AI Summary Overview
Hernia Symptoms That Should Not Be Ignored
Some hernia remain stable for a long time. However, a change in the size, appearance or behaviour of the lump can indicate a complication. The table below explains hernia symptoms and changes that should prompt medical assessment:
| Symptom or Change | What It May Indicate |
| A lump that is becoming noticeably larger | Enlargement of the hernia or increasing protrusion of tissue |
| Increasing pain or tenderness around the bulge | Irritation, pressure or possible trapping of tissue |
| A bulge that previously went back in but now remains present | An incarcerated hernia, where the contents become trapped and cannot return to the abdomen |
| Persistent groin or abdominal discomfort affecting normal activities | Increasing pressure or irritation around the hernia |
| Abdominal pain with bloating | Possible involvement of the bowel or intestinal obstruction |
| Repeated nausea or vomiting | Possible intestinal obstruction, particularly when accompanied by abdominal pain or bloating |
| A new painful or tender lump | A possible complication that needs prompt assessment |
| Difficulty or pain when swallowing with reflux symptoms | A swallowing problem that may need further assessment in a person with a hiatus hernia |
Why Do Hernia Symptoms Occur?
Hernia symptoms occur when tissue, such as fat or part of the intestine, pushes through a weak area in the abdominal wall or surrounding connective tissue. This can create a visible or noticeable lump, particularly in the abdomen, groin or around the navel.
Coughing, lifting, straining or standing for long periods can temporarily increase pressure inside the abdomen. This may make the hernia bulge more prominent and can contribute to aching, burning, pressure or a heavy feeling.
A hiatus hernia develops differently. Part of the stomach moves through an opening in the diaphragm and into the chest. This can make gastro-esophageal reflux more likely, allowing stomach contents to move back towards the esophagus and causing symptoms such as heartburn, acid reflux or difficulty swallowing.
Hernia Symptoms That Require Immediate Medical Attention
A hernia can become an emergency if its contents become trapped, the blood supply to the trapped tissue is reduced, or the intestine becomes blocked. Seek urgent medical attention if you develop:
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Sudden or severe pain in or around the hernia
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A bulge that suddenly becomes larger, firm or very tender
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A lump that previously went back in but can no longer be pushed back
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Red, purple, dark or otherwise discoloured skin over the bulge
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Persistent nausea or vomiting, especially with abdominal pain or bloating
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Severe abdominal pain with swelling or bloating
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Inability to pass stool or gas
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Fever with increasing pain, tenderness or a change in the hernia
These symptoms can occur with an incarcerated or strangulated hernia or with intestinal obstruction and require prompt medical assessment.
Symptoms of Hernia Based on Type
The table below explains how hernia symptoms can differ according to the type and location of the hernia:
| Type of Hernia | Typical Symptoms |
| Inguinal hernia | A bulge in the groin with aching, burning, heaviness or pressure that may become more noticeable when coughing, lifting or standing |
| Femoral hernia | A lump or discomfort in the lower groin or upper thigh; pain, nausea or vomiting may occur if the hernia becomes trapped or causes bowel obstruction |
| Umbilical hernia | A soft bulge around the navel, which is often painless in children but may cause discomfort in adults |
| Incisional hernia | A bulge at or near a previous abdominal surgery scar, sometimes accompanied by aching or discomfort |
| Hiatus hernia | Often causes no symptoms; when symptoms occur, they may include heartburn, acid reflux, regurgitation, bloating or difficulty swallowing |
Hernia Symptoms in Men
Inguinal hernias are more common in men and often cause a bulge or discomfort in the groin. The lump may become more noticeable when standing, coughing, lifting or straining. If an inguinal hernia extends into the scrotum, it may cause swelling, heaviness or discomfort in the scrotum on the affected side.
Hernia Symptoms in Women
Women can develop the same general hernia symptoms as men, but femoral hernias occur more often in women. A femoral hernia may appear as a lump or discomfort in the lower groin or upper thigh.
