Abdominal Hernia

What Is an Abdominal Hernia?

An abdominal hernia occurs when an internal organ or tissue pushes through a weak spot in the surrounding abdominal muscle or connective tissue. Hernias most commonly develop in the groin (inguinal hernia), near the belly button (umbilical hernia), or at the site of a previous surgical incision (incisional hernia). Less commonly, hernias can appear along the abdominal wall or where blood vessels exit the abdomen.

While some hernias cause no symptoms and are discovered during routine exams, others may lead to a visible bulge, discomfort, or pain — especially during physical activity, lifting, coughing, or standing for long periods. If the herniated tissue becomes trapped (incarcerated) or its blood supply is compromised (strangulated), this can create a medical emergency that requires immediate attention.

Causes and Risk Factors

Abdominal hernias are usually the result of a combination of increased internal pressure and weakened muscle or tissue. Common contributing factors include:

  • Heavy lifting or strenuous physical activity
  • Chronic coughing or straining (e.g., due to constipation)
  • Obesity or significant weight gain
  • Smoking or poor nutrition
  • Previous abdominal surgery or injury
  • Aging and natural weakening of muscle tissue
  • Genetic predisposition to weak connective tissue

Hernias may develop gradually over time or appear suddenly after heavy exertion or trauma.

Signs and Symptoms

Symptoms of an abdominal hernia can vary depending on the type and size of the hernia. Common signs include:

  • A noticeable bulge or lump in the abdomen, groin, or near a surgical scar
  • Discomfort, aching, or burning at the bulge site
  • Pain or pressure that worsens with activity or lifting
  • A feeling of heaviness or weakness in the abdomen
  • In severe cases, sudden, intense pain, nausea, or vomiting (possible signs of strangulation)

Some small hernias cause no symptoms at all and are discovered during routine physical exams or imaging for unrelated concerns.

How Hernias Are Diagnosed

Diagnosis begins with a physical examination in which a clinician assesses the location and size of the bulge. To confirm the presence of a hernia and evaluate its extent, imaging may be used, such as:

  • Ultrasound
  • CT scan (computed tomography)
  • MRI (magnetic resonance imaging)
  • These imaging tools help determine whether a hernia contains fat, intestine, or other abdominal contents and assist in surgical planning if repair is recommended.
  • Treatment Options

Not all hernias require immediate surgery. In some cases, particularly with small, asymptomatic hernias, watchful waiting may be appropriate. However, hernias that cause pain, grow over time, or carry a risk of incarceration or strangulation are typically treated surgically.

Common surgical approaches include:

  • Open hernia repair, in which an incision is made directly over the hernia to return the protruding tissue to the abdominal cavity and reinforce the muscle wall with stitches or mesh
  • Laparoscopic hernia repair, a minimally invasive technique using small incisions and a camera to guide repair with mesh reinforcement

The goal of hernia surgery is to restore normal anatomy, relieve symptoms, and reduce the risk of future complications.

Divisions Involved in Your Care

Procedures We Use

Frequently Asked Questions

An inguinal hernia occurs in the groin, where the abdominal wall is naturally weaker. An umbilical hernia appears near the belly button. Both involve tissue pushing through muscle but occur in different locations.

Small hernias without symptoms may be monitored over time. However, hernias can enlarge or become trapped, leading to incarceration or strangulation — conditions that can cut off blood supply to the affected tissue and require emergency surgery.

Recovery varies depending on the surgical approach. Minimally invasive (laparoscopic) repairs often allow patients to return to normal activities sooner, while open repairs may require a slightly longer healing period. Your surgeon will provide specific guidance.

While hernia repair is generally effective, there is a small risk of recurrence. Techniques that use mesh reinforcement tend to have lower recurrence rates than repairs without mesh.

Most patients can gradually return to routine activities with guidance from their surgeon. Heavy lifting and strenuous exercise are usually restricted initially to allow healing.

If you experience sudden severe pain, nausea, vomiting, or the hernia becomes tender and cannot be pushed back in, seek urgent care — these may be signs of incarceration or strangulation.