Inguinal hernia: symptoms, diagnosis and treatment

An inguinal hernia occurs when tissue pushes through a weak area in the lower abdominal wall near the groin. It may form a bulge in the groin or scrotum and can be more noticeable when standing, coughing or straining. It is also known as a groin hernia.

Some people notice a soft groin lump, pressure, burning or an ache that develops with activity. An inguinal hernia can present with abdominal pain, and some men notice discomfort extending towards the testicle. A hernia may be painless, especially at first. Sudden severe pain, a firm tender lump that will not settle, vomiting, or a swollen abdomen needs urgent assessment.

The groin contains a natural passage through the abdominal wall. An inguinal hernia can develop when this area is weak or when pressure inside the abdomen repeatedly pushes tissue through it. Some people have a weakness from birth, while in others it develops over time.

A hernia may stay similar for a while or gradually become more noticeable. Symptoms often fluctuate with physical effort, constipation or coughing. Hernias do not close by themselves, although avoiding triggers can reduce discomfort. A clinician can explain whether watchful waiting or repair is appropriate for your symptoms and circumstances.

Repeated heavy lifting, chronic cough, constipation and straining to pass urine can increase pressure in the abdomen. Previous abdominal surgery, pregnancy, ageing and a family tendency may also be relevant. These factors do not mean a person will develop a hernia, but they can help guide prevention and treatment discussions.

A clinician will ask about the lump, pain and activities that bring symptoms on. Examination is often done standing and may include asking you to cough or bear down. If the examination is unclear, an abdominal ultrasound can help assess the groin area and rule out other causes of a lump or pain.

Treatment depends on symptoms, the hernia's features and your general health. A small hernia with minimal symptoms may be monitored with a safety plan. Surgery repairs the weakness and is commonly considered when pain interferes with daily life, the bulge is enlarging, or complications are a concern. Your surgical team can discuss the approach, recovery and individual risks.

Until a care plan is in place, avoid activities that reliably trigger pain and manage constipation or cough with clinical advice. Supportive underwear may feel more comfortable for some people, but it does not repair the hernia. Note changes in the lump, pain, bowel symptoms and ability to reduce usual activities so you can describe them clearly at review.

Occasionally, tissue caught in a hernia can become trapped, affecting the bowel or its blood supply. This may cause sudden pain, a tender non-reducible bulge, nausea, vomiting or abdominal swelling. Do not try to force a painful lump back in; seek urgent medical care instead.

Not every hernia can be prevented, especially when there is an existing weakness. Keeping bowel habits regular, addressing a long-lasting cough, using careful lifting technique and maintaining a weight that is suitable for you can reduce repeated strain. After repair, follow the activity advice provided by your surgical team.

A GP consultation can assess a new groin lump or pain and arrange referral when needed. An abdominal ultrasound may be used if the diagnosis is uncertain. Seek urgent in-person care rather than waiting for a routine appointment if severe pain, vomiting or a tender persistent bulge develops.