Dear Doctor Column
August 27, 2001

I am a 28-year-old man. While working out with weights, I experienced a pain in my abdomen down to my groin. Now, the pain regularly flares up after my workouts. This has been going on for about two weeks, and I am afraid that I have a hernia. Does this sound like a hernia? What kind of treatments are available?

Answer:

You need to see your doctor right away for a thorough examination to determine if you have an inguinal hernia.

An inguinal hernia is a condition in which part of the intestine bulges through a tear in muscles and tendons in the lower abdomen or groin area. It is common in baby boys and older men. If a hernia occurs in a younger man, it most often develops suddenly after lifting or carrying something that is unusually heavy. Inguinal hernias are rare in women, who account for fewer than one-tenth of all cases.

Hernias can occur in various parts of the body, but the most common is the inguinal hernia, the area between the abdomen and thigh. It is called "inguinal" because the intestines push through a weak spot in the inguinal canal, which is a triangle-shaped opening between layers of abdominal muscle near the groin.

The hernia may or may not result in a visible bulge. Symptoms can include tenderness and pressure or discomfort when bending over, coughing, straining or lifting something heavy, which is caused from the constant pressure of tissue pushing its way through the weakened spot. As more tissue pushes through the area, the feeling of pressure increases.

The doctor diagnoses a hernia by performing a physical examination, often asking you to cough as he examines the inguinal canal to determine if it is clear or filled with intestinal tissue. Even though an inguinal hernia is generally not serious, surgery is usually recommended. Without it, complications are possible. Tissue or intestine may protrude through the opening and become stuck (incarcerated), which requires surgery - perhaps on an emergency basis - to reposition the tissue and repair the defect. Incarceration can lead to strangulation, meaning the blood supply in the protruding tissue is cut off. The result can be life-threatening gangrene of the bowel, although this is a rare occurrence.

While complications can occur with any surgery, today's surgical and anesthesiology techniques have greatly decreased the risk of problems. Most patients undergoing surgical repair of an inguinal hernia today experience minimal post-operative discomfort, a speedy recovery and lasting relief.

To help prevent the development of an inguinal hernia: maintain muscle strength with regular exercise; avoid constipation by eating a healthy, high-fiber diet that contains plenty of fruit, vegetables and whole grains; drink plenty of fluids (an average 8 cups a day); lose weight if you are overweight; and use proper form (lift with the legs and not with the back) when picking up or carrying heavy loads.