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Reducing Your Risk of Hernia: Ventral & Groin Hernias Explained for Older Adults

It’s always disconcerting when you discover a lump, bump or bulge. As you get older, hernias are worth understanding so you can stay ahead of your health and know your treatment options.

 

While some hernias are caused by genetic factors, others may be prevented by taking practical steps to reduce your risk of hernia. In this article we look at what ventral and groin hernias are, when hernias become a medical emergency, who is at risk, how to reduce your risk, and what treatment could involve.

Reducing Your Risk of Hernia

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Typically occurring in your abdomen or groin, a hernia occurs when a part of an organ or tissue pushes through a weak spot in the muscle or tissue that contains it. Most hernias involve an organ like the intestines, pushing through the abdominal wall and resulting in a bulge – this is a hernia.

 

Hernias can affect anyone, even babies are born with them. However, hernias are more common in older people, as our abdominal wall gradually weakens with age and the strain placed on it adds up over your life. Here are some examples of how you put strain on your abdominal wall:

 

  • Being overweight.
  • Constipation.
  • Pregnancy.
  • Lifting, carrying, pushing things.
  • Coughing or sneezing.

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The most common types of hernias are groin and ventral hernias.

Inguinal hernia

Inguinal hernias account for 75% of all hernias, mostly affecting men. They occur when tissue protrudes through a weak spot in your inguinal canal, a passageway that runs down either side of your pelvis. In men it carries the spermatic cord, and in women the round ligament of the uterus.

Not all inguinal hernias have symptoms, but symptoms you may notice include:

  • A bulge in the groin on either side of your pubic bone. This may extend into down to your scrotum or labia.
  • Pain and/or pressure in your groin, especially with movement or strain.
  • A radiating feeling of aching or pinching across the pelvis or down the leg.

Ventral hernias

A ventral hernia is a hernia that occurs through the front of the abdominal wall. There are a few types:

 

  • Umbilical hernias, occur in and around the natural weak spot of abdominal wall at the belly button. These are one of the most common types of hernias.
  • Epigastric hernias, occur in the epigastric region in the upper part of your abdomen. 
  • Incisional hernias, occur where you have had an abdominal incision from abdominal surgery.

 

Not all ventral hernias have symptoms, but symptoms you may notice include:

 

  • A lump or bulge in your abdomen (tummy).
  • Pain and/or pressure at the site of the bulge.
  • Abdominal pressure makes the hernia more pronounced.
  • Bloating or constipation.

When is a hernia a medical emergency?

A strangulated hernia can become a life-threatening medical event if not treated as soon as possible. A strangulated hernia occurs when the blood supply is cut off to the piece of intestine or tissue that is within the hernia bulge.

 

Without treatment as soon as possible, the intestines or tissue cut off from blood supply will begin to die in as little as four hours. Necrotic tissue can lead to extremely serious and potentially fatal conditions like gangrene or sepsis.

 

Symptoms of a strangulated hernia can include:

  • Severe pain, that can begin suddenly.
  • Changes to appearance of hernia, becoming red, purple or darker.
  • The hernia becomes firm and/or tender.
  • Nausea and vomiting.

 

A strangulated hernia must be examined by a doctor as soon as possible. If you have the symptoms of a strangulated hernia you should head to your nearest urgent care (A&E).

Who is at higher risk of hernias?

Here are some of the risk factors that put you at higher risk of hernias.

  • Age, as we get older our muscles naturally weaken. Older adults who have weaker abdominal walls are at a higher risk.
  • Sex, men are much more likely to get inguinal hernias. This is due to biological differences.
  • Weight, if you are overweight or obese your abdomen is under more stress/pressure putting you at higher risk.
  • Pregnancy also puts pressure and strain on the abdominal wall. The abdominal wall muscles are stretched during pregnancy, putting you at higher risk of an umbilical hernia.
  • Family history of hernia can be an indicator of your future risk of hernia, for example due to a family history of weaker abdominal muscles.
  • Chronic coughing puts repeated stress on the abdomen, chronic coughs are often seen in smokers.
  • Constipation increases your risk of hernia through straining, putting pressure on the abdomen.

Practical ways to reduce your risk of hernia

There are some practical ways to reduce your risk of hernias. Here are some of the steps you can take:

 

  • Maintain a healthy body weight through regular exercise and a balanced diet.
  • Strengthen your core muscles using exercises like crunches, pelvic tilts, bridges, modified planks, seated leg lifts, and standing core presses.
  • Lift safely by using proper lifting techniques. Avoid straining your muscles, bend at the knees, use your leg strength, and keep objects close to your body.
  • Improve bowel health with a healthy diet high in fibre and drink plenty of water.
  • Manage chronic cough and lung conditions by taking any prescribed medication and stop smoking if you do.
  • Take care after any abdominal surgery, to make sure abdominal incisions heal well.

Diagnosis and treatment

If you suspect you have a hernia book a physical exam with your healthcare provider. They will be able to diagnose it, determine how serious it is, and recommend next steps. This could be waiting and seeing for small, painless hernia or surgery. Most hernia surgery methods are minimally invasive, and your surgeon will make a decision based on their experience and judgment.

How your pharmacist can help

If you are worried about hernias here are some ways our pharmacists can help:

 

  • Review your medicines, identifying ones that may worsen constipation or coughs.
  • Recommend appropriate laxatives, fibre supplements, or stool softeners to help with bowel health.
  • Help with smoking cessation and smoking cessation products.
  • Provide guidance on safe pain management while waiting for surgery.

 

Pharmacists are a great point of contact for personalised advice on reducing your risk of hernia, especially if you take multiple medicines.

Resources:

  • Havard Health Publishing – The best core exercises for older adults (External Link)

  • Healthify – Abdominal hernia (External Link)

  • Cleveland Clinic – Ventral Hernia: What It Is, Symptoms, Types, Treatment & Repair. (External Link)

  • Cleveland Clinic – Inguinal Hernia: Types, Causes, Symptoms & Treatment. (External Link)

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