Inguinal Hernia: Symptoms, Causes & Treatment Options

An inguinal hernia is a common condition affecting people across all age groups, particularly men. It occurs when soft tissue, typically part of the intestine, protrudes through a weak spot or tear in the lower abdominal wall, specifically in the inguinal canal. While not immediately life-threatening, untreated inguinal hernias can lead to complications, such as strangulation of the intestine, which requires emergency intervention. You can consult an experienced surgeon like Dr. Vikas Singhal. He specializes in hernia repair surgery, laparoscopic gastric surgery, laparoscopic anti-reflux surgery and intra-operative endoscopy. Let us explore the symptoms, causes, diagnostic process, and treatment options for inguinal hernia to provide a comprehensive understanding of the condition.

What is an Inguinal Hernia?

An inguinal hernia occurs when soft tissue, typically part of the intestine or fatty tissue, pushes through a weak spot or tear in the lower abdominal wall near the groin. This condition results in a noticeable bulge in the groin or scrotum, which may become more apparent when standing, coughing, or straining. While both men and women can develop inguinal hernias, they are significantly more common in men due to anatomical differences in the groin area.

Inguinal hernias are classified into two main types:

1. Indirect Inguinal Hernia: This type is congenital and results from a failure of the inguinal canal to close properly during fetal development. It can appear at any age but is more common in infants and young adults.
2. Direct Inguinal Hernia: This type is acquired and typically occurs in adults due to muscle weakness or strain, often linked to aging, heavy lifting, or chronic conditions.

While some hernias may remain asymptomatic, others can cause pain, discomfort, or swelling. Left untreated, an inguinal hernia can lead to complications, such as strangulation of the intestine, requiring emergency surgery. Early diagnosis and appropriate management are crucial for preventing further issues.

Also Read: What Size Hernia Needs Surgery?

Symptoms of Inguinal Hernia

Inguinal hernia symptoms vary based on the severity and progression of the condition. In many cases, a hernia begins as a mild bulge in the groin area, which becomes more noticeable with physical activity or strain. Here are the most common symptoms:

1. Visible Bulge in the Groin or Scrotum: A soft lump, often more pronounced when standing, coughing, or straining, is one of the hallmark signs. The groin hernia bulge may disappear when lying down.
2. Pain or Discomfort: A dull ache or burning sensation in the groin is common, particularly after prolonged standing, heavy lifting, or physical exertion.
3. Feeling of Heaviness or Weakness: Many individuals experience a dragging or heavy sensation in the groin, which can be uncomfortable.
4. Swelling in the Scrotum: In men, the hernia may extend into the scrotum, causing swelling or tenderness.
5. Digestive Symptoms: In severe cases, symptoms such as nausea, vomiting, or difficulty passing stools may indicate a strangulated hernia, which requires emergency medical attention.

Some inguinal hernias may be asymptomatic, detected only during routine medical examinations. However, any persistent discomfort or noticeable bulge should prompt medical evaluation by Dr. Vikas Singhal to prevent complications such as incarceration or strangulation. He completed a five-year Surgical Residency at the Guthrie Clinic in Pennsylvania. After this he pursued a Fellowship in Advanced Laparoscopy and Bariatric Surgery from Case Medical Center, Cleveland, USA. He is an American Board of Surgery certified surgeon.

Causes of Inguinal Hernia

An inguinal hernia typically develops due to a combination of muscle weakness and strain. Factors that contribute to its onset include:

1. Congenital Weakness: A birth defect in the abdominal wall or an improperly closed inguinal canal can predispose individuals to hernias.
2. Aging: Muscle tissue naturally weakens with age, increasing the likelihood of hernia development.
3. Excessive Strain: Activities such as heavy lifting, persistent coughing, or intense physical exertion can place undue pressure on the abdominal wall.
4. Obesity: Extra weight strains abdominal muscles, heightening hernia risk.
5. Chronic Conditions: Persistent conditions like constipation, chronic cough, or prostate enlargement may induce hernia development through continuous pressure in the groin area.
6. Pregnancy: Increased abdominal pressure and hormonal changes during pregnancy may weaken abdominal walls, contributing to hernias.

Understanding these causes helps in implementing preventive measures, such as maintaining a healthy weight and avoiding unnecessary strain on the abdominal muscles.

Also Read: Do I Need Hernia Surgery?

Diagnosis of Inguinal Hernia

The diagnosis of an inguinal hernia typically involves:

1. Medical History Review: The doctor inquires about symptoms, lifestyle factors, and any history of hernias or surgeries.
2. Physical Examination: The physician checks for a visible or palpable bulge in the groin area, often asking the patient to cough or strain to make the hernia more apparent.
3. Imaging Tests:
   • Ultrasound: Helps visualize the hernia and assess its size.
   • CT Scan or MRI: May be recommended for complex cases to provide detailed views of the hernia and surrounding tissues.

A prompt and accurate diagnosis from an experienced specialist like Dr. Vikas Singhal ensures the condition is managed before complications arise. He has received the Fellowship of American Society of Metabolic & Bariatric Surgery (FASMBS). He believes in honest and ethical patient care and practice of Evidence Based Medicine.

Different Treatment Options for Inguinal Hernia

The treatment for an inguinal hernia depends on its severity, the patient’s overall health, and personal preferences. Options include:

• Watchful Waiting

For small, asymptomatic hernias, doctors may recommend monitoring the condition closely. This approach, known as watchful waiting, is suitable for patients at low risk of complications. Lifestyle modifications, such as avoiding heavy lifting and maintaining a healthy weight, can prevent the hernia from worsening.

• Surgical Treatment

Surgery is the definitive treatment for inguinal hernias. It is typically advised for symptomatic hernias or cases with a high risk of complications. Inguinal hernia surgery options include:

1. Open Hernia Repair (Herniorrhaphy):

• The surgeon makes an incision in the groin, pushes the herniated tissue back into place, and reinforces the weakened area with sutures.
• In most cases, a synthetic mesh is placed over the abdominal wall to strengthen the repair (hernioplasty).
• Recovery time is longer than minimally invasive procedures, but this open inguinal hernia repair surgery is effective for large or complex hernias.

1. Laparoscopic Hernia Repair:

• A minimally invasive technique that uses small incisions and a camera (laparoscope) to guide the repair.
• The hernia is repaired using mesh, similar to open surgery, but the smaller incisions reduce recovery time and the risk of complications.
• Laparoscopic surgery is ideal for patients with bilateral or recurrent hernias.

3. Emergency Surgery

During strangulation or incarceration is when to worry about hernia pain, where the hernia cuts off blood supply to the trapped tissue and emergency inguinal hernia surgery is required. Delayed treatment can lead to severe complications such as tissue death, infection, or bowel obstruction.

Conclusion

An inguinal hernia, though common, is a condition that should not be ignored. Its symptoms, ranging from mild discomfort to visible bulges, can escalate into severe complications if left untreated. Understanding the causes and risk factors helps in adopting preventive measures to reduce the likelihood of hernia development.

If you suspect an inguinal hernia, consult Dr. Vikas Singhal promptly to determine the best course of action. He has special interests in newer laparoscopic and endoscopic procedures for reflux disease and complex hernia surgery, including component separation techniques.