How Do I Know If I Have a Hernia?

What is a hernia?

A hernia happens when something internal — usually a small piece of bowel or fatty tissue from inside the abdomen — pushes through a gap or weak spot in the surrounding muscle wall. The result is usually a visible or felt lump, often with some aching or dragging discomfort around it.

Hernias are very common. Groin (inguinal) hernias affect about 1 in 4 men at some point in their lives, and women get them too. Hernias can appear at the belly button (umbilical hernia), through an old surgical scar (incisional hernia), in the upper midline of the abdomen (epigastric hernia), or in the groin (inguinal or femoral hernia).

The important thing to understand is that hernias do not heal on their own — the gap in the muscle wall does not close by itself, and the hernia will typically grow over time. Most hernias need surgical repair at some point.

The classic symptoms of a hernia

The most recognisable signs are:

• A visible lump or bulge in the groin, at the belly button, or along a surgical scar — usually most obvious when you are standing, coughing, or straining
• The lump softens or disappears when you lie down or gently press it back in
• An aching, dragging, or heavy feeling at the site — especially after being on your feet for a long time or after exercise
• A sharp pain when you cough, lift something, or exercise

Many hernias cause no pain at all — they are simply noticed as a new lump. Others cause discomfort from the start. Both are worth getting checked.

Types of hernia

Groin (inguinal) hernia

The most common type. It appears in the groin and is far more common in men, though women get them too. It passes through a natural channel in the groin wall, and can sometimes extend downward into the scrotum. You will typically notice a lump in the crease where your leg meets your body.

Femoral hernia

Also in the groin area, but sits slightly lower and further toward the thigh. More common in women. Femoral hernias carry a higher risk of becoming trapped than inguinal hernias, which is why they should be repaired promptly once diagnosed.

Belly button (umbilical) hernia

A protrusion at or around the belly button. More common in adults who have been pregnant or who carry extra weight around the abdomen. Often looks like the belly button is poking outward.

Incisional hernia

A hernia that appears through a previous surgical scar. It can develop months or even years after abdominal surgery. These hernias tend to be larger and can be more complex to repair.

Epigastric hernia

A small hernia in the upper midline of the abdomen, above the belly button. Usually involves fatty tissue rather than bowel. Despite being small, it can cause a surprising amount of discomfort.

When is a hernia an emergency?

Warning signs to watch for:

• The lump suddenly feels hard, very tender, and you cannot push it back in
• Severe, constant pain — quite different from the usual mild aching
• Nausea or vomiting
• Fever

Even if the hernia has not yet reached the strangulation stage but simply cannot be pushed back in (called incarceration), this still needs urgent surgical assessment — same day if possible.

How is a hernia diagnosed?

Most hernias are diagnosed simply by your doctor listening to what you have noticed and then examining the area. No scan is needed in the majority of cases — a good examination is usually enough. Occasionally, an ultrasound or CT scan will be organised if the presentation is unusual, if the hernia is very small and difficult to feel, or if your surgeon wants more detail before planning a complex repair.

What are the treatment options?

Watchful waiting

For a small groin hernia in an older person who has no symptoms and other health conditions that make surgery more risky, keeping a close eye on things — without operating straight away — can be appropriate. That said, for most people, elective repair is the better path, because hernias grow over time and are easier and safer to fix while they are still small.

Keyhole (laparoscopic) repair

The preferred approach for most groin and femoral hernias. Your surgeon makes two small cuts (each about 5–10 mm), and the hernia is repaired using a mesh patch placed behind your abdominal wall. The advantages: less pain after surgery, a faster return to normal life (desk work within 1–2 weeks, most activity by 6–8 weeks, heavy lifting by 8–12 weeks), lower chance of the hernia coming back, and the ability to repair both sides at once if needed.

Open repair

A single incision made directly over the hernia. Used for certain hernia types, very large hernias, or situations where keyhole surgery is not the right fit. A mesh is usually placed at the same time to reinforce the repair.

Incisional hernia repair

Repairing a hernia through an old scar requires careful individual planning. Keyhole or robotic-assisted techniques are used where possible. For larger or more complex cases, an open approach with mesh reinforcement of the abdominal wall may be needed. Your surgeon will discuss the right plan with you.

Frequently asked questions