Can a Hernia Exist Without a Bulge?
Well, if you ask an average person about a hernia, most likely they will describe it as a visible bulge coming out of the abdomen or groin area. Though this is true in most of the cases, in some patients this visible bulge is absent. In such cases, the possibility of misdiagnosis is higher, and treatment might also be delayed. So it is important to know about these hidden hernias and identify the signs to get the proper medical treatment.
How do hernias occur?
In simple terms, a hernia is defined as an organ or part of the intestine making a forced entry or protruding through a weak spot in the tissue lining the abdomen and through the surrounding layers. Since the abdominal wall is naturally weaker in some areas like the groin, belly button, linea alba (midline), upper thigh, etc., those areas can be marked as hernia spots. Depending on the areas they occur, hernias are classified into various types, such as inguinal hernia, femoral hernia, umbilical hernia, and ventral hernia, each of which has its own distinct features as well as risk of complications.
Mostly, hernias are the result of a combination of increased pressure inside the abdomen and a weak abdominal muscle wall. Usually people with hernias experience symptoms like pain in the groin or belly area when they cough, are constipated, and especially while performing any physical activities like lifting heavy weights. These activities exert more pressure on the abdominal wall. However, sometimes patients can experience such intense pain even in the absence of a visible hernia bulge, which indicates that the patient has a hidden hernia.
Why do some hernias not have any visible bulging?
There are many reasons why the hernia bulge is not visible outside. For instance, the hernia might be very small, or it is located deep inside the abdomen, which makes it quite difficult for the hernia to pop out. Hiatal hernias occur without causing an external bulge—a section of the stomach is pushed up through the esophageal opening of the diaphragm, thereby affecting only the internal organs. Sports hernia, also known as athletic pubalgia, is a tear of the muscle or tendon in the lower abdomen area that can cause groin pain without any visible bulge.
Also, in some cases hernias can come and go, which means that the bulge will appear when you cough or strain, and when you relax, it disappears. These are called reducible hernias and can be missed sometimes during a casual self-examination, which is why consulting a hernia expert is necessary for correct diagnosis.
Signs of Hidden Hernias
Patients suffering from a hernia without a visible bulge can experience continuous groin pain, abdominal pain, or a sudden sharp pain in the lower abdomen, which might become worse when involved in physical activities. Also, patients might experience difficulty in passing stools and a feeling of heaviness around the pubic bone area, and the symptoms might get aggravated with strenuous activities. The nature of the pain could be burning, aching, or pulling, which can restrict patients’ regular activities.
Experts say that these invisible hernias are more common in women compared to men, and the symptoms are also different from men, which is why women are underdiagnosed for this condition. These invisible hernias can result in severe pain in the pelvic region and might be misdiagnosed as other conditions.
The risk of developing a hidden hernia increases if any of your family members had it or have a birth defect, etc. In addition, strenuous physical activities (lifting heavy weights, rigorous exercising), chronic cough, and obesity can also increase the risk of developing these hernias.
How are these hidden hernias treated?
Doctors perform thorough physical checkups along with some advanced scanning procedures, such as CT scans or ultrasounds, which can diagnose even the smallest hidden hernias that are missed during routine checks. Diagnosing these hidden hernias at the early stages is very important to prevent serious complications like strangulation, where the blood supply gets cut off and requires immediate medical intervention.
Various treatment methods are available to fix these hernias: one can go for laparoscopic surgery, where tiny cuts are made and special instruments, including a camera, are used to make it less invasive, or an open surgery for large and complex hernias. With the help of advanced surgical techniques, surgeons can push back the hernia contents to their place and, at the same time, use mesh if required to strengthen the abdominal wall to prevent recurrence.
Dr. Venugopal Pareek is an experienced laparoscopic surgeon in Hyderabad who can diagnose and treat all kinds of hernias, including the invisible hernias. He uses the latest diagnostic technology for accurate diagnosis and advanced surgical equipment for effective treatment to ensure the best outcomes. Call +91 91777 77715 to book your appointment with the doctor.
