Hernias & Abdominal Wall

A hernia occurs when abdominal contents, such as fat or bowel, push through a weak area of the muscle wall. Hernias do not heal on their own and may enlarge over time. Most can be repaired safely as planned procedures, often with minimally invasive techniques, while some need urgent treatment if they become trapped.

Inguinal hernia

What it is: The most common hernia, appearing as a bulge in the groin that may extend into the scrotum in men.

Symptoms: A lump in the groin that is more noticeable when standing, coughing or lifting, sometimes with aching or discomfort.

Treatment: Mesh repair, laparoscopic (TEP/TAPP) or open, depending on the hernia and the patient. Small painless hernias may sometimes be observed.

Femoral hernia

What it is: A hernia appearing just below the groin crease, more common in women and more likely to become trapped.

Symptoms: A small lump in the upper thigh near the groin, sometimes painful.

Treatment: Repair is recommended because of the higher risk of strangulation, using laparoscopic or open techniques.

Umbilical and paraumbilical hernia

What it is: A hernia at or near the belly button, common after pregnancy, with weight gain or in people with raised abdominal pressure.

Symptoms: A bulge at the navel that may be tender or enlarge with effort.

Treatment: Suture or mesh repair depending on size, as open or laparoscopic surgery.

Epigastric hernia

What it is: A hernia in the midline between the navel and the breastbone, usually containing fat.

Symptoms: A small, sometimes painful lump in the upper abdomen.

Treatment: Surgical repair, often combined with treatment of any associated diastasis or other midline hernias.

Incisional hernia

What it is: A hernia that develops through a previous surgical scar, as the wound in the muscle layer has not healed fully.

Symptoms: A bulge along or near a scar, discomfort, and in larger hernias difficulty with daily activities or skin problems.

Treatment: Repair with mesh using open, laparoscopic or robotic techniques, sometimes with abdominal wall reconstruction for complex hernias. Weight optimisation and stopping smoking improve results.

Parastomal hernia

What it is: A hernia that forms next to a stoma (colostomy or ileostomy).

Symptoms: Swelling around the stoma, difficulty fitting the appliance, leakage or discomfort.

Treatment: Support garments for mild cases; surgical repair with mesh or stoma relocation for symptomatic hernias.

Diastasis recti

What it is: A widening of the gap between the two vertical abdominal muscles, commonly after pregnancy. It is not a true hernia but often coexists with umbilical or epigastric hernias.

Symptoms: A midline ridge or bulge on straining, and a feeling of core weakness.

Treatment: Physiotherapy and core exercises first. Surgical plication, often combined with hernia repair, is considered for significant symptoms.

Incarcerated and strangulated hernia

What it is: A hernia becomes incarcerated when its contents are trapped and cannot be pushed back, and strangulated when the blood supply to the trapped tissue is cut off.

Symptoms: Sudden pain, a hard tender lump that does not go back, vomiting and abdominal distension.

Treatment: A surgical emergency requiring prompt operation to release the trapped tissue and repair the hernia.

How assessment is organized

Most hernias are diagnosed by clinical examination. Ultrasound or CT may be used when the diagnosis is uncertain or for complex and recurrent hernias. The choice of repair takes into account the hernia type and size, previous surgery and your general health and activity level.

This information is general and does not replace individual medical assessment.