Inguinal hernia

Inguinal hernia symptoms include:

• A bulge in the area on either side of the pubic bone, which becomes more obvious when upright, especially when coughing or straining.
• A burning or aching sensation at the bulge.
• Pain, discomfort or pressure in the groin, especially when bending over, coughing or lifting.
• Occasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotum.

Symptoms in children

Inguinal hernias in newborns and children result from a weakness in the abdominal wall that's present at birth. Sometimes the hernia will be seen only when a baby is crying, coughing or straining during a bowel movement. The baby might be irritable and have less appetite than usual.

In an older child, a hernia is likely to be more noticeable when the child coughs, strains during a bowel movement or stands for a long period.

Signs of trouble

If a hernia can't be pushed in, the contents of the hernia may be trapped in the abdominal wall. This is known as an incarcerated hernia. An incarcerated hernia can become strangulated, which cuts off the blood flow to the tissue that's trapped. A strangulated hernia can be life-threatening if it isn't treated.

Symptoms of a strangulated hernia include:

• Nausea, vomiting or both.
• Fever.
• Sudden pain that quickly gets worse.
• A hernia bulge that turns red, purple or dark.
• Not being able to move the bowels or pass gas.

Some inguinal hernias have no apparent cause. Others might happen because of:

• Increased pressure within the abdomen.
• A preexisting weak spot in the abdominal wall.
• Straining during bowel movements or urination.
• Strenuous activity, such as heavy lifting and standing or walking for many hours each day.
• Pregnancy.
• Coughing or sneezing often.

In many people, the abdominal wall weakness that leads to an inguinal hernia happens before birth when a weakness in the abdominal wall muscle doesn't close properly. Other inguinal hernias form later in life when muscles weaken or break down due to aging, strenuous physical activity or coughing that accompanies smoking.

Weaknesses also can happen in the abdominal wall later in life, especially after an injury or abdominal surgery.

In men, the weak spot usually occurs in the inguinal canal, where the spermatic cord enters the scrotum. In women, the inguinal canal carries a ligament that helps hold the uterus in place, and hernias sometimes happen where connective tissue from the uterus attaches to tissue surrounding the pubic bone.

Factors that contribute to forming an inguinal hernia include:

• Being male. Men are 8 to 10 times more likely to have an inguinal hernia than are women.
• Being older. Muscles weaken as you age.
• European ancestry. Studies show that people of European ancestry, often referred to as white, may be more likely to get inguinal hernias than people of other racial or ethnic backgrounds.
• Family history. You have a close relative, such as a parent or sibling, who has the condition.
• Long-lasting cough, such as from smoking.
• Long-lasting constipation. Constipation causes straining during bowel movements.
• Pregnancy. Being pregnant can weaken the abdominal muscles and cause increased pressure inside the abdomen.
• Premature birth and low birth weight. Inguinal hernias are more common in babies who are born prematurely or with a low birth weight.
• Having a connective tissue condition, such as Ehlers-Danlos syndrome or Marfan syndrome.
• Having a prostatectomy, which is the surgical removal of the prostate gland.
• Previous inguinal hernia or hernia repair. Having a previous hernia in childhood increases the risk of forming another inguinal hernia later in life.