- A lump, swelling or bulge in the abdominal wall. This bulge can come and go or be present at all times
- Pain or discomfort, especially when straining or lifting heavy objects, coughing, or prolonged sitting or standing
- Severe, continuous pain, redness, and tenderness are signs that the hernia may be entrapped or strangulated. These symptoms are cause for concern and immediate contact of your physician or surgeon is necessary
A bulge or lump in the abdominal wall is usually a hernia. A hernia is a hole in the fascia of your abdominal wall. The bulge is the intestines or a layer of fat in your abdomen, the omentum, bulging through the hernia . Strenuous activities such as lifting, straining, or coughing may cause the bulge to increase as abdominal contents are forced through the hernia. When you lie down, intestine or fat may fall back though the hernia into your abdomen and the bulge will disappear. This is why hernias or the bulge may “come and go”. A bulge may or may not be painful.
Pain / Discomfort
Discomfort is the most common symptom from hernias. Patients generally experience an ache to their groin, which worsens as the day progresses. Some patients experience pain, as well. Pain and discomfort usually occur because the tissue at and around the hole (hernia) is being stretched or torn. This usually will cause pain directly at the site of the hernia and is referred to as localized pain. The discomfort and or pain from a hernia has been described as a burning, tearing, sharp, dull or pulling pain.
Pain may also occur as a result of irritation of or damage to nerves around the hernia, as hernia contents push or pinch into nerves. This too may cause localized pain, or may cause pain at a more distant area and is called referred pain.
With referred pain, pain may be referred to other regions supplied by the same nerve, when the nerves are irritated and the pain travels along the nerve root. For example, pain from an inguinal hernia may be felt as discomfort in the scrotum of men or the labia of women, or the back, upper leg and /or hip area. This is because nerves that supply sensation to these remote areas travel through and around the groin and may therefore be irritated or inflamed by the hernia itself.
A potential serious complication of all hernias is when abdominal contents, usually the small intestine, become trapped within the hernia. When the contents are trapped, it is called incarceration. The contents may still be able to be forcibly pushed back into the abdomen. If the hernia cannot be reduced, this may lead to strangulation. In both instances, the pain may become more generalized in location and may even involve the entire abdomen.
Generalized pain results when abdominal contents, such as the intestine or colon, become trapped or blocked in the hernia. These organs get stuck in the hernia which leads to decreased blood flow to the organ. Pain results due to the decreased blood flow. If the hernia is unable to be pushed back into the abdomen, relieving the blockage, the pain will increase in severity. The organ may begin to die due to the loss of blood flow. The results can be fatal if prompt surgery is not performed.
A thorough evaluation should be performed by physician after an episode of severe groin pain. The pain may be caused by a hernia, however, other non-hernia causes of pain will be explored.