Hernia 101: Types, Causes, Symptoms & Treatment

A hernia is when an internal part of the body pushes its way through a weak spot in the muscle or tissue. Learn more about the different types of hernia, its causes and how to treat it in Malaysia.

by Katherine Khaw

What is a Hernia?

What is a hernia? Hernia can be defined as the occurrence whereby an internal portion of the body pushes through a weakness in the muscle or surrounding tissue wall. One of the most noticeable symptoms of a hernia is a swelling or lump in your abdomen or groin. Hernias commonly develop between the chest and hips area, but they can develop in other parts of the body.

While it is a protrusion, the lump can be pushed back in or even vanishes when the affected person lies down. A strain or coughing fit, however, may cause the lump to reemerge in the area of the body.

While some hernias may cause some mild symptoms, some are flagged as an immediate medical emergency.

Types of Hernia

There are various types of hernia, as below:

  1. Epigastric Hernia

This particular hernia occurs in the epigastric region of the abdomen. Thus, it is located above the belly button and below the rib cage. According to a study published in 2012, approximately 2 to 3 per cent of abdominal hernias are epigastric hernias. In fact, some babies may be born with it. Adults may experience this type of hernia as well.

Usually, epigastric hernias are small in nature and do not cause symptoms.

  1. Femoral Hernia

This occurs when tissue pushes through a weak point, either in the groin or inner thigh. This could feel like a small or medium-sized lump in the groin. This type is rarely found in children but is more likely in women rather than men due to the larger female pelvis.

This is one of the dangerous hernias as it is located near the femoral artery and vein. It could affect blood vessels and flow to and from the leg.

  1. Hiatal Hernia

This is a condition where a person’s stomach bulges out through the diaphragm area, which has a weak point. This muscle carries the responsibility for breathing, separating the lungs compartment from the abdominal organs.

Doctors are not sure of the causes of hiatal hernia, but it is more common in older adults, such as the following groups: over 50 years old, pregnant, or overweight.

  1. Incisional Hernia

This may develop after a person undergoes stomach surgery (about 15 to 20 per cent of persons are affected). If the wound is not healed completely, the person may develop an incisional hernia.

These are the persons who may develop incisional hernia:

  • Undergoing surgery
  • Experiencing complications during or after the surgery
  • Having chronic conditions such as diabetes or kidney failure
  • Smoking
  • Certain long-term medications
  1. Inguinal Hernia

This hernia happens when a portion of the intestine or fat protrudes through the lower stomach wall. As such, the bulge would intersect the inguinal canal, located in the groin area. This hernia may contain part of the small intestine or the female reproductive organs. Usually, this would occur on the right side.

Statistically, this would occur in younger children (up to 5 years old) or adults aged 75 to 80 years old. Usually, inguinal hernias would be repaired with surgery as this type of hernia may cause intestinal obstruction and potential death.

  1. Umbilical Hernia

These hernias bulge in the belly button area, through an area of weakness. Oftentimes, the bulge can be seen during a coughing fit or a strain during a bowel movement. Notably, umbilical hernias are common in babies under 6 months old, but they would usually repair by the time the child is 4 or 5 years old.

In regular circumstances, most umbilical hernias are not painful and problem-free. Then, they would go away on their own.

Causes of Hernia

A hernia is normally caused by a combination of the following: pressure and muscle opening or weakness. Then, this would cause the organ or tissue to be pushed through that opening or weak spot. Muscle weakness is something that can be present at birth (such as genetics) or later in life (due to old age).

Some instances that may risk the development of a hernia in one’s body are as follows:

  • Lifting heavy objects with the wrong posture (which can hurt the abdominal muscles)
  • Bowel issues such as diarrhoea or constipation
  • Frequent coughing or sneezing fits
  • Obesity
  • Poor nutrition intake
  • Lifestyle habits such as smoking
  • Cystic fibrosis

These factors can weaken a person’s muscles and as a result, increase the likelihood of a hernia.

Risk Factors of Hernia

There are some risk factors based on the hernia type.

  1. Hiatal Hernia

The risk is higher in people who are 50 years old and above, or have obesity.

  1. Incisional Hernia

This is a hernia that can appear after surgery on the abdomen area. Thus, people are most likely to get an incisional hernia if they are involved in exerting activities, gain additional weight, or become pregnant. This is due to the extra pressure on the tissue as it heals from the surgical procedure.

  1. Inguinal Hernia

These are the following risk factors for inguinal hernia:

  • Age (older adults)
  • Close relatives who have had an inguinal hernia (hereditary risk)
  • History of having an inguinal hernia
  • Males
  • Smoker (tobacco weakens the body’s tissue)
  • People with chronic constipation
  • Premature birth and low birth weight
  • Pregnancy
  1. Umbilical Hernia

This is most common with babies having a low birth weight. This is also possible with premature babies. For adults, the risk factors would be being overweight, having multiple pregnancies, or being female.

