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Hernia Signs and Symptoms - Magdi Alexander MD - Magdi Alexander MD - General Surgeon in Pasadena California

What is a Hernia?

A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. For example, the intestines may break through a weakened area in the abdominal wall. Hernias are most common in the abdomen, but they can also appear in the upper thigh, belly button, and groin areas.


Do these symptoms sound familiar?

  • Visible or tangible bulge in abdomen or groin
  • Abdominal discomfort
  • Discoloration of skin
  • If male, swelling or pain in the scrotum
  • Nausea, vomiting, or fever
  • (In Hiatal hernias) Heartburn, indigestion, unusual belching, or difficulty swallowing

What are the risks and complications associated with hernias?

Risks vary with the location, size, and the length of time the hernia has been present.

  • Risks of Strangulation: In considering when to have a reducible hernia operated on, it is important to know the risk of strangulation.
  • Risks of Irreducibility: Hernias that are considered irreducible are also known as incarcerated hernias and cannot be pushed back into place and must be removed through surgical methods.


A hernia specialist should examine all hernias. Untreated hernias can increase in size and pain, evolving into potential life-threatening complications. If you believe you have a hernia, see Dr. Magdi Alexander immediately. He will confirm the diagnosis and discuss the best treatment options for you.

We will make the process as easy as possible for you, from your first consultation to your recovery after treatment or surgery.

Doctor Magdi Alexander is a professional physician who will become your partner on this journey to a better, healthier you. As a compassionate and caring physician, he will take time to talk to you about your condition to develop the best possible treatment. His bedside manner is like no other.

Common Hernia Types

Inguinal Hernia

Inguinal hernias occur when tissue squeezes its way through a weak spot in the groin muscle, causing a bulge in the groin or scrotum that may cause pain or a burning sensation. The bulge may develop over a timeframe of weeks or months; however they can appear suddenly after lifting heavy weights, coughing, straining, or even laughing.

Inguinal hernias are the most common type of hernia and make up almost 3/4 of all hernias treated. Many people often do not seek treatment for this specific hernia because no symptoms may be seen. However, if you suspect an inguinal hernia, prompt medical attention can prevent it from becoming a discomfort.

The inguinal canal is found at the base of the abdomen in the groin area. In men, it is the area where the spermatic cord passes from the abdomen to the scrotum, holding up the testicles. In women, the inguinal canal contains a ligament that helps to hold the uterus in place. While the inguinal canal is present in both men and women, this hernia is more common in men. This is because after the man’s testicles descend through the inguinal canal shortly after birth, the canal is supposed to close almost completely behind them. Unfortunately, the canal does not always close properly, thus leaving a weakened spot prone to hernias.

Hiatal Hernia

A hiatal hernia occurs when the upper portion of the stomach bulges through the diaphragm into the chest cavity. Since the diaphragm has a small opening to allow access to the esophagus to connect to the stomach, the stomach will often push up through this opening. Most hiatal hernias will not be discovered, causing no problems. However if the hiatal hernia is large, it can cause food and acid to back up in the esophagus. Patients over 50 years old will often be diagnosed with hiatal hernias. If a child has the condition, it is typically caused by a congenital (birth) defect.

Umbilical Hernia

An umbilical hernia occurs when a portion of the intestine pushes through the umbilical opening in the abdominal muscles and navel. Most umbilical hernias are common and typically harmless, though you should seek medical advice if you find a bulge near your navel as immediate diagnosis and treatment will help prevent any avoidable complications. Emergency care is highly recommended as soon as the bulge becomes painful or tender.

Being overweight or having multiple pregnancies may increase the risk of developing an umbilical hernia. More commonly found in women, the umbilical hernia will grow bigger over time. Leaving the hernia untreated can lead to it becoming a strangulated hernia, which is when the intestine or fat is trapped and the blood supply to the tissue is cut off. Strangulated hernias are very painful and require emergency surgery.

Incisional Hernia

Incisional hernias can occur months or even years after a previous abdominal surgery. The intestines may push through the incision scar or the surrounding, weakened tissue. Usual incisions made are to get an internal organ such as the appendix, or a caesarian section. The incisional hernia is the next most common hernia, behind the inguinal hernia.

What Causes a Hernia?

Hernias are developed from increased pressure and strain of a weakness in the muscles and or connective tissues. A hernia can develop quickly or over a long period of time, depending on its cause.

Common causes of muscle weakness include:

  • Failure of the abdominal wall to close properly in the womb (congenital defect)
  • Age
  • Chronic coughing
  • Damage from injury or surgery

Factors that strain your body and may cause a hernia (especially if your muscles are weak) include:

  • Being pregnant (puts pressure on your abdomen)
  • Being constipated (causes you to strain when having a bowel movement)
  • Heavy weight lifting
  • Fluid in the abdomen (ascites)
  • Suddenly gaining weight
  • Persistent coughing or sneezing

Am I at Risk for a Hernia?

Several factors increase your risk of developing a hernia, including:

  • A personal or family history of hernias
  • Being overweight or obese
  • A chronic cough
  • Chronic constipation
  • Smoking (which can trigger a chronic cough)

Conditions such as cystic fibrosis can also indirectly increase your risk of developing a hernia. Cystic fibrosis impairs the function of the lungs, causing a chronic cough, which can contribute to hernias.

What Are the Symptoms of a Hernia?

In most cases, the hernia causes no more than painless swelling in the abdominal area. There are times when the hernia will cause discomfort and pain, often worsening when standing, straining, or lifting heavy objects.

Other common symptoms of an inguinal hernia include:

  • Pain or discomfort in the affected area (usually the lower abdomen), especially when bending over, coughing, or lifting
  • Weakness, pressure, or a feeling of heaviness in the abdomen
  • A burning, gurgling, or aching sensation at the site of the bulge

Other symptoms of a hiatal hernia include:

  • Acid reflux (when stomach acid moves backwards into the esophagus causing a burning sensation)
  • Chest pain
  • Difficulty swallowing

How Is a Hernia Diagnosed?

Doctors can correctly diagnose a hernia through a physical examination. They may feel for a bulge in your abdomen or groin that gets larger when you stand, cough, or strain.

A hiatal hernia may be diagnosed with a barium X-ray or an endoscopy. A barium X-ray is a series of X-ray pictures of your digestive tract that are recorded after drinking a barium-containing liquid solution, which shows up well on X-ray images. An endoscopy involves threading a small camera attached to a tube down the throat and into the esophagus and stomach.

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