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I have a hernia - What next?

What to do when you suspect that you have an inguinal hernia...

1) Get a formal diagnosis quickly.

You may not be in pain but the sooner that your medical practitioner is aware of your condition the better.
You may be referred for an ultrasound scan (sonography) to confirm the diagnosis.

2) Be aware of the risks of a strangulated hernia.

In a small number of cases (3%) a hernia may become strangulated. This is  a medical emergency and requires immediate attention. The most common cases of strangulation are the smaller hernias as the larger hernias tend to slide in and out easily and so are less at risk of being clamped shut by the muscle 'opening'.

Symptoms of a strangulated hernia:

  • Sharp or severe pain
  • Vomiting
  • Blood in excrement
  • Constipation
  • Malaise with or without a fever
  • A burning sensation around the hernia

    Source - British Hernia Centre

2) Get a surgery date.

In the UK at least, GP's should refer 'all patients with an overt or suspected inguinal hernia to a surgical provider' according to the Royal College of Surgeons Commissioning Guide 2013. The only exceptions to this are patients who do not want surgical repair  or who have significant other health issues.   The pain will not go away and although it can be managed somewhat pre-surgery groin pain will likely increase over time. In 90% of cases for a ten year old hernia patients were in pain.The earlier you seek surgical attention the better.

If you are being refused a hernia surgery date you may want to listen to Radio 4's Inside Health Programme on elective hernia surgery.
Download (25Mb .mp3 file)

3) Your Surgeons expertise in Inguinal Hernia surgery may be a bigger factor than other operations.
A report from the Hernia Outcomes group cites surgical expertise as a factor in re-occurance rates and post-operative pain. The average surgeon does 21 Inguinal Operations per year according to the most recent study.

4) Consider life-style changes before Surgery.

Loosing weight, stopping smoking (both of which are predisposing factors in an inguinal hernia) and are especially good things to do. Increase the roughage in your diet to put less pressure on your abdomen by reducing constipation. Consider Yoga and Pilates and other forms of gentle exercise. Wear  hernia briefs to gently retain your hernia in the abdomen and stop it expanding. The smaller the hernia the better the surgical outcome.

5) Post-Surgery

Unfortunately hernias tend to reoccur, either in the existing site or opposite side of the groin which is pre-disposed to the same muscle wall weakness. The NHS quotes a 10% post-operative re-occurance rate.  You may need some lifestyle changes to reduce the likelihood of hernia re-occurance.

1 Hair A, Patterson C, Wright D,Baxter J,O'Dwyer P. What effect does the duration of an inguinal hernia have on patient symptoms? J Am Coll Surg 2001; 193:125-9