Hernia Development

A hernia is a weakness or tear in the abdominal muscles through which the inner lining of the abdomen pushes the weakened area of the abdominal wall to form a small balloon-like sac. A loop of intestine or abdominal tissue can push into the sac, which can cause a noticeable bulge under the skin. Early on, it may flatten out when you lie down because it’s still a reducible hernia (the hernia contents can go back into the abdomen). Often, the loop of intestine becomes trapped and you lose the ability to make the bulge flatten out. A painful non reducible hernia (abdominal contents are no stuck in the hernia and cannot move back into the abdomen) has formed.

The pressure of tissue pushing through the weakened area can cause significant pain and discomfort. The abdominal wall has natural areas of potential weakness that are present from birth. Other areas of weakness develop due to a variety of factors, such as surgery, injury, pregnancy, aging or strain.

These activities and events may aggravate a hernia, or may lead to the discovery of a hernia: lifting, twisting, pulling, muscle strains, weight gain, prostate problems, chronic constipation, or chronic cough.

How are hernias formed?

All hernias are caused by a disruption in the fascia of the abdominal wall. Fascia is a strong sheet of connective tissue that extends from the top of you abdomen (where it meets your chest) down past your groin. The fascia is the strength layer of your abdominal wall. It is responsible for keeping your abdominal contents in your abdomen. A hernia is a hole in your fascia.  Hernias can occur anywhere in your abdominal wall but most commonly occur in the groin and belly-button. These two areas are the weakest areas of your abdominal wall. Thus, from wear and tear, the fascia in these areas are more prone to breaking down. Once you have a hole in the fascia, abdominal contents, most likely intestine, can protrude through the hernia and cause symptoms. A hernia does not get better over time, nor will it go away by itself. Many hernias are diagnosed on routine physical exams, without the patient even knowing he/she had a hernia.