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. (See ‘What is a hernia’)
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.
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.