Symptoms of Hernia

Generally, a hernia would generate a noticeable lump or bulge that can be pushed in or disappear when the person is lying down. During exertion or physical activities, such as laughing, coughing or other movements – this may make the lump reappear.

Other symptoms of a hernia are:

  • Swelling or bulge in the groin or scrotum area
  • Increased pain in the bulge area
  • Experiencing pain while lifting or bending over
  • Bulge size increases over time
  • A dull aching sensation
  • Experiencing fullness (a heavy feeling in the abdomen) or bowel issues

For hiatal hernias, there would not be any visible bulges outside the body. So, symptoms may differ, such as heartburn, indigestion, issues with swallowing, frequent regurgitation and chest pains.

When To See A Doctor

It may get stuck in the abdomen area, being unable to be pushed in. Then, this may cut off or strangulate blood flow (known as a strangulated hernia). Then, this would require medical assistance immediately.

These are the symptoms of a strangulated hernia:

  • Nausea and/or vomiting
  • Fever
  • Pain that suddenly happens and worsens quickly
  • A bulge that changes to red, purple or dark colour
  • Not being able to defecate or pass gas

It is important to note that it cannot go away on its own. Other non-surgical approaches such as wearing a corset or binder are measures to reduce pain and discomfort for temporary relief only.

Diagnosis and Treatment

A hernia is diagnosed by seeing or feeling the bulge with physical examination, such as standing upright. The doctor may also place their hand on the patient’s body part and instruct the patient to cough. In other means, tests such as a CT scan are able to diagnose the condition. Ultrasound and abdominal X-rays may be ordered to determine the patient’s condition as well.

As hernias do not go away on their own, doctors will usually observe that it goes back through the abdominal wall. Larger hernias that cause symptoms are likely to require surgery, to keep them from getting worse or causing a medical emergency.

These are the types of surgeries for hernia:

  • Open surgery – Results in closing the hernia with sutures, mesh, or both. The skin wound is also closed with sutures, staples or surgical glue.
  • Laparoscopic repair – Meant for repeat operations to avoid ongoing scars. It is more expensive but less likely to incur complications. It enables the use of smaller incisions, guided by a laparoscope. This would induce a quicker recovery from the operation.
  • Robotic hernia repair – It is similar to laparoscopic surgery. However, the surgeon would be handling the surgical instruments from the console in the operating room. It can be used for smaller hernias or to reconstruct the abdominal wall.

All surgeries are performed under anaesthesia. Then, there are no dietary restrictions either. Work and regular activities can be resumed shortly after undergoing hernia surgery.


These are some ways to try to prevent the development of a hernia (aside from a combination of genetic and medical history):

  • Maintain a healthy weight to avoid pressure on the abdominal wall
  • Quit smoking if you are practising the habit
  • Avoid straining when lifting weights, especially after undergoing abdominal surgery
  • Avoid straining when passing a bowel movement by eating a high fibre diet and drinking plenty of fluids
  • Visit the doctor if you are ill with persistent coughing or sneezing

In general, if you have any doubts and worries about your body, you can make an appointment with your local practitioner. Should there be any further assessments required, your medical authority is able to issue and direct you to the best option available.

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  1. Allarakha, S. (2020). Can You Heal a Hernia Without Surgery? [Website]. Retrieved 23 June 2022, from https://www.medicinenet.com/can_you_heal_a_hernia_without_surgery/article.htm .
  2. Cleveland Clinic (2018). Hernia [Website]. Retrieved 21 June 2022, from https://my.clevelandclinic.org/health/diseases/15757-hernia .
  3. DerSarkissian, C. (2021). Understand Hernia – the Basics [Article]. Retrieved 21 June 2022, from https://www.webmd.com/digestive-disorders/understanding-hernia-basics .
  4. Healthline (2021). The 6 Most Common Types of Hernia [Article]. Retrieved 21 June 2022, from https://www.healthline.com/health/types-of-hernia .
  5. MAcGill, M. (2017). Types and treatments for hernia [Article]. Retrieved 23 June 2022, from https://www.medicalnewstoday.com/articles/142334 .
  6. National Health Service (NHS) (2019). Hernia [Article]. Retrieved 20 June 2022, from https://www.nhs.uk/conditions/hernia/ .
  7. Poten, J.E., Somers, K.Y., & Nienhuijs, S.W. (2012). Pathogenesis of the epigastric hernia [Journal]. Retrieved 21 June 2022, from https://pubmed.ncbi.nlm.nih.gov/22824990/ .
About the Writer
Katherine Khaw
Katherine is an avid reader, finding joy in halls of words. Aside from the imagination wandering in worlds not here, she enjoys stargazing and gardening. In her heart of hearts, she aspires to be a writer, and to be more than mere dust.
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