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A hernia occurs when an internal organ or tissue pushes through a weakened area in your muscle wall, most commonly in the abdomen or groin. While not all hernias require immediate surgery, certain warning signs indicate that surgical intervention is necessary to prevent serious complications.

Hernias will not go away on their own, so it is important to meet with a trained physician or hernia specialist who can evaluate your case and help develop a treatment plan specific to you. Understanding these critical warning signs could save your life.

Understanding Hernia Complications

Before diving into the specific signs, it's crucial to understand why timing matters. A strangulated hernia can be fatal if gangrene or sepsis sets in, making it a medical emergency that requires immediate surgical attention.

Top 10 Signs You Need Hernia Surgery

1. Severe or Worsening Pain

Daily activities may be limited due to pain. If you are experiencing pain or have a bulge in your abdomen or groin, it is important you see a doctor.

Pain that progressively worsens or becomes unbearable often indicates that the hernia is enlarging or potentially becoming incarcerated.

2. A Visible Bulge That Cannot Be Pushed Back

One of the most obvious signs of a problematic hernia is a visible bulge in your abdomen or groin that cannot be gently pushed back into place.

If a hernia can't be pushed in, the contents of the hernia may be trapped in the abdominal wall. This is known as an incarcerated hernia.

3. Nausea and Vomiting

When strangulation exists, the patient may present with bowel obstruction symptoms, including nausea, vomiting, and obstipation.

These symptoms often indicate that the hernia is affecting your digestive system, potentially blocking normal bowel function. When combined with other symptoms, this becomes a medical emergency.

4. Inability to Pass Gas or Have a Bowel Movement

Complete bowel obstruction is a serious complication of hernias that requires emergency surgery.

Other signs that you need emergency hernia surgery include: A bulge that doesn't go back inside the abdomen as it once did, nausea or vomiting.

5. Fever and Signs of Infection

Call 911 or your local emergency number if you have symptoms like fever and chills.

These symptoms suggest that tissue within the hernia may be dying due to lack of blood supply.

6. Sudden Color Changes in the Hernia

The skin around the bulge or lump in your abdomen or groin becomes paler than usual, then turns darker than usual. A hernia bulge that turns red, purple or dark is a clear sign of strangulation.

7. Rapid Heart Rate and Signs of Shock

Strangulated hernias cause excruciating abdominal pain, fever, nausea, vomiting and rapid heartbeat. If bowel ischemia is present, the patient has severe pain and may present with sepsis (hypotension, tachycardia).

8. Groin Pain Radiating to Other Areas

Pain, discomfort or pressure in the groin, especially when bending over, coughing or lifting. Occasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotum.

9. Progressive Weakness of the Abdominal Wall

Delaying hernia surgery will allow the hernia to grow and muscles will likely become weaker. This will make surgery and recovery more difficult.

10. Quality of Life Impact

Surgery, however, is the best treatment to have the best chance of return to a normal life.

When to Seek Emergency Care

Types of Hernias Most Likely to Require Surgery

Inguinal Hernias

Men are 8 to 10 times more likely to have an inguinal hernia than are women. These are the most common type, accounting for 75% of all hernias.

Femoral Hernias

Incisional Hernias

An incisional hernia occurs when tissue protrudes through a former incision in your abdominal wall that weakened over time. It's a common side effect of abdominal surgery.

Surgery Options and Recovery

Modern hernia surgery offers several approaches:

Minimally Invasive Options

The three main types of hernia repairs are open, laparoscopic and robotic surgery. With minimally invasive surgery, patients are back to their regular activity within two weeks.

Traditional Open Surgery

Open surgery is the other treatment option — recovery takes four to six weeks.

Success Rates

Risk Factors That Increase Urgency

Certain factors make surgical intervention more urgent:

• Age: Elderly patients may have higher complication rates
• Gender: A woman with an inguinal hernia is likely to also have a hidden femoral hernia behind it, which will only be found through surgery. Femoral hernias have a higher risk of complications
• Size of hernia: Larger hernias are more likely to cause complications
• Location: Femoral hernias have the highest strangulation risk
• Medical history: Previous surgeries or chronic conditions

Prevention and Early Management

While you cannot always prevent hernias, you can reduce your risk:

Stop smoking. Besides its role in many serious diseases, smoking often causes a long-lasting cough that can lead to an inguinal hernia or make an existing one worse.

The Bottom Line: Don't Wait

Remember: A hernia that starts as a minor inconvenience can quickly become a life-threatening emergency. If you recognize any of these warning signs, don't delay seeking medical attention.