, see your GP.
If the hernia grows and becomes impossible to push back in, it’s called an incarcerated hernia. When this happens, there is a risk that the blood supply to the protruding gut may be cut off. This is then called a strangulated hernia, which is a serious complication that requires urgent surgery.
It’s vital that you get medical help immediately when you have a hernia and it becomes incarcerated, especially if:
Anything that increases the pressure in your abdomen can cause an abdominal hernia, including:
The risk of having an abdominal hernia increases with age because the older you get, the weaker your abdominal wall muscles become.
Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history.
Your GP will examine the bulge or swelling. This may be when you're standing up or lying down. He or she will check if the bulge can be pushed back in, and may ask you to cough while placing a finger over the hernia to see if there is a change in the swelling. Your GP may also refer you for an ultrasound scan to confirm a diagnosis.
Umbilical hernias in young children usually get better on their own as the abdominal muscles get stronger. However, most abdominal hernias generally get larger with time and don't go away without treatment. Surgical repair is usually recommended in adults.
An abdominal hernia repair operation involves pushing the hernia back into your abdomen and repairing the weakened muscle. This can be done as a keyhole procedure (where the operation is done through small cuts in your lower abdomen) or open surgery (where a single, larger cut is made).
The only way to prevent having an abdominal hernia is to limit the problems that make it more likely. Some examples are listed below.
If you’re a woman and are pregnant, it may be helpful to wear a support belt to ease the pressure on your abdominal muscles. Speak to your GP or obstetrician (a doctor who specialises in pregnancy and childbirth) for more information.
If you have any type of abdominal hernia, as well as having a bulge, you might also have a dragging or aching feeling in the area. This may get worse when you're physically active.
Abdominal hernias can sometimes be very small and difficult to diagnose, particularly in people who are overweight. If you suspect you have a hernia but don’t notice a bulge, you may have other symptoms, such as a dragging or aching feeling in your abdomen (tummy).
You will have more obvious symptoms if the hernia becomes strangulated (when the blood supply to your gut becomes cut off). Because you can develop complications even from small hernias, it’s important to seek medical help immediately if:
If the hernia is strangulated, you will need to have surgery urgently.
There is no sure way of preventing another hernia but you can take steps to reduce the chances of it happening again. These include managing factors that may put a strain on your abdominal muscles.
After having a hernia, you're at an increased risk of having another. The likelihood of this happening will depend on the type and size of the initial hernia, your general health, weight and lifestyle.
Your general health
A chronic cough, violent sneezing or constipation can increase your risk of having another hernia. Some self-help measures to ease these problems are listed below.
Being overweight can put a strain on your abdominal muscles, so it’s important to maintain a healthy weight.
Any physical activity that involves straining your abdominal muscles can increase your risk of getting another hernia. If your job involves heavy lifting, it’s important to look at ways to reduce or not do this type of activity.
Regular exercise is good for your general health and wellbeing; however strenuous activity can put pressure on your abdominal muscles. If you have had a hernia before, talk to your GP for advice before starting a new physical activity.
Apart from umbilical hernias in small children, abdominal hernias don’t usually go away by themselves and tend to get bigger slowly over time. You are therefore likely to need surgery.
Most people will eventually need to have surgery for an abdominal hernia, but how soon you need to have the operation may depend on how severe your hernia is and your individual circumstances. Your surgeon will be able to advise you about your options and the right type of surgery for you.