Inguinal hernia: symptoms, surgery and recovery

The abdominal wall is a layer of muscle that holds your internal organs in place. A hernia forms where part of an organ, such as the bowel, pushes through a gap or weak area in that muscle. The NHS lists the inguinal hernia as the type that occurs where the leg joins the abdomen, in the groin, and separates it from hiatus, umbilical, femoral, lumbar and stoma hernias.

Inguinal hernias are the form most people think of when they hear the word hernia. They typically show as a bulge in the groin that can be felt or seen, and the size of the bulge varies from day to day.

The NHS general hernia page says the lump may get bigger when you cough, sneeze or cry and smaller when you lie down. The skin over it may look tight and stretched. A heavy, dragging feeling in the leg can come from an inguinal hernia. Pain can occur with smaller hernias, and the NHS notes that a large hernia may look uncomfortable yet not hurt, because the stretched muscle lets it pass through easily.

See a GP if you think you have a hernia. They may refer you for tests or treatment if needed.

A hernia can become trapped so that blood supply to the bowel is cut off, which is called strangulation. The NHS advises getting help from NHS 111 if you have a hernia together with any of the following:

• pain in or around the hernia

• a bloated tummy

• feeling or being sick, or vomiting blood or vomit that looks like coffee grounds

• constipation

• a high temperature, or feeling hot, cold or shivery

• sudden confusion

The NHS says you might have a repair if the hernia is causing symptoms such as pain, or to prevent a blocked bowel or a strangulated hernia, and that a hernia that causes no symptoms may not need treatment. In practice that makes the decision a conversation between you and a surgeon, weighing how much the lump bothers you, your job and activities, and your general health.

The type of surgery offered depends on where the hernia is, how big it is and your general health. For both approaches the hernia is pushed back into place and a thin sheet of mesh is usually placed over the weak spot and fixed with small stitches, although sometimes stitches alone are used.

The NHS says recovery usually takes up to 4 to 6 weeks, but can take longer. It describes some bleeding from the wound for a couple of days, pain around the wound for a few days, bruising or swelling around the wound or genitals for a couple of weeks, and numbness below the wound that usually fades.

• Take painkillers such as paracetamol or ibuprofen if needed.

• Keep moving with gentle exercise such as walking and build up slowly.

• Keep the wound covered, clean and dry, and hold a hand over it when you cough or sneeze.

• No heavy lifting or strenuous activity for at least 4 to 6 weeks.

• No bath or swimming until the wound has healed, usually around 2 weeks.

• Check with your healthcare team and insurer before driving again.

The NHS calls complications uncommon. They include wound infection, a lump or swelling where the hernia was that can last weeks or months, a large painful bruise in the groin or genitals lasting a few months, pain or numbness in the groin that may last longer than 3 months, the hernia coming back, damage to the bowel, blood vessels or bladder, and blood clots.

After surgery, contact NHS 111 for pus from the wound, a hot, red, swollen or very painful wound, fever, a worsening swollen tummy, heavy bleeding, vomiting beyond 24 hours, throbbing or cramping leg pain, or breathlessness. Call 999 for chest or upper back pain, severe difficulty breathing, coughing up more than a few flecks of blood, or a racing or irregular heartbeat, as these can signal a blood clot in the lungs.

The NHS says you cannot always prevent a hernia, but you can lower the chance of some types by keeping to a healthy weight, staying active (at least 150 minutes of moderate or 75 minutes of vigorous activity a week), stopping smoking and seeing a GP about a cough that does not clear. The British Hernia Society is the NHS's suggested source for a Living with a hernia guide.