What is an inguinal hernia?
An inguinal hernia is the protrusion (bulging) of your intestine (bowel) through a weakness in the muscle wall in your groin.
How does an inguinal hernia develop?
The abdominal wall is made up of a sheet of tough muscles and tendons that run down from your ribs to your groin. It acts as nature’s corset holding all the internal organs, especially the intestines (bowels), in your abdomen. If a weakness or gap develops in your abdominal wall, then the ‘corset effect’ is lost and part of your abdominal contents, usually the intestine, bulge through, causing a lump in your groin. Some people are born with a weakness in their groin, while others develop a weakness over time.
Age – peak at 5 yrs and 70-80 years, Gender- males, hereditary predisposition ( first degree relatives especially females) , Abnormal collagen metabolism , previous open prostate cancer operations and obesity are strong risk factors.
Rare connective tissue disorders like Ehlers Danlos syndrome, presence of hernia on one side is associated with hernia on the other side – moderate risk.
Race (Blacks)Coughing and straining, chronic constipation, pregnancy, lifting heavy weights and smoking may contribute to the risk of hernia formation- low risk factors.
Can having an inguinal hernia become dangerous?
Many people have a hernia for years and never need surgery, but sometimes a hernia may become strangulated. This is when the loop of intestine, which forms the hernia, twists on itself. This could cause a bowel obstruction (blockage) which can be very dangerous if left untreated. If this were to happen you would usually start vomiting (being sick), your abdomen would swell and you would become constipated and you may feel pain. If this happens you must seek urgent advice from your GP/A&E, as you may require an urgent operation.
Should I have my hernia fixed?
What if I choose not to have surgery? Your hernia may stay the same and not cause you any problems. If it can’t be reduced back into the abdominal cavity by pressure and causes pain then it is likely that this would get worse with time.
Watchful waiting is safe in asymptomatic patients. Even though the risk of strangulation is low (3% at two years) nearly 70 % of pts opt for an operation over a period of ten years due to pain. The outcome of the operation if done as an emergency or at a later stage may not be as good due to complications. So, it really comes down to how much the hernia bothers you and how you feel about the risk of having surgery. This conversation varies from patient to patient as some may have health problems.
Watchful waiting is not recommended in symptomatic patients.
A hernia will never heal itself and medicines will not cure it. An abdominal support (truss) may relieve your discomfort but will not heal or repair your hernia. The truss can sometimes cause harm by unnecessary pressure on the hernia . that makes having an operation more difficult.
If your hernia becomes acutely painful, or you cannot push it back in, you may need to have this repaired urgently. So please seek an expert opinion!