A hernia can lead to constipation, but usually only under specific circumstances. While both hernias and constipation are common, a simple, uncomplicated hernia rarely causes constipation directly. The connection is far more significant when a hernia causes a physical blockage or when indirect factors, such as pain management, come into play.
Defining Hernias and Constipation
A hernia occurs when an internal part of the body, such as a segment of the intestine, pushes through a weakness in the surrounding muscle or tissue wall. These protrusions frequently occur in the abdomen or groin, leading to a visible lump or bulge. Common types include inguinal hernias in the groin, which are the most frequent, and umbilical hernias near the belly button.
Constipation is defined as having infrequent bowel movements, typically fewer than three per week, or experiencing difficulty passing stool. Stool often becomes hard, dry, or lumpy because it moves too slowly through the large intestine, allowing too much water to be absorbed. While diet, hydration, and activity levels are common causes, other medical conditions or certain medications can also trigger this digestive issue.
The Mechanism of Bowel Obstruction
The most direct way a hernia causes constipation is by physically blocking the digestive tract, a complication known as bowel obstruction. This blockage begins when the protruding tissue becomes trapped in the muscle wall defect, a condition referred to as incarceration. Inguinal and femoral hernias are particularly prone to this issue because they often involve a segment of the small intestine or colon.
When a loop of intestine is trapped, the passage through which waste normally travels becomes narrowed or completely closed off. This physical barrier prevents stool, liquids, and gas from moving forward, resulting in sudden and severe constipation. If this obstruction is not resolved, the trapped bowel segment can lose its blood supply, becoming a life-threatening strangulated hernia.
Indirect Causes of Constipation Related to Hernias
A hernia can lead to constipation even without causing a direct physical blockage. One common factor is pain avoidance, where individuals avoid straining during a bowel movement due to the discomfort caused by the hernia. This reluctance to strain slows down bowel motility, creating a cycle where constipation worsens the hernia and the hernia worsens the constipation.
Pain management associated with a hernia can also contribute to digestive slowdown. Pain relievers, particularly opioid medications prescribed for discomfort or after surgery, are well-known to cause constipation. Changes in diet, such as reduced fluid or fiber intake due to general discomfort or pre-surgery fasting, also slow the movement of waste through the intestines.
Recognizing Emergency Symptoms
Constipation that is sudden and severe in a person with a known hernia may indicate a medical emergency, such as an incarcerated or strangulated hernia. The inability to pass gas or stool suggests a complete intestinal blockage. This requires immediate medical attention to prevent serious complications.
Signs of a complicated hernia include a sudden, sharp increase in pain and a hernia bulge that is firm, tender to the touch, and cannot be pushed back in. Additional emergency indicators are severe abdominal cramping, nausea, vomiting, or a fever. The skin over the hernia may also become discolored, appearing red, purple, or blue, which signals that the blood supply to the trapped tissue has been cut off.