An abdominal wall hernia is a common condition usually occurring
when there is a weakness in the muscles that make up the wall of
the abdomen or tummy. A particular area of weakness may develop
into a hole that can allow your insides to bulge through the hole
and form a lump under the skin. This most commonly occurs with fat
or bits of bowel, but can include other organs such as the bladder.
Abdominal wall hernias are the most common types of hernia, but
there are other types of hernia that can occur at different sites
around the body.
Hernias are given names depending upon where they are in the
body. The most common type is called an inguinal hernia, and occurs
in the groin, on either side of the middle. Other common hernias
include umbilical or paraumbilical (through or next to the belly
button), epigastric (above the belly button), femoral (in the groin
close to an inguinal hernia), and incisional (at the site of a
previous cut for an operation). Hernias that involve the front part
of the abdominal wall are often also referred to as 'ventral'
hernias, which includes umbilical, paraumbilical, epigastric and
many incisional hernias.
Image credit: Blausen.com staff (2014), "Medical gallery of
Blausen Medical 2014".
Hernias can cause no symptoms, or they may cause a range of
symptoms which are described below.
Lump
As there is effectively a hole in the muscles, this allows
things to bulge through the hole. Therefore a lump is part of
having a hernia. The lump may be small, and may come and go. For
example, many people find that the lump goes when they lie down and
relax. Conversely, anything that increases the pressure inside the
tummy will tend to push things into the hole, making it stick out
and become more obvious. This can happen when lifting something
heavy, or when going to the toilet. In some cases, the lump may
always be present.
Aching or pain
Hernias can cause an ache or pain at the site of the lump. This
may be made worse by increased activity. Some people find they get
more discomfort at the end of the day, particularly if they have
been active through the day.
Occasionally hernias can cause more severe discomfort or pain.
Increased pain can be a sign of an emergency problem, particularly
if the hernia gets stuck out and becomes tender to touch. If this
happens, you should see a doctor urgently, as hernias that get
stuck and become very painful can need emergency surgery.
Vomiting, bloating and constipation
Sometimes hernias that contain bowel can cause a blockage to
food and fluid passing through the bowel. If this happens, you may
develop an increasingly bloated feeling in the tummy, nausea, and
over time you may start vomiting and stop opening your bowels. This
would usually be associated with the lump coming out and getting
stuck (meaning it would not be possible to push the lump back in if
you lie down), and it may become increasingly painful and tender to
touch. This is an emergency and requires you to see a doctor
urgently.
