Abdominal (Ventral) Hernia: Symptoms, Causes & Treatment

Have you noticed a bulge in your stomach that wasn’t there before? Or maybe you’ve been experiencing discomfort when lifting, coughing, or straining? These could be signs of an abdominal, or ventral, hernia. This happens when tissue or part of an organ pushes through a weak spot in the abdominal wall, creating a noticeable lump. Some hernias develop slowly, while others appear after surgery, injury, or heavy lifting.

While some hernias are mild, others can cause pain or lead to complications if left untreated. This article looks at the symptoms, causes and treatment options for ventral hernias, to help you recognise early warning signs and understand when to seek medical care.

What Are the Symptoms of Abdominal (Ventral) Hernia?

​​Symptoms of an abdominal (ventral) hernia can vary from mild discomfort to severe, life-threatening complications. Recognising these signs early is crucial for timely treatment.

• Lump in the Abdomen: The most obvious sign is a soft bulge under the skin, often near the belly button or at a previous surgical site. It is usually more noticeable when standing, coughing or straining and may flatten when lying down.
• Pain or Discomfort: Some hernias cause mild aching, while sudden or severe pain may signal a trapped (incarcerated) hernia that needs urgent care.
• Nausea and Vomiting: These symptoms could suggest that part of the intestine may be obstructed within the hernia sac.
• Fever: A rise in temperature may indicate infection or tissue strangulation.
• Discolouration of the Skin: Redness or a bluish tint could mean the blood supply is affected, which is a situation that requires immediate attention.
• Inability to Push the Bulge Back In: A hernia that cannot be pushed back manually is likely incarcerated and at risk of strangulation.
• Difficulty Passing Stool or Gas: This may indicate a complete intestinal blockage and is a surgical emergency.

What Causes an Abdominal (Ventral) Hernia?

A hernia occurs when a weak spot in the abdominal wall meets increased pressure inside the abdomen, forcing tissue or organs to push outward. While some people are born with weaker abdominal walls that make them more prone to hernias, most cases develop gradually over time due to repeated strain or muscle weakening.

Common causes include:

• Previous Abdominal Surgery: After surgery, the incision site may remain weaker than the surrounding tissue. If healing is incomplete or scar tissue forms unevenly, a hernia can appear months or even years later.
• Chronic Coughing: Persistent coughs from