Inguinal Hernia

Inguinal hernia is the most common type of hernia, affecting thousands of people in Singapore every year. This condition can happen to both men and women, although it is more common among men. They also affect all age groups, from children to the elderly. While it is generally not dangerous, inguinal hernias tend to grow and potentially cause serious complications if left untreated.

What is an Inguinal Hernia?

An inguinal hernia occurs when one’s intestinal tissue protrudes through a weak muscle in the abdominal wall near the pubic bone. This common condition affects more men than women. In men, the inguinal canal is a passageway for the spermatic cord and blood vessels into the testicles; in women, it holds the round ligament that supports the womb.

What Causes an Inguinal Hernia?

The primary causes of inguinal hernias are increased abdominal pressure and a weakened abdominal wall. This combination can push tissue through the weak spot, resulting in a hernia. Several factors can contribute to these factors, such as:

• Genetics – Some people inherit a natural weakness in their abdominal muscles, making them more prone to developing inguinal hernias.
• History of Inguinal Hernia or Repair – Previous inguinal hernias or repairs can weaken the abdominal wall, making one more susceptible to future inguinal hernias.
• Gender – Men are more likely to develop inguinal hernias than women due to anatomical differences, such as natural weakness in the groin area.
• Premature Birth – Babies born prematurely may have underdeveloped abdominal muscles, leaving them with weaker walls.
• Obesity – Excess weight can put continuous extra pressure on the abdominal muscles, increasing the strain on the weak areas.
• Pregnancy – Hormonal changes and the growing uterus can weaken the abdominal wall, adding pressure to the abdomen.
• Chronic Cough – Persistent coughing can increase pressure within the abdomen, especially in areas that are already weak.
• Chronic Constipation – Straining during bowel movements due to constipation can put excessive pressure on the abdominal muscles.

Signs and Symptoms of an Inguinal Hernia

The symptoms of an inguinal hernia may vary depending on the patient's age. Common signs and symptoms include:

• Adults
  • A bulge on either side of the groin, which increases in size when standing up, coughing, or straining
  • Pain or discomfort in the groin, especially when lifting, coughing, or exercising
  • A burning or aching sensation
  • A swollen scrotum in men
  • Weakness or pressure in the groin
• Newborns or Children
  • A bulge in the groin area, often more noticeable when the infant is crying, coughing, or straining during bowel movement
  • Irritability
  • Reduced appetite
  • Swelling or tenderness in the groin

Possible Complications of Inguinal Hernias

Inguinal hernias can lead to several complications if left untreated. Common complications include:

• Increasing Pressure – As the hernia grows over time, the protruding tissue can put pressure on the nearby muscles, nerves, and organs in the abdominal and groin areas.
• Incarceration – Growing, untreated hernias may result in incarceration, where the herniated tissue becomes trapped in the groin and cannot be pushed back into place. This can lead to significant discomfort and pain, increasing the risk of further complications.
• Bowel Obstruction – In some cases, an inguinal hernia may cause a blockage in the intestines, leading to nausea, vomiting, and abdominal pain.
• Strangulation – In more severe cases, it can lead to strangulation, where the intestine in an incarcerated hernia has its blood flow cut off. This can cause tissue death and requires emergency surgery.

How to Prevent Inguinal Hernias

Preventing inguinal hernia involves adopting certain healthy habits to help reduce your risk. Beyond maintaining a healthy weight and quitting smoking, here are some specific measures for inguinal hernia prevention:

• Consume Fibre-rich Foods – A fibre-rich diet helps prevent constipation, which reduces strain on the abdominal muscles, a common cause of hernia formation.
• Avoid Heavy Lifting – Whenever possible, avoid lifting heavy objects to reduce abdominal strain. If lifting is necessary, use proper techniques to minimise the risk of injury.