What is an inguinal hernia?

An inguinal hernia happens when part of your intestine or other tissue pushes through a weak spot in the lower abdominal wall, often in the groin area.

Inguinal hernias are the most common type of hernia, making up about 75% of all abdominal wall hernias. Around 90% of inguinal hernias occur in men. Sometimes, the hernia can bulge outward or move down the inguinal canal toward the scrotum. While this area is supposed to strengthen after birth, it can weaken later in life, leading to a hernia.

There are two types of inguinal hernias:

  • Direct inguinal hernia: These develop when tissue bulges through a weak area in the abdominal wall, usually just below the belt line.
  • Indirect inguinal hernia: The most common type. It follows the path of the inguinal canal, which normally closes early in life but can remain a weak spot.

Inguinal hernia symptoms

Symptoms of an inguinal hernia can vary. Some people notice only mild discomfort at first, while others experience more noticeable pain or a visible bulge in the groin.

Common inguinal hernia symptoms include:

  • A bulge in the groin that may be more noticeable when standing, coughing or lifting
  • Pain or discomfort in the groin that may worsen with activity
  • A burning or aching sensation near the bulge
  • A heavy or dragging feeling, especially after exercise or at the end of the day
  • Pain that may radiate into the scrotum or upper leg

Men may notice a bulge in the scrotum, while women may see or feel swelling near the labia.

When to see a doctor

If you notice signs or symptoms of an inguinal hernia, see your doctor. Many conditions have similar symptoms, so an accurate diagnosis is important.

Untreated hernias can grow larger and become dangerous. As hernias grow, more abdominal contents may enter the hernia sac, increasing the risk of compromised blood supply (strangulation), which is life-threatening and requires immediate surgery.

Go to the emergency room if you experience:

  • A hernia that suddenly becomes larger or cannot be pushed back in
  • Fever with pain at the hernia site
  • Nausea and vomiting with abdominal bloating
  • Redness or skin changes around the hernia
  • Severe, sudden or shooting pain at the hernia site

Inguinal hernia causes

An inguinal hernia can develop for several reasons. This area of the abdominal wall is naturally more vulnerable because, during infancy, the testicle passes through a small canal that later needs to close. If that closure isn’t strong, the canal can remain a weak spot, making hernias more likely. This is also why inguinal hernias occur more often in men than in women.

It’s not always clear why one person develops a hernia and another doesn’t. Factors that may play a role include genetics, the strength of tissue healing, obesity or added pressure on the area from heavy lifting, trauma or other strain.

Inguinal hernia risk factors

Inguinal hernias occur significantly more often in men than women and at certain ages. Researchers are still investigating other possible risk factors, but generally, health conditions that weaken muscle tissues and activities that increase pressure on your abdomen may increase the risk of an inguinal hernia.

Risk factors for inguinal hernias include:

  • Age: Inguinal hernias occur more often in some age groups, including adults aged 75 to 80 and children up to age 5.
  • Chronic cough: A long-term cough, related to smoking or a condition like chronic obstructive pulmonary disease (COPD), can increase your risk.
  • Constipation: Straining when you go to the bathroom can increase abdominal pressure.
  • Family history: You are four times more likely to have a hernia if a close family member had one.
  • Heavy lifting: Not lifting items correctly can strain your abdomen.
  • Low or high body weight: Obesity increases the risk of hernias, but inguinal hernias can occur more often in people with a low body mass index (a measurement of body fat based on height and weight).
  • Premature birth: Babies born prematurely are more likely than other infants to get inguinal hernias.
  • Sex: Inguinal hernias are more likely to affect men than women.

Complications

An inguinal hernia can become stuck, or incarcerated, which means you or your doctor cannot push it back into place.

An incarcerated hernia can become strangulated, which means the blood supply is restricted and tissues in the hernia sac can start to die. Incarceration and strangulation can also cause intestinal obstruction, in which air, food, fluids and stool (poop) can’t pass through your intestines. This can be life-threatening and usually requires emergency surgery.

How is an inguinal hernia diagnosed?

Doctors can diagnose an inguinal hernia through a physical exam. Inguinal hernias are often visible, and they may try to push your hernia back inside the abdomen. If your doctor suspects you might have a hernia but can’t see or feel one during an exam, they might order imaging to get a better look or rule out other types of masses in the groin.

Medical history and exam

Your doctor will ask you about any symptoms you have and your medical and family history.

During a physical exam, they will likely examine you while you are standing, looking for bulges and asymmetry. They might press on your groin or scrotum and do the same on the other side of the body to see if they’re symmetrical. You may be asked to cough or change positions to see if a bulge moves. Your doctor might gently massage the hernia to see if it can be pushed back in your abdomen.

Inguinal hernia treatment

Surgery is the only way to repair an inguinal hernia. Each case is unique, and your surgeon will discuss the risks and benefits of surgery versus watchful waiting. If you choose to delay surgery, monitor symptoms closely and notify your provider if they worsen.

Find specialized care for an inguinal hernia near you

At Baylor Scott & White Health, our hernia surgery centers across North and Central Texas offer expert care for inguinal hernias. Our experienced team provides personalized treatment to help improve your quality of life. Whether you need diagnostic testing, treatment options, or ongoing support, we are here to help.

Frequently asked questions

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