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Hernia inguinalis
A gap in the abdominal wall through which tissue protrudes — in adults it does not close by itself, and a suddenly hard bulge that can no longer be pushed back is an emergency.
Also known as: inguinal hernia · hernia · rupture · umbilical hernia · incisional hernia · femoral hernia · hiatal hernia · hiatus hernia · diaphragmatic hernia · abdominal wall · hernia sac · neck of the sac · strangulated hernia · incarceration · groin pain · groin lump · bulge in the groin
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
A hernia is a gap in the abdominal wall through which the peritoneum and sometimes fat or a loop of bowel protrudes. The gap is called the neck, the protrusion the hernia sac. Typically there is a bulge that grows on coughing, straining or standing and can often be pushed back when lying down, together with a dragging or pressing sensation. The inguinal hernia is the commonest form; the lifetime risk is about 27 per cent in men and about 3 per cent in women. An umbilical hernia in an infant usually closes by itself by the age of four or five; in adults it persists. Incisional hernias arise at the scar after abdominal surgery, in about 10 to 20 per cent after a midline incision and usually within the first two years. The femoral hernia lies below the inguinal ligament, affects women more often and strangulates more readily. In a hiatal hernia, part of the stomach slides up through the opening in the diaphragm; more than 90 per cent are sliding hernias, many without symptoms, some with reflux. Raised pressure in the abdomen favours hernias: heavy lifting, chronic coughing, straining with constipation, excess weight, pregnancy. In adults a hernia gap does not close by itself, and a truss does not hold it shut; it is closed surgically, open or by keyhole technique, usually with a mesh. For small, symptom-free inguinal hernias in men, watchful waiting has been studied: the strangulation rate is about 0.2 per cent a year, and a large share are operated on over time anyway because symptoms develop. After surgery, about 10 per cent have longer-lasting groin pain, marked in 1 to 3 per cent; the recurrence rate with mesh is about 1 to 5 per cent. Seek medical assessment at once if the bulge suddenly becomes hard and tender, can no longer be pushed back, the skin over it reddens, or if nausea, vomiting and an absence of stool and wind appear: bowel may then be trapped and its blood supply cut off — that is counted in hours, not days.
A bulge that disappears when lying down is the ordinary situation. If it stays hard, becomes tender, turns red, with nausea or vomiting: that is a strangulation and belongs in the emergency room at once.
Pressure in the belly rises most when bearing down with held breath. Breathe out during the effort, lift close to the body, use the legs — that is the everyday lever.
A chronic cough, stubborn constipation, straining to pass water with an enlarged prostate, marked excess weight: all press daily on the same spot. Treating them relieves the repair — before and after an operation.
It holds the bulge back as long as it is worn and does not close the gap. For people for whom an operation is out of the question it is a help; as a substitute for a planned procedure it is not recommended.
For a small groin hernia without complaints, watchful waiting is a recognised route. Most do choose the operation over the years because complaints appear — the timing stays plannable.
Walking from the first day, light work usually after one to two weeks, heavy lifting after agreement — the advice differs by technique. A new lump or pain at the same place belongs shown, not sat out.
About one in four men develops an inguinal hernia in their lifetime, women far less often. A hernia never recedes by itself and grows with time. The risk of strangulation is about one to three in a hundred a year — so a hernia without symptoms is not an emergency, and waiting is a possible decision. After surgery, taking it easy lasts one to two weeks for light work and four to six for heavy; the mesh needs three months to integrate.
There is no drug for a hernia, and a truss only holds it back while it is in place — it heals nothing and can weaken the tissue if worn for long. What helps is closure with a mesh. Painkillers bridge the gap. The one point where it becomes urgent: if the hernia can no longer be pushed back and pain, nausea and vomiting come with it, hours count — bowel is trapped.
Visible or palpable when coughing, lifting or standing, and gone again when lying down. That is exactly why the examination is done standing and with a cough.
A dull pull in the groin that grows after long standing or physical work and eases when lying down. With a groin hernia it can pull into the testicle or the labia.
The bulge becomes hard, very tender, can no longer be pushed back, the skin over it reddens, with nausea, vomiting and a standstill of stool and wind. That belongs in the emergency room at once.
A navel hernia in a baby usually closes by itself in the first years of life. A groin hernia in a child does not and is operated on — here the distinction matters.
Soluble fibres like psyllium and oats bind water and make the stool supple. Wheat bran and a lot of raw vegetables, by contrast, increase bloating and pain in a sensitive gut — this distinction explains most of the failures.
Fibre without water makes the stool harder instead of softer. The two belong together, and the effect only sets in after some days.
Draws water into the bowel and therefore works with a sluggish stool. The belly shows the upper limit: if the stool gets too loose, the dose at once was too high.
Yoghurt, kefir, sauerkraut and the like bring living cultures with them. Many tolerate them well; with a strongly bloated belly they can also do the opposite in the first weeks.
Effective when deficient; effects on sleep and stress plausible but moderate. Too much causes loose stool.
The inguinal canal is wider in men, because the testicle travelled through it in the womb. That is the whole reason inguinal hernias are about eight times more common in men — anatomy, not strain.
In pregnancy the connective tissue and abdominal wall loosen, and the pressure rises. Umbilical hernias and the parting of the straight abdominal muscles arise then — and often partly recede in the months afterwards.
Every strain raises pressure in the belly. 25–30 g fibre a day and enough fluid keep stool soft — which eases the hernia opening day to day.
Soft stool means less straining, and less straining means less pressure on the hernia opening. 5–10 g a day in plenty of water.
Core strength eases the abdominal wall day to day. It does not close the hernia — only an operation can — but it makes daily life more bearable until then.
checked 2026-09