Why hernias cannot heal themselves
A hernia is a gap in the tough fibrous tissue (called fascia) that makes up the wall of your abdomen. Through that gap, tissue from inside your abdomen — often a bit of fat or a loop of bowel — can poke through. Unlike muscle, which can repair itself after a strain, this fibrous tissue cannot grow back and close the gap once it has opened.
Think of it differently from a muscle tear or sprained ligament. Those injuries can heal because your body sends in repair cells to rebuild the damaged tissue. Your abdominal wall fascia does not work that way. Once the gap exists, it stays. It will not shrink or seal itself without surgery.
What sometimes happens is that the hernia stays roughly the same size for a while — especially if you are careful about heavy lifting and straining. But "stable" does not mean "healed." The gap is still there, the risk of the hernia getting stuck remains, and most hernias do slowly get bigger over months and years.
Umbilical hernias in infants: the exception
There is one situation where a hernia can close on its own — and that is the belly button hernia (umbilical hernia) in very young babies. In infants under two years of age, these hernias often disappear as the abdominal wall finishes developing. That is because the belly button opening was still in the process of closing naturally, and the gap is due to that delayed closure — not a true breakdown of mature tissue.
In adults, umbilical hernias — just like all other adult hernias — cannot heal without surgery. If yours is causing symptoms or getting bigger, repair is usually the right step.
What about trusses and hernia support belts?
A truss is a firm supportive garment worn over the hernia to hold the bulge in — keeping the protruding tissue inside your abdomen. People have used them for centuries, long before modern surgery was an option.
Why a truss does not fix a hernia: A truss holds things in place while you wear it, but it does not repair the gap in your abdominal wall. Take the truss off, and the hernia is still there. Wearing one long-term does not shrink the gap — and it can actually cause scar tissue to build up around the hernia, which makes surgery more complicated later. A truss also does not protect you from strangulation. A hernia can still get dangerously stuck even while you are wearing one, if it shifts position or is fitted incorrectly.
A truss might be considered as a short-term comfort measure if you genuinely cannot have surgery at a given time. But it is not a real solution for most people, and it should never be seen as a permanent substitute for repair.
Other non-surgical approaches
Weight loss
Losing weight reduces the pressure inside your abdomen and can ease hernia symptoms — but it does not close the gap. What it does do is make surgery safer and simpler. Surgeons often encourage weight loss before elective repair, especially for larger hernias or hernias through a previous scar, because it lowers the risk of complications.
Activity modification
Cutting back on heavy lifting and activities that make your hernia worse can reduce discomfort and may slow things down. This is a sensible short-term approach while you are waiting for surgery, or if surgery genuinely is not right for you at this time. But please do not mistake "managing the symptoms" for "fixing the problem" — the gap remains.
Core strengthening exercises
Strengthening your abdominal muscles will not close a hernia and should not be used as an alternative to surgery. Some exercises — particularly ones that make you strain or hold your breath — can actually make symptoms worse. A physiotherapist who understands hernias can help you figure out what is safe to do before and after repair.
Why delaying surgery makes repair more complex
Many people feel that waiting is the "safer" option. In surgical terms, the opposite is usually true. Here is what tends to happen the longer a hernia is left:
- Hernias enlarge over time — a bigger gap is harder to repair, is more likely to have bowel involved, and needs a larger patch (mesh). It also has a higher chance of coming back after surgery.
- Scar tissue builds up — over time, the contents of the hernia can stick to surrounding structures. This makes surgery more complicated and increases the chance of bowel being nicked during repair.
- Loss of domain — in very large hernias that have been left for many years, so much bowel has moved into the hernia that your abdominal cavity has essentially "forgotten" how to hold it all. Getting everything back inside becomes a significant challenge.
- Emergency surgery is far riskier than planned surgery — if your hernia gets strangled (blood supply cut off), emergency repair carries far higher complication rates than a planned operation done at the right time.
The risk of getting stuck increases over time
The yearly risk of strangulation — where the hernia gets trapped and its blood supply is cut off — is fairly low for a groin hernia with no symptoms: roughly 0.3–0.5% per year. But that adds up. Over five years, you are looking at a 1.5–2.5% cumulative risk. Over ten years, higher still. And as the hernia grows, the risk grows with it, because a bigger hernia has more bowel that could become trapped.
Femoral hernias — which tend to occur lower in the groin and are more common in women — carry a much higher strangulation risk and should never be simply watched and waited on.
When not having surgery is the right decision
There are situations where choosing not to operate is genuinely the best option for you:
- You have significant heart, lung, or other health problems that make surgery and anaesthetic riskier than the hernia itself
- You have a serious illness with a limited life expectancy where the burden of surgery outweighs any benefit
- You have a small groin hernia with no symptoms and you are an older man who has talked this through thoroughly with your surgeon and made an informed choice to defer
These decisions are always made together — you and your surgeon, with a full, honest understanding of the ongoing risks. They need to be reviewed regularly, because your situation can change over time.
Hernia repair: a common, well-tolerated procedure
For many people, worry about surgery is what keeps them from coming in — and that is completely understandable. But it is worth knowing that keyhole (laparoscopic) hernia repair is one of the most commonly performed and well-tolerated operations in Australia. Most patients go home the same day, feel comfortable with simple over-the-counter pain relief within a few days, and are back at a desk job within one to two weeks. The risks of a planned, non-urgent repair are very low in otherwise healthy people — far lower than the risks of emergency surgery after a hernia has become strangulated.
Frequently asked questions
No, and this is a very common thing to notice. The size you see on any given day reflects how much tissue happens to be sitting inside the hernia at that moment. When you are lying down, relaxed, or there is less in your bowel, the hernia can look smaller. But the gap in the wall itself has not changed — it is still there.
No. Physiotherapy and exercise cannot close the gap in your abdominal wall. A physio can help you manage symptoms before surgery and is very helpful for rehabilitation afterwards — but physiotherapy alone is not a treatment for the hernia itself.
A well-fitted support garment, used for short-term comfort, is unlikely to cause immediate harm. But wearing one for a long time can cause scar tissue to build up around the hernia, which makes later surgery more complex. Always check with your surgeon before using a truss as part of your ongoing plan.
Age alone is rarely a reason to avoid hernia repair. What actually matters is your overall health and how well you would tolerate an anaesthetic. Many people in their 70s and 80s have hernia repairs safely. If you have been told surgery is not appropriate for you, ask your surgeon to walk you through the specific reason — and if you are unsure, a second opinion is always reasonable.
It depends on the type of hernia, how big it is, and what symptoms you have. Femoral hernias (low groin hernias) should not be left. Groin hernias causing symptoms should be repaired without much delay. A groin hernia in a man with no symptoms can sometimes be watched, but most surgeons recommend repair within one to two years before things progress. Your surgeon will give you advice that fits your specific situation.
Losing weight is genuinely helpful and we would encourage it — but it will not close the hernia. The gap in the tissue remains no matter what you weigh. What weight loss does do is make surgery safer and lower the risk of complications, which is why surgeons often encourage it before elective repair.
Learn more about this procedure — including what to expect, benefits, risks, and recovery.
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Mr Ba Nguyen offers honest, straightforward advice on hernia management — no unnecessary pressure, just clear information. A GP referral is required. Call (03) 9816 3951 or email admin@northeasternsurgical.com.au.