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On-Call Advice

What is a hernia, and can it be dangerous?

A hernia is the intrusion or bulge of an organ or soft tissue through a weak spot in the muscle or tissue that holds it in place. Although hernias can occur in various parts of the body, they are most common in the abdominal wall. Symptoms usually include swelling, a lump or bulge, and pain—but in some cases there are no noticeable symptoms, at least initially. 

An increase of pressure in the abdomen can cause an organ to begin to squeeze or bulge through a weak spot. Common causes of increased abdominal pressure include lifting heavy objects; chronic, persistent coughing or sneezing; and straining when having a bowel movement. Some hernias occur due to a weakness that has existed since birth, or following injury or surgery. Depending on the type of hernia, some can occur suddenly, while others happen gradually over time. 

The most common types of hernias include: 

• Inguinal hernia: More common in men, inguinal hernias occur when fatty tissue or a portion of the intestine or bladder bulges through the abdominal wall into the inguinal canal in the groin. 

• Femoral hernia: More common in women, femoral hernias happen when fatty tissue or a portion of the intestine pushes into the canal containing the femoral artery. 

• Umbilical hernia: This variety, which can occur at any age and is more common for women during pregnancy, results when fatty tissue or part of the intestine pushes through the abdominal wall near the navel. 

• Incisional hernia: This type occurs when fatty tissue or a portion of the intestine comes through the abdominal wall at the site of an incision following prior surgery. 

Hernias almost never go away by themselves (an exception to this is the umbilical hernia in an infant or small child, which may disappear as the child grows). Usually, a hernia diagnosis will prompt a consultation with a surgeon to discuss whether repair is recommended—a decision that is tailored to each individual’s clinical situation and overall health. 

Fortunately, most hernias are not life-threatening. One potentially serious complication can occur when a portion of the intestine gets caught in the hernia, causing obstruction or blockage of the intestine and resulting in severe pain, nausea, abdominal bloating and constipation. If blood flow to the intestine is cut off, that portion of the organ can die, resulting in a life-threatening emergency that requires immediate medical attention. These risks should be discussed with your doctor, and you should seek immediate medical care if symptoms of intestinal obstruction arise.

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