What is inguinal hernia?
An inguinal hernia is a condition in which intra-abdominal fat or part of the small intestine, also called the small bowel, bulges through a weak area in the lower abdominal muscles. An inguinal hernia occurs in the groin—the area between the abdomen and thigh. This type of hernia is called inguinal because fat or part of the intestine slides through a weak area at the inguinal ring, the opening to the inguinal canal. An inguinal hernia appears as a bulge on one or both sides of the groin. An inguinal hernia can occur any time from infancy to adulthood and is much more common in males than females. Inguinal hernias tend to become larger with time.
What are the types and causes of inguinal hernia?
The two types of inguinal hernia have different causes.
Indirect inguinal hernia. Indirect inguinal hernias are congenital hernias and are much more common in males than females because of the way males develop in the womb. In a male fetus, the spermatic cord and both testicles—starting from an intra-abdominal location—normally descend through the inguinal canal into the scrotum, the sac that holds the testicles. Sometimes the entrance of the inguinal canal at the inguinal ring does not close as it should just after birth, leaving a weakness in the abdominal wall. Fat or part of the small intestine slides through the weakness into the inguinal canal, causing a hernia. In females, an indirect inguinal hernia is caused by the female organs or the small intestine sliding into the groin through a weakness in the abdominal wall.
Indirect hernias are the most common type of inguinal hernia. Premature infants are especially at risk for indirect inguinal hernias because there is less time for the inguinal canal to close.
Direct inguinal hernia. Direct inguinal hernias are caused by connective tissue degeneration of the abdominal muscles, which causes weakening of the muscles during the adult years. Direct inguinal hernias occur only in males. The hernia involves fat or the small intestine sliding through the weak muscles into the groin. A direct hernia develops gradually because of continuous stress on the muscles. One or more of the following factors can cause pressure on the abdominal muscles and may worsen the hernia:
* sudden twists, pulls, or muscle strains
* lifting heavy objects
* straining on the toilet because of constipation
* weight gain
* chronic coughing
Indirect and direct inguinal hernias usually slide back and forth spontaneously through the inguinal canal and can often be moved back into the abdomen with pressure from a hernia truss and physical therapy.
What are the symptoms of inguinal hernia?
Symptoms of inguinal hernia include
* a small bulge in one or both sides of the groin that may increase in size and disappear when lying down; in males, it can present as a swollen or enlarged scrotum
* discomfort or sharp pain—especially when straining, lifting, or exercising—that improves when resting
* a feeling of weakness or pressure in the groin
* a burning, gurgling, or aching feeling at the bulge
How is inguinal hernia diagnosed?
To diagnose inguinal hernia, the doctor takes a thorough medical history and conducts a physical examination. The person may be asked to stand and cough so the doctor can feel the hernia as it moves into the groin or scrotum. The doctor checks to see if the hernia can be gently massaged back into its proper position in the abdomen.
Femoral Hernia
Much like an inguinal hernia, a femoral hernia develops in the groin area although it occurs somewhat lower – at or near where the leg meets torso. In many cases, telling the difference between the these two hernia types is quite difficult by doctors with little experience clinically evaluating hernias.
These account for an estimated 15-20% of all hernia cases and are more commonly seen in women – in fact women are five times more likely to suffer from this type of hernia than men. This happens when part of your intestine or bowel protrudes through the femoral canal (main blood vessels in the legs) and bulges out into the front thigh.
Symptoms Of A Femoral Hernia
If you find a painful bulge on or around the crease of your leg, next to the pubic area, that is the primary symptom of a femoral hernia. This is very close to where inguinal hernias occur, however either way it’s likely you could have a hernia of some sort. If you’re a women, it’s even more likely to be femoral (men are more likely to have an inguinal hernia – again because of anatomic structure). Worse yet, in some cases both kinds of hernias can occur at the same time.
Location Of Femoral Hernias
When it comes to this condition, it’s all about location. Femoral hernias occur in an anatomically shaped triangular gap found between three parts of the body. This includes the inguinal ligament, which is essentially your leg crease; the underside of the pubic bone; and the femoral vein. This gap, coincidentally, is larger in females because of the angle and shape of the a woman’s pelvis – which is attributed to why they’re more commonly found in woman.
Causes Of A Femoral Hernia
Risk factors include obesity, constipation (straining going to the bathroom), lifting excessive weight and pregnancy. Obviously anything that increases the pressure on the abdomen will increase risk. Having a strong, healthy core and being in overall good help will help reduce the chances of getting a hernia.
Early diagnosis is important, as femoral hernias have a much higher likelihood of developing incarceration or strangulation. It’s strongly advised to see your local general practitioner or specialist if you think you might have this – before potential complications occur.
