A hernia occurs when an organ or tissue protrudes through a weak spot in the surrounding muscle or connective tissue. This protrusion can create a bulge, often in the abdomen or groin, and may or may not be accompanied by pain. While a cough is not a universal direct symptom of all hernias, there are specific types and circumstances where a connection between a hernia and coughing can exist. This article explores the relationship between certain hernias and coughing, and how coughing impacts existing hernias.
How Certain Hernias Can Lead to Coughing
A hiatal hernia is the primary way a hernia can lead to coughing. A hiatal hernia develops when a portion of the stomach pushes upward into the chest cavity through an opening in the diaphragm, the muscle separating the chest from the abdomen. This anatomical shift can disrupt the normal function of the lower esophageal sphincter, a muscular ring that usually prevents stomach acid from flowing back into the esophagus.
When the lower esophageal sphincter is compromised due to a hiatal hernia, stomach acid can reflux into the esophagus, causing gastroesophageal reflux disease, or GERD. Chronic acid reflux irritates the lining of the esophagus. Sometimes, acid or vaporized stomach contents travel into the throat and airways. This irritation can trigger a persistent “reflux cough” as the body attempts to clear the irritant.
While less common, some large or incarcerated abdominal hernias could, in rare instances, indirectly contribute to a cough. This might occur if the hernia causes significant discomfort, pressure on surrounding organs, or changes in abdominal mechanics. However, the direct link between hernias and coughing is overwhelmingly associated with the mechanisms of hiatal hernias and subsequent acid reflux.
The Reverse: Coughing’s Impact on Hernias
Forceful coughing significantly increases intra-abdominal pressure, which can have a direct impact on existing hernias or contribute to their formation. When a person coughs, the abdominal muscles contract, pushing downward and outward on the abdominal contents. This surge in pressure can exacerbate a pre-existing weak spot in the abdominal wall.
For individuals with an existing hernia, this increased pressure can force more tissue or organs through the weakened area, making it larger or more noticeable. The bulge may become more prominent during coughing, and some individuals might experience increased discomfort or pain at the hernia site. Repetitive strain can worsen the weakened tissue, leading to hernia progression.
Chronic, forceful coughing, such as that experienced by individuals with conditions like chronic bronchitis, asthma, or a smoker’s cough, can also contribute to the development of new hernias. The repeated episodes of elevated intra-abdominal pressure can gradually weaken the abdominal wall muscles and connective tissues. Sustained stress can create new openings or weak points, potentially leading to common hernia types like inguinal or umbilical hernias.
When to Seek Medical Advice
It is advisable to consult a healthcare professional if you experience a persistent cough, especially if it is accompanied by new or worsening symptoms related to a hernia.
Seek immediate medical attention if you notice any of the following, as these could indicate a serious complication like strangulation or incarceration:
- Sudden, severe pain at a hernia site
- The hernia bulge becomes red, swollen, or tender to the touch
- Nausea
- Vomiting
- Fever
- An inability to push the hernia back in
- Changes in bowel habits
Even without these severe symptoms, any new bulge or pain in the abdomen or groin area should be evaluated by a doctor. A medical professional can accurately diagnose the type of hernia and determine if it is contributing to your cough, or if your cough is impacting the hernia. Treatment options vary and may include monitoring the hernia, making lifestyle adjustments to manage reflux-related coughs, or considering surgical repair to address the hernia itself.