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An abdominal wall hernia is a weakness in the muscles of the abdominal wall.
When a hernia occurs, it can cause pain, and sometimes fat or intestines from the abdominal wall can bulge out.
The abdominal wall is made up of muscle and tissues that attach those muscles to each other and to bone. These provide strength to the abdominal wall to hold all of the contents of the abdominal cavity inside. Sometimes there is an opening in the abdominal wall allowing what is inside to push through to the outside. This is called a hernia.
Some hernias occur in natural openings in the abdominal wall that allow body structures to go from the inside to the outside of the body. For example, an umbilical hernia occurs in the abdominal wall near the belly button (umbilicus) where the umbilical cord was.
Several types of hernias may occur in the groin area. In men, the tubes that carry sperm from the testicles to the penis travel from inside to the outside of the abdominal cavity. The location in the groin where this occurs is a very common place to get a hernia. These are known as inguinal hernias. Sometimes hernias occur low in the groin, where blood vessels travel from inside the abdomen to the legs. These are called femoral hernias.
When people have abdominal surgery, sometimes the incisions where the abdominal cavity was entered do not heal well, and a hernia can form in this location. These are known as incisional hernias. In the October 18, 2016, issue of JAMA, there is an article reporting on long-term outcomes for abdominal wall incisional hernia repair.
If you have a hernia, it is best to avoid straining and heavy lifting. If you have to strain to urinate, you should be evaluated by a clinician to see if it can be treated. Avoiding constipation is a good idea, and using laxatives or stool-bulking agents like psyllium may be helpful. You should be evaluated by a physician to determine if you should have the hernia repaired.
Hernias are repaired by surgeons. They close the hernia either by pulling the muscles at the edge of the hernia together with stitches (sutures) or by placing synthetic mesh material over the defect. Although most hernias should be repaired, if you do not have pain or there is little risk of damage to the intestines because the hernia is present, surgery can be avoided.
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at www.jama.com. Spanish translations are available in the supplemental content tab. A previous JAMA Patient Page on hernia was published in the May 25, 2011, issue of JAMA.
Sources: Kokotovic D, Bisgaard T, Helgstrand T. Long-term recurrence and complications associated with elective incisional hernia hepair. JAMA. doi:10.1001/jama.2016.15217
Itani KMF. New findings in ventral incisional hernia repair. JAMA. doi:10.1001/jama.2016.15722
Topic: Digestive Diseases
Livingston EH. What Is an Abdominal Wall Hernia?. JAMA. 2016;316(15):1610. doi:10.1001/jama.2016.15755