At The Center for Bariatrics, in Tijuana, Mexico an inguinal hernia happens in your groin, in a passageway called the inguinal canal. You might see a bulge on one side of your pelvic bone. It’s caused by abdominal tissue pushing through an opening in your lower abdominal wall. The opening may be congenital (present at birth), or due to normal, age-related muscle degeneration.

According to Dr. Ismael V. Bailon, the opening may be congenital (present at birth), or due to normal, age-related muscle degeneration.

What is an inguinal hernia?

A hernia occurs when tissue from one body cavity bulges through an opening in your muscle wall into another. Inguinal hernias are the most common type of hernia. They happen when abdominal tissue, such as belly fat or a loop of intestines, bulges through an opening in your lower abdominal wall. This is the wall that separates your abdomen from your groin.

Inguinal hernias occur in the inguinal canal, which is a passageway that runs down either side of your pelvis into your sex organs. They’re also called groin hernias. (“Inguinal” means “in the groin.”) They’re the most common type of groin hernia, though not the only type. (Less common are femoral hernias, which happen in the smaller femoral canal that runs underneath the inguinal canal.)

What's the difference between a direct inguinal hernia and an indirect inguinal hernia?

• Direct inguinal hernia: A direct inguinal hernia penetrates directly through the wall of your inguinal canal. This type of hernia occurs in adults over time, from a combination of weakening abdominal muscles and chronic pressure on the muscle wall.
• Indirect inguinal hernia: An indirect inguinal hernia enters your inguinal canal through the top. This usually occurs because of a birth defect. In some fetuses, the opening to their canal doesn’t close all the way during development in the uterus.

How common are inguinal hernias?

Up to 75% of all hernias are inguinal hernias. Around 25% of people AMAB will have an inguinal hernia during their lifetime, compared to 2% of people AFAB. Direct (acquired) inguinal hernias are more common in middle-aged and older men.

Indirect inguinal hernias affect up to 4.5% of children, including 2% of babies AMAB and 1% of babies AFAB. Premature babies are up to 30% more likely to get one.

How serious is an inguinal hernia?

Hernias aren’t always serious, but serious complications can develop. Hernias do tend to worsen over time. As the opening becomes weaker and wider, more tissue can push through it. The more tissue pushes through, the more likely it is to become trapped. This can be painful, and in extreme cases, can be dangerous. Once trapped, a piece of your intestine could become pinched and blocked, or the tissue could become cut off from your blood supply.

If your hernia already causes you discomfort, Dr. Ismael V. Bailon will probably recommend fixing it in surgery before it becomes worse. If you don’t have symptoms yet, they may just wait and watch it for a while, but most inguinal hernias will become symptomatic with time.

What are the symptoms of an inguinal hernia?

Not all inguinal hernias have symptoms. Sometimes, symptoms come and go. A hernia may slide in and out of the opening, or you may only feel it during certain activities. In children, you may see a lump in their groin area that appears bigger when they cry. It may go away when they sleep.

An indirect inguinal hernia may not be palpable (able to be felt) to the touch because it may be tucked behind muscle fibers. You might notice:

• A bulge in your groin area on either side of your pubic bone. It can go into your scrotum or labia.
• A feeling of pressure or heaviness in your groin.
• Pain in your groin, especially when straining, lifting, coughing or bending over.
• A burning or pinching sensation that may radiate through your pelvis or down your leg.

What is the main cause of inguinal hernia?

An inguinal hernia occurs when there’s a weakness or opening in your lower abdominal wall that allows abdominal tissue to push through. Many things can contribute to this, including:

• An opening or weak spot that’s present at birth.
• Congenital differences in the strength of your connective tissue (collagen).
• An opening or weak spot from previous abdominal surgery.
• Chronic coughing or sneezing.
• Chronic straining to pee or poop.
• Frequent strenuous exercise or manual labor.
• Years of pregnancy and carrying small children.
• Jobs that require standing for many hours at a time.
• Intra Abdominal pressure from chronic obesity.
• Normal age-related tissue degeneration.

What are the possible complications of an inguinal hernia?

• Enlargement over time. The pressure of an existing hernia on weakened tissues can have a snowball effect, making things worse. In those AMAB, an enlarged testicular hernia that moves down into your scrotum can cause painful swelling.
• Incarceration. An incarcerated hernia is one that can’t be “reduced” — physically moved back into place. A trapped hernia is more likely to become pinched as it grows bigger, causing pain and other complications.
• Small bowel obstruction. If part of your small intestine is herniated and becomes trapped and pinched, it can cause a blockage. It may stop you from being able to poop or pass gas, causing severe abdominal pain, nausea and vomiting.
• Strangulation. A strangulated hernia has been cut off from blood supply. This can lead to inflammation and infection of the tissue, and eventually tissue death (gangrene). Strangulation is a medical emergency.

What is the best treatment for inguinal hernia?

Dr. Ismael V. Bailon recommends surgery for most inguinal hernias, and for all in children and those AFAB. Most inguinal hernias will eventually cause symptoms, and children and women are more at risk of dangerous complications. For adults AMAB with small hernias that aren’t causing symptoms, Dr. Cardenas may take a wait-and-watch approach. But most will need treatment eventually.

If you have health conditions that make surgery less safe for you, you and Dr. Bailon will need to weigh the risks and benefits together. Dr. Ismael V. Bailon may be able to massage your hernia back into place (reduction). In this case, they might suggest that you wear a belt or truss to hold the hernia in while you’re doing certain activities. This may stop it from continuing to grow.