If you're a guy, you probably know the drill by now: The doctor snaps on a latex glove and tells you to turn your head and cough. You probably wonder, "Why do I have to do this?"
Your doctor is checking you for a condition called a hernia. There are several types of hernias, and they don't just happen to guys — everyone from your baby sister to your grandfather can develop them. But learning to prevent hernias isn't hard to do.
What Are Hernias?
A hernia (pronounced: hur-nee-uh) is an opening or weakness in the wall of a muscle, tissue, or membrane that normally holds an organ in place. If the opening or weakness is large enough, a portion of the organ may be able to poke through the hole. Imagine an inner tube poking through a hole in an old tire — that's what a hernia is like.
Hernias happen more frequently in certain parts of the body, like the abdomen, groin and upper thigh area, and belly button area. They also can happen in any place where you may have had an incision from surgery.
How Do People Get Hernias?
It might take a long time for a hernia to develop or it might develop suddenly. Hernias are caused by a combination of muscle weakness and strain, although the cause of the weakness and the type of strain may vary. Hernias are actually more common in babies and toddlers. And most teens who are diagnosed with a hernia actually have had a weakness of the muscles or other abdominal tissues from birth (called a congenital defect). In these cases, straining your muscles doesn't cause the hernia; it only makes the hernia more apparent (and painful!).
Here are some types of strain on the body that may induce hernias:
- obesity or sudden weight gain
- lifting heavy objects
- diarrhea or constipation
- persistent coughing or sneezing
- pregnancy
These types of strain on their own probably won't give you a hernia. But when they team up with a weak muscle, a hernia is more likely to result.
Many hernias are discovered during routine physical exams. If you're a guy, you may have had a physical exam where your doctor gave you a testicular exam and checked your testicles for a hernia. By placing a finger at the top of your scrotum and asking you to cough, the doctor can feel if you have a hernia.
It's good for girls to know about hernias, too, because they can affect you, especially if you've been pregnant or are obese. A doctor can check for any possible hernias in girls by gently pressing on the organs or looking for possible signs during an examination.
Types of Hernias
Inguinal Hernias
Inguinal (pronounced: in-gwuh-nul) hernias are more likely to occur in guys than girls. More than 70% of all hernias that occur are inguinal hernias, which means that a part of the intestines protrudes through an opening in the lower part of the abdomen, near the groin, called the inguinal canal. In guys, the inguinal canal is a passageway between the abdomen and the scrotum through which a cord called the spermatic cord passes (the testicles hang from the spermatic cord). In girls, the inguinal canal is the passageway for a ligament that holds the uterus in place. Nearly all cases of inguinal hernias in teens are due to a congenital defect of the inguinal canal. Instead of closing tightly, the canal leaves a space for the intestines to slide into.
If you have an inguinal hernia, you might be able to see a bulge where your thigh and your groin meet. In guys, the protruding piece of intestine may enter the scrotum, which can cause swelling and pain. Other symptoms of an inguinal hernia might include pain when you cough, lift something heavy, or bend over. These types of hernias require surgery to repair; in fact, inguinal hernia operations are the most common type of surgery performed on kids and teens.
Umbilical Hernias
Umbilical hernias are common in newborns and infants younger than 6 months. They occur when part of the intestines bulge through the abdominal wall next to the belly button. In babies with umbilical hernias, parents may see bulging around the belly button area when the baby cries. Unlike other types of hernias, umbilical hernias may heal on their own, usually by the time a baby is 1 year old. If not, surgery can repair the hernia.
Epigastric Hernias
In an epigastric (pronounced: eh-pih-gas-trik) hernia, which is also called a ventral hernia, part of the intestines protrude through the abdominal muscles located between the belly button and the chest. It's mostly guys who have to worry about this type of hernia — about 75% of epigastric hernias occur in males. People with this type of hernia may notice a lump. Surgery is a common way to fix this problem.
Incisional Hernias
If you've had surgery in your abdominal area, you might experience this type of hernia. In incisional hernias, part of the intestines bulge through the abdomen around a surgical incision. In this case, surgery actually weakened the muscle tissue in the abdomen. This type of hernia requires another surgery to repair it.
Hiatal Hernias
This type of hernia occurs at the opening of the diaphragm where the esophagus (the pipe that food travels down) joins the stomach. If the muscle around the opening to the diaphragm becomes weak, the uppermost part of a person's stomach can bulge through the diaphragm. Hiatal (pronounced: high-a-tul) hernias are common, although small ones don't usually cause any symptoms. Unlike the other types of hernia, you won't be able to see a bulge on the outside of your body, but you might feel heartburn, indigestion, and chest pain. Hiatal hernias can be treated with medication and diet changes, but they do sometimes require surgery.
What Do Doctors Do?
If you notice a bulge or swelling in your groin, abdomen, scrotum, or thigh, you should talk to your doctor. Sometimes a hernia may also cause sharp or dull pain and the pain may worsen when you are standing.
With most types of hernias, including inguinal, umbilical, epigastric, and incisional, your doctor will be able to see and feel the bulge and diagnose you with a hernia.
Except for umbilical hernias in babies, hernias don't just go away on their own — you must talk to your doctor and receive treatment. Over time, your hernia may become larger and more painful, and in some cases of hiatal hernia, a piece of the intestine could become trapped (this is known as incarceration). In a true surgical emergency, the blood supply could be cut off to the incarcerated intestine (this is known as strangulation). This situation is painful and dangerous because it can cause infection and may cause the strangulated tissue to die, so it's important to call your doctor.
If you've had a hernia operation and you notice redness or discomfort around your incision (the area where the cut was made to perform the operation), be sure to let your doctor know. It could be a sign of infection that will require further treatment.
Can Hernias Be Prevented?
Here are a few tips for keeping hernias from hurting you:
- Stay at a healthy weight for your height and body type. Talk to your doctor or a dietitian about a healthy eating and exercise program if you think you are overweight or obese.
- Make fruits, veggies, and whole grains a "regular" part of your diet. Not only are these foods good for you, they're also packed with lots of fiber that will prevent constipation and straining.
- Be careful when weight lifting or lifting heavy objects. Make sure you lift weights safely by never lifting anything that's too heavy. If you have to lift something that's heavy, bend from your knees, not at your waist, or don't lift it at all.
- See your doctor when you're sick. If you have a persistent cough from a cold or you sneeze a lot because of allergies, see your doctor about cough or allergy medicines.
- Quit smoking. Smoking can cause persistent coughing, and this can strain your abdominal muscles. The risk of getting hernias is just one more reason to kick the habit!
Reviewed by: T. Ernesto Figueroa, MD
Date reviewed: September 2007
