A hernia occurs when an organ or fatty tissue pushes through a weak spot in the surrounding muscle or connective tissue. This creates a bulge, commonly in the abdomen or groin. A hernia will not heal on its own and tends to worsen. Understanding the consequences of an untreated hernia is crucial for timely medical attention.
How Untreated Hernias Progress
If left untreated, hernias typically increase in size as the weakened area expands. This enlargement can lead to increased discomfort, pain, and pressure in the affected area. The growing bulge may become more noticeable, particularly when standing, coughing, or straining.
Different types of hernias progress in specific ways. For instance, an untreated inguinal hernia can enlarge and, in men, may extend into the scrotum, causing painful swelling. Umbilical hernias can also grow larger and become prone to complications. Hiatal hernias can worsen acid reflux symptoms, leading to chronic heartburn and esophageal damage. Incisional hernias, forming at previous surgical sites, can progressively enlarge, causing persistent pain.
Life-Threatening Complications
While hernias often progress gradually, they can lead to life-threatening complications if the protruding tissue becomes trapped or its blood supply is compromised. These complications arise when the opening through which the hernia protrudes constricts, squeezing the contents.
One such complication is incarceration, where the herniated tissue, often a portion of the intestine, becomes trapped within the hernia sac and cannot be pushed back into its normal position. An incarcerated hernia may not immediately cut off blood flow, but it can cause significant pain, tenderness, and swelling. If the trapped tissue is part of the intestine, it can lead to a blockage, preventing the normal passage of food and waste.
Strangulation is a more severe complication, often developing from an incarcerated hernia. This occurs when the constricted opening completely cuts off the blood supply to the trapped tissue. Without adequate blood flow, the tissue begins to die. Strangulation is a medical emergency, as dead tissue can release toxins, leading to severe infection, sepsis, and fatal outcomes.
Bowel obstruction is another serious risk, particularly with inguinal, umbilical, or incisional hernias involving the intestine. This happens when a segment of the intestine becomes kinked, compressed, or blocked within the hernia, stopping the flow of digestive contents. Symptoms include severe abdominal pain, bloating, nausea, vomiting, and an inability to pass gas or have a bowel movement. A bowel obstruction can quickly escalate to strangulation if the intestinal loop’s blood supply is compromised.
Recognizing Emergency Signs and Seeking Care
It is important to recognize warning signs that indicate a hernia has progressed to an emergency. Sudden, severe pain at the hernia site is a significant indicator. The bulge may become firm, tender, or change in color, appearing red, purple, or dark.
Other concerning symptoms include nausea, vomiting, fever, or the inability to have a bowel movement or pass gas. If the hernia cannot be pushed back in when it previously could, this suggests incarceration. Any of these signs warrant immediate medical attention, typically by going to an emergency room, as prompt treatment can prevent life-threatening complications.