If the lump becomes suddenly painful, firm or difficult to push back, particularly with nausea, vomiting or abdominal pain, urgent medical assessment is needed because the hernia may have become trapped or caused bowel obstruction.
Hernia Symptoms in Children
Inguinal and umbilical hernias are common types seen in children. An inguinal hernia may appear as a bulge in the groin that becomes more noticeable when a child cries, coughs or strains.
An umbilical hernia causes a soft swelling around the navel that may become more noticeable when a child cries or strains. It is usually painless, particularly in young children.
A painful, firm or swollen lump that cannot be pushed back, especially when accompanied by vomiting, abdominal pain or a change in the colour of the skin over the lump, requires urgent medical assessment.
Can You Have a Hernia Without Symptoms?
Yes, a hernia can cause little or no discomfort. An abdominal wall hernia may only be noticed as a small lump when standing, coughing or straining. Some hernias may be found during an examination or imaging carried out for another reason.
A hiatus hernia can also be asymptomatic because it develops inside the body and may not cause reflux or other noticeable symptoms.
When Can Hernia Symptoms Become Life-Threatening?
Hernia complications can become life-threatening when trapped tissue blocks the intestine or loses its blood supply. The table below explains the main emergency conditions associated with hernia symptoms:
| Emergency Condition | Why It Is Serious |
| Incarcerated hernia | The hernia contents become trapped and cannot be returned to the abdomen, increasing the risk of further complications |
| Strangulated hernia | The blood supply to trapped tissue is cut off, which can cause tissue death and requires emergency treatment |
| Intestinal obstruction | A trapped section of intestine prevents the normal passage of food, fluid and gas through the bowel and can cause severe abdominal symptoms |
A strangulated hernia is particularly serious because loss of blood supply can damage the affected tissue. An intestinal obstruction can also worsen quickly, particularly when it is associated with a trapped section of bowel.
How are Hernia Symptoms Diagnosed?
Doctors usually diagnose an abdominal wall or groin hernia by reviewing symptoms and examining the affected area. Imaging may be recommended when the diagnosis is unclear or a complication is suspected. The table below explains the main assessments that may be used to investigate hernia symptoms:
| Diagnostic Test or Assessment | Purpose |
| Medical history | Reviews where the lump or discomfort occurs, when it appears and which activities make it more noticeable |
| Physical examination | Checks for a bulge, often while the person stands, coughs or strains |
| Ultrasound | Helps identify a groin or abdominal wall hernia when examination does not provide a clear diagnosis |
| CT scan | Provides detailed images of the abdomen and can help identify a hernia or complications such as bowel obstruction |
| MRI | Provides detailed images of soft tissues and may be used when other assessments do not give a clear diagnosis |
| Upper gastrointestinal endoscopy | May be used to investigate reflux or swallowing symptoms associated with a suspected hiatus hernia |
| Barium swallow X-ray | Can show the position and movement of the esophagus and stomach when investigating a hiatus hernia or swallowing symptoms |
A physical examination is often sufficient to identify an inguinal or other abdominal wall hernia. Ultrasound, CT or MRI may be used when the diagnosis is uncertain or complications need to be assessed.
FAQs
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Q1. What is usually the first symptom of a hernia?
Ans: A common first symptom of a hernia is a lump or swelling in the groin, abdomen or around the navel. The hernia lump may become more noticeable when standing, coughing, lifting or straining. -
Q2. Does a hernia always cause pain?
Ans: No, a hernia does not always cause pain. Some hernias cause little or no discomfort and are noticed because of a visible or palpable bulge, while others may cause aching, burning, heaviness, pressure or tenderness. -
Q3. Why does a hernia bulge get bigger when coughing?
Ans: A hernia bulge can become bigger when coughing because coughing temporarily increases pressure inside the abdomen. This can push tissue further through the weak area and make the hernia more prominent.
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References
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https://www.ncbi.nlm.nih.gov/books/NBK395554/
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