Hernias happen. They happen to overweight, out-of-shape smokers, and they happen to highly-trained athletes. They happen to persons who strain too much while lifting, and they happen to those who merely sit in a chair. While they are more common in men, they also occur frequently in pregnant woman.

A hernia occurs when a small portion of tissue from inside pushes through a weak spot in the abdominal wall. In about 75 percent of cases, this happens in the inguinal canal, the area where the abdomen meets the thigh. Men are 25 times more likely than women to develop an inguinal hernia, and the bulge sometimes protrudes into the scrotum.

Other abdominal hernias likely to affect women as well as men include femoral (also in the groin, nearer the thigh), umbilical (around the naval) and epigastric (above the stomach).

It was once believed that hernias were caused by heavy lifting, coughing or straining. Those activities may well bring on a hernia if a weakness already exists in the abdominal tissue, but the current belief is that the weakness is usually caused by an impairment in collagen metabolism. When this weakness already exists, smoking, infection and obesity – as well as straining – can increase the risk.

If you have a hernia, you may not know it until a doctor detects it on a routine examination. The hernia can be seen or felt as a tender bulge or round lump that becomes more prominent when you cough, strain or stand up. In the early stages, it’s possible to push the protruding tissue back in place temporarily.

A break in the abdominal wall will not get better on its own. And a serious problem could occur if fatty tissue or an organ gets trapped inside the hernia (known as “incarceration”) and deprived of blood flow (“strangulation”). Because of the risk of tissue death, strangulation is a life-threatening condition requiring emergency surgery. New surgical approaches to treat hernias aim include stitching a mesh patch made of synthetic material into the defect. Another new approach is laparoscopic surgery – using three smaller incisions rather than one large one and a thin scope to view and repair the hernia.

As far as the patient is concerned, the best procedure is usually the one with which the surgeon has had the most experience. Not all hernias require surgery, however. Adults choosing to delay surgery might need to wear a truss, belt or other device in order to handle every day activities without pain or discomfort.

If you have a small hernia that doesn’t cause symptoms, there’s no need to let it worry you. When it becomes large enough to cause you pain, you should not have trouble finding an experienced surgical team to help you.