You can check for most common hernias by looking and feeling for a bulge that appears when you stand up or bear down. The telltale sign is a lump near your groin, belly button, or along a surgical scar that becomes more noticeable when you cough, strain, or stand for a while, and may flatten or disappear when you lie down. That “now you see it, now you don’t” quality is what separates a hernia from most other lumps. Here’s how to do a thorough self-check and know what your findings mean.
The Standing Self-Check
The best time to check is after you’ve been on your feet for a while, since gravity helps push tissue through any weak spot in your abdominal wall. Stand in front of a mirror in a well-lit room, undressed from the waist down.
Start by simply looking. Scan your groin creases on both sides, the area around your belly button, and any spot where you’ve had surgery. You’re looking for any bulge, asymmetry, or swelling that isn’t normally there. Then bear down as if you’re trying to have a bowel movement, or give a firm cough. Watch those same areas closely. A hernia will often pop out visibly during that moment of increased pressure.
Next, use your fingers. Place your fingertips flat over the groin crease on one side, right where your thigh meets your lower abdomen. Cough or strain again and feel for anything pushing outward against your hand. Repeat on the other side. For an umbilical hernia, press gently around your belly button and cough. A soft bulge that pushes against your fingers during the strain, then retreats when you relax, is the classic hernia finding. This is essentially the same cough test a doctor performs during a physical exam.
What Each Type Feels Like
Hernias show up in different locations depending on where the abdominal wall is weakest, and the symptoms vary accordingly.
Inguinal Hernia
This is the most common type, especially in men. You’ll notice a bulge in the groin area, sometimes extending into the scrotum. It often feels like a dull ache or heavy dragging sensation that worsens with lifting, standing for long periods, or straining during bowel movements. The bulge may disappear completely when you lie flat.
Femoral Hernia
More common in women, a femoral hernia appears slightly lower than an inguinal hernia, in the inner upper thigh just above the groin crease. It can cause lower abdominal pain, nausea, and pain in the upper thigh that ranges from a deep ache to sudden sharpness. These hernias are smaller and easier to miss on self-exam, but they carry a higher risk of becoming trapped.
Umbilical Hernia
This shows up as a bulge at or near the belly button. It’s common in newborns but also develops in adults, particularly after pregnancy or significant weight gain. The lump becomes more obvious when you sit up, cough, or strain.
Incisional Hernia
If you’ve had abdominal surgery, tissue can push through the healing scar. Check along the full length of any surgical scar by pressing gently and coughing. A soft bulge along the scar line is the giveaway.
Hernias You Can’t Feel From the Outside
Not all hernias produce a visible lump. A hiatal hernia occurs when part of your stomach slides upward through an opening in your diaphragm into your chest cavity. There’s no bulge to feel. Small hiatal hernias often cause no symptoms at all and are discovered incidentally during imaging for something else.
Larger hiatal hernias tend to announce themselves through persistent heartburn, acid reflux, regurgitation of food or liquid, difficulty swallowing, chest or abdominal pain, and feeling full unusually quickly during meals. Some people experience shortness of breath. If these symptoms are ongoing, an upper endoscopy or specialized X-ray (a barium swallow) is typically how they’re confirmed.
How to Tell a Hernia From Other Lumps
Not every lump in the groin or abdomen is a hernia. The key distinction is whether the lump changes with your body position.
A hernia bulge typically appears or enlarges when you stand and reduces or vanishes when you lie down. It often feels soft and may be gently pushed back in. Fatty lumps (lipomas) and sebaceous cysts, by contrast, are soft or firm lumps that stay the same size regardless of whether you’re standing or lying flat. They don’t disappear when you relax, and they tend to be slow-growing and painless. Swollen lymph nodes in the groin are usually firm, fixed in place, and may be tender if there’s an active infection nearby.
A couple of conditions can mimic the disappearing-bulge pattern of a hernia. Diastasis recti, a separation of the abdominal muscles, creates a football-shaped ridge down the midline of the belly that’s most visible when you do a sit-up or strain. In women, endometriomas can form tender, cyclical lumps near C-section scars. A doctor can distinguish these from true hernias during an exam.
What Happens at the Doctor’s Office
In most cases, a physical exam is all that’s needed to confirm an inguinal hernia. Your doctor will examine you both standing and lying down, because the pressure difference between positions can reveal hernias that aren’t obvious in just one. You’ll be asked to cough or bear down while they feel the area.
When a hernia is suspected but can’t be confirmed by touch alone (called an occult hernia), imaging is the next step. Ultrasound is the preferred first-line test. When performed by experienced specialists, it picks up groin hernias with a sensitivity above 96% and is especially good at catching small or femoral hernias that are easy to miss on physical exam. CT scans are less reliable for occult inguinal hernias, with sensitivities ranging from only 54% to 80%, so ultrasound is generally the better option for groin concerns. CT becomes more useful for complex or internal hernias.
Risk Factors Worth Knowing
Understanding what increases your risk can help you decide how closely to monitor yourself. Anything that chronically raises pressure inside your abdomen makes a hernia more likely. That includes long-lasting constipation (and the straining that comes with it), a persistent cough from smoking or lung conditions, heavy lifting, standing or walking for many hours each day, and pregnancy. Prior abdominal surgery creates a weak point in the muscle wall. A family history of hernias also raises your odds.
If several of these apply to you and you notice even a subtle bulge or unexplained groin discomfort, it’s worth getting checked. Femoral hernias in particular can be small enough to overlook but are more prone to complications.
When a Hernia Becomes an Emergency
Most hernias are not dangerous. They may cause discomfort or grow slowly over time, but they aren’t immediately harmful. The serious exception is a strangulated hernia, where the trapped tissue loses its blood supply. This is a medical emergency.
The warning signs are hard to miss: sudden, severe pain in the abdomen or groin that keeps getting worse, nausea and vomiting, and skin color changes around the bulge. The skin may first turn paler than usual, then shift to a reddish or darker color. If the bulge that you were previously able to push back in suddenly becomes firm, painful, and won’t reduce, that’s a sign the tissue may be trapped. Get to an emergency room immediately if this happens.
Watching and Waiting vs. Repair
Finding a hernia doesn’t automatically mean you need surgery right away. For inguinal hernias that cause mild symptoms or none at all, watchful waiting is a legitimate approach, particularly for men over 50. A long-term randomized trial following patients for 12 years found that watchful waiting was not inferior to having surgery upfront. The majority of people in the monitoring group did eventually choose to have surgery as symptoms progressed over the years, but delaying repair didn’t lead to worse outcomes.
The decision comes down to how much the hernia bothers you, how quickly it’s growing, your overall health, and the type of hernia involved. Femoral hernias are more often repaired promptly because of their higher strangulation risk. For other types, you and your doctor can weigh the timing together based on your symptoms and daily life.