A common problem, especially in men, requires medical evaluation and, in most cases, surgery to avoid complications
Inguinal hernia is among the most common surgical problems of the digestive system. Although it often progresses slowly and causes few symptoms at first, it is a condition that deserves medical attention from the first signs.
It occurs when a part of the abdominal contents, usually fat or a loop of intestine, finds an area of weakness in the groin muscles and protrudes outwards, forming a visible or palpable bulge. This volume usually appears or increases with physical exertion, coughing or long periods of standing and usually disappears when lying down.
Although it can affect women, inguinal hernia is much more common in men, due to the anatomical characteristics of the region.
Why does inguinal hernia arise?
Hernia formation is related to the weakening of the abdominal wall, associated with increased pressure within the abdomen. There are two main types:
- Indirect inguinal hernia – usually linked to a congenital predisposition. It can manifest itself in childhood or in young adults.
- Direct inguinal hernia – acquired throughout life, more common in adult and elderly men, related to the natural wear and tear of the groin muscles.
Some factors significantly increase the risk of developing a hernia, such as repetitive physical exertion, chronic constipation, persistent cough, obesity, smoking and family history. All of these elements contribute to increasing abdominal pressure and facilitating the emergence of a hernia.
What signs deserve attention?
The most characteristic symptom is the appearance of a lump in the groin, which may or may not cause pain. In many cases, there is only local discomfort, a feeling of heaviness or burning after physical exertion.
As the condition progresses, the pain may become more frequent and limit daily activities. In more serious situations, the hernia may become trapped (incarcerated) or have its circulation compromised (strangulated). In these cases, intense and sudden pain, hardening of the bulge, nausea, vomiting, fever and risk of serious complications appear.
Hernia strangulation is a surgical emergency and requires immediate care.
How is the diagnosis made?
Most of the time, the diagnosis is clinical, based on a physical examination carried out by the doctor, both standing and lying down, evaluating the groin region during exertion maneuvers.
When there is doubt, imaging tests can help, such as ultrasound, which is widely used, or computed tomography and magnetic resonance imaging, indicated in specific or more complex cases.
Is there treatment without surgery?
Surgery is the only definitive treatment for inguinal hernia. There are no medications, exercises or external devices capable of correcting the abdominal wall defect.
Currently, most cases are treated using minimally invasive techniques, such as laparoscopy or robotic surgery, which tend to provide faster recovery. Traditional open surgery is still indicated in some specific situations.
In patients with small, asymptomatic hernias, clinical monitoring may initially be chosen, a strategy known as active surveillance. However, studies show that the majority of these patients end up needing surgery over the years, either due to the progression of symptoms or the risk of complications.
Final considerations
Inguinal hernia is common and, most of the time, progresses slowly, but it should not be neglected. The diagnosis is simple, surgical treatment is safe and the results are usually excellent when the intervention occurs at the appropriate time.
Have you noticed a bulge in your groin or feel discomfort when exerting yourself? Early medical evaluation is essential to define the best course of action and avoid complications, ensuring greater safety and quality of life.
Dr. Antonio Couceiro Lopes (CRM/SP 100.656 | RQE 26.013) is a digestive system surgeon and member of Brazil Health.
