Hernia risk factors: inguinal and hiatal hernias

What a hernia is

A hernia happens when part of an internal organ or tissue bulges through a weak area of muscle. Most hernias are in the abdomen (MedlinePlus). There are several types of hernias, including (MedlinePlus):

• Inguinal, in the groin. This is the most common type.
• Umbilical, around the belly button
• Incisional, through a scar
• Hiatal, a small opening in the diaphragm that allows the upper part of the stomach to move up into the chest
• Congenital diaphragmatic, a birth defect that needs surgery

Hernias are common. They can affect men, women, and children. A combination of muscle weakness and straining, such as with heavy lifting, might contribute. Some people are born with weak abdominal muscles and may be more likely to get a hernia (MedlinePlus).

Inguinal hernia: who is more likely

An inguinal hernia is a bulging of the contents of the abdomen through a weak area in the lower abdominal wall (NIDDK). Researchers estimate that about 27 percent of men and 3 percent of women will develop an inguinal hernia at some point in their lives (NIDDK).

Among adults, the chance of having an inguinal hernia increases with age, and inguinal hernias are most common in people ages 75 to 80. Among children, they are most common between the ages of 0 and 5 years, and among infants they are more common in premature infants (NIDDK). Inguinal hernias are also more common in (NIDDK):

• males, who are 8 to 10 times more likely than women to develop inguinal hernias
• males who have had prostatectomy
• people with a family history of inguinal hernias
• people who have a lower body mass index (BMI)
• people who have connective tissue disorders

What causes inguinal hernias

A weak area in the muscles and connective tissue of the lower abdominal wall at the inguinal canal allows an inguinal hernia to develop (NIDDK). Indirect inguinal hernias are related to a defect in the lower abdominal wall that is present at birth, although the hernia may not occur until many years later. Direct inguinal hernias are related to a weak area in the inguinal canal wall that develops later in life; this type primarily occurs in men, and women and children rarely develop it (NIDDK).

Researchers are studying other factors that might play a role in causing inguinal hernias. These factors include (NIDDK):

• connective tissue that is weaker than normal or connective tissue disorders
• genes that increase the risk of inguinal hernias
• health conditions that cause increased pressure inside the abdomen, such as chronic cough or chronic constipation
• regular or repeated activities that cause increased pressure inside the abdomen, such as heavy lifting and standing or walking for many hours each day at work

Symptoms of an inguinal hernia

Symptoms may include a bulge in the groin, a bulge in the scrotum in a male, and feelings of discomfort, pain, heaviness, or burning in the groin. Symptoms may get worse when you strain, lift, cough, or stand for a long time and may get better when you rest or lie down (NIDDK).

Seek medical help right away for a stuck or strangulated hernia

Inguinal hernias may become stuck, or incarcerated. A stuck hernia may become strangulated, meaning the blood flow to the hernia is cut off (NIDDK). A strangulated hernia is a life-threatening condition. If you have symptoms of a stuck or strangulated hernia, seek medical help right away (NIDDK). Symptoms may include (NIDDK):

• a hernia bulge that is suddenly larger than before
• a hernia bulge that used to go back inside the abdomen but no longer does
• fever
• redness in the area of the hernia
• sudden or severe pain or tenderness in the area of the hernia
• symptoms of intestinal obstruction, such as abdominal pain, bloating, nausea, and vomiting

Hiatal hernia: who is more likely

A hiatal hernia is a condition in which the upper part of your stomach bulges through an opening in your diaphragm, the thin muscle that separates your chest from your abdomen. When you have a hiatal hernia, it is easier for acid to come up into your esophagus, which is called GERD (MedlinePlus); see GERD risk factors.

Often, the cause of a hiatal hernia is unknown. It may have to do with weakness in the surrounding muscles, and sometimes the cause is an injury or a birth defect (MedlinePlus). MedlinePlus lists these risk factors (MedlinePlus):

• Older age. Your risk goes up as you age; hiatal hernias are common in people over age 50.
• Obesity. The BMI calculator shows where your weight falls.
• Smoking

People usually find out that they have a hiatal hernia when they are getting tests for GERD, heartburn, chest pain, or abdominal pain (MedlinePlus).

Treatment

Treatment for a hernia is usually surgery to repair the opening in the muscle wall. Untreated hernias can cause pain and health problems (MedlinePlus). Most people with inguinal hernias will need surgery to repair the hernia (NIDDK). You don't need treatment if your hiatal hernia does not cause any symptoms or problems; if you do have symptoms, lifestyle changes such as eating small meals, avoiding certain foods, not smoking or drinking alcohol, and losing weight may help (MedlinePlus).

Common questions

Can heavy lifting cause a hernia?

A combination of muscle weakness and straining, such as with heavy lifting, might contribute (MedlinePlus). Heavy lifting is among the factors researchers are studying for inguinal hernias (NIDDK).

Are hernias more common in men?

Inguinal hernias are more common in males, who are 8 to 10 times more likely than women to develop them (NIDDK).

Does a hiatal hernia cause GERD?

A hiatal hernia makes it easier for acid to come up into the esophagus (MedlinePlus), and it can increase the chance of getting GERD or make GERD symptoms worse (NIDDK).