Health Insights · General health & symptoms
Hernias: what the lump means and when to act
A hernia is a bulge where an internal structure pushes through a weakness in the abdominal wall. Most are uncomfortable rather than dangerous and many can be watched. But a hernia that becomes trapped is a surgical emergency, and knowing the difference is the point of this leaflet.
Call 999 or go to an emergency department if a hernia
- becomes suddenly painful, hard or tender
- cannot be pushed back in when it previously could
- turns red, purple or dusky
- comes with vomiting, and not passing wind or stool
- comes with fever, a racing heart or feeling very unwell
- is in a baby or child and cannot be reduced
A strangulated hernia has lost its blood supply and the trapped bowel dies within hours. This is a surgical emergency requiring an operation the same day, not a wait-and-see. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
The common types
- Inguinal — groin, by far the commonest, much more frequent in men. May extend into the scrotum.
- Femoral — upper thigh, more common in women, and far more likely to strangulate, so usually repaired promptly.
- Umbilical and paraumbilical — at or near the navel. Common in babies, where most close on their own by age four or five.
- Incisional — through the scar of a previous operation.
- Hiatus — stomach through the diaphragm. Causes reflux rather than a visible lump, and is managed differently.
What you may notice
- a bulge that appears on standing, coughing or straining and disappears on lying down
- a dragging or aching discomfort, worse at the end of the day
- in men, swelling extending into the scrotum
- occasionally no symptoms at all, found on examination
- Hernias do not heal by themselves in adults, and they gradually enlarge.
Do small hernias need repairing?
Not always. For a small, painless inguinal hernia in a man that reduces easily, watchful waiting is a reasonable option — the risk of strangulation is low. Most people do eventually come to surgery because symptoms increase. Femoral hernias are different and are repaired promptly because of the strangulation risk, as are hernias that are painful, enlarging or difficult to reduce.
Surgery
- Open repair through a small incision, usually with a mesh, under local, regional or general anaesthetic.
- Keyhole repair, often preferred for hernias on both sides or recurrent hernias, and generally with less post-operative pain.
- Most repairs are day cases.
- Recovery: light activity within days; driving when you can perform an emergency stop without hesitation, usually one to two weeks; heavy lifting and manual work typically after four to six weeks.
- Bruising and swelling in the groin or scrotum is common and settles over weeks.
- Risks include recurrence, and in a small proportion persistent groin pain.
Living with one before surgery
Helps
- Treating constipation and avoiding straining
- Treating a chronic cough, and stopping smoking
- Losing excess weight, which reduces pressure and makes repair easier
- Lifting with technique, and avoiding very heavy single lifts
- Knowing the strangulation warning signs
Not recommended
- Trusses and support belts as a long-term solution — they do not treat it and can cause complications
- Pushing hard to reduce a hernia that has become painful
- Ignoring a hernia that is enlarging or newly uncomfortable
- Heavy gym work while a hernia is symptomatic
- Assuming a groin lump is a hernia without examination
Why come to us. A groin lump needs examining, and not every one is a hernia — enlarged nodes, a hydrocele, a lipoma and a femoral aneurysm all present similarly. We examine you, perform ultrasound on site in the same visit where the diagnosis is uncertain, advise honestly on whether repair is needed now or can be watched, and arrange surgery through our CQC-registered partners without a wait. 7 days a week, no referral needed.
Private hernia assessment in East London
A hernia is a bulge that appears when tissue pushes through a weak spot in the abdominal wall, often in the groin or around the tummy button, and may show up on standing or straining. A private GP in East London can examine you, arrange an ultrasound if the diagnosis is unclear, and refer for surgical assessment where repair is appropriate. Most hernias are not urgent, but a hernia that becomes hard, very painful and cannot be pushed back, especially with vomiting, may be trapped — call 999 or use our urgent care service straight away. Tower Bridge Hospital is on Whitechapel Road in East London, a short journey from Canary Wharf and the City, with same-day appointments and no referral required.
Hernias in London: common questions
Do all hernias need surgery?
Not always — small, painless hernias can be watched, while those causing symptoms or at risk of complications are usually repaired.
What are the warning signs of a trapped hernia?
A hernia that becomes firm, painful and irreducible, especially with vomiting or severe pain, may be strangulated and needs emergency care.
How is a hernia diagnosed?
Usually by examination; an ultrasound helps when the lump is small or the diagnosis is uncertain.
Can I be seen the same day?
Yes — same-day private GP appointments are available most days for assessment.
Examined and scanned in one visit
Ultrasound on site, honest advice on whether it needs repairing.