Do I have hernia?

An abdominal hernia is simply a hole in the abdominal wall muscle through which something can protrude. The hole itself is rarely painful.  So you will only have discomfort when the swelling protrudes.  As soon as the swelling goes back -reduces – the discomfort should disappear.

When something protrudes through the hole – usually intestine or the fat around the intestine – you will see or feel a swelling under the skin. There is sometimes, but not always, some discomfort as well – but it is not excruciating pain.

Is there always a swelling?  So in the vast majority of cases, for groin or inguinal hernias there is an obvious swelling, seen under the skin, which aches a bit and which disappears when you lie down.  That is why doctors examine you standing and coughing when checking for a hernia.

And that means that if there is no swelling or lump to see or feel it is unlikely that there is a hernia.

But I have pain! and my doctor thinks it could be a hernia.. Yes it could be – but unlikely if you were examined properly, standing up,  and there really was no swelling or lump.

Are there any tests, xrays or scans, that could help?– Ultrasound, CT scan or MRI scan sometimes help.  But in my experience ultrasound tends to ‘over diagnose’ hernias. They often report a ‘possible’ or ‘small’ hernia when really it is just some fat pushing out or normal body wall movement when you strain or cough.

Ultrasound– I would say it is at best unhelpful and at worst frankly misleading.