Health Answers

Q. What is a hernia, and what causes it?

A. Most hernias occur when a segment of the small intestine slips through a hole in the abdominal wall and lands in the groin.

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“You may see a bulge on the skin or may feel something funny,” said Dr. Michael Stone, a surgeon at Boston Medical Center.

The condition, which affects more men than women, can usually be treated with outpatient surgery, lasting a few hours, to push the intestine back into the abdomen and seal the hole with mesh.

In healthy young adults, a wall of abdominal tissue holds the intestines in place. In older adults or athletes who exercise strenuously, the tissue separating the abdomen from the groin can grow weak or tear. Coughing, straining to lift weights, or pushing to urinate or defecate can increase pressure in the abdomen and force the intestines through the abdominal wall and into the groin.

Maintaining a healthy body weight can be one way to decrease pressure on the abdominal wall, said Stone.

Early-stage hernias can often be reversed by pushing on the groin or lying down. But over time, the hole may stretch, allowing a bigger piece of intestine to fall through and get stuck. Once trapped, the intestine can become inflamed like a finger constricted inside a tight ring. Without adequate circulation, the intestine may become infected, eventually dying, rupturing, and spilling toxic waste products into the body.

“That’s a disaster. That’s exactly what we’re trying to prevent,” said Stone, who advises patients to consult a doctor earlier rather than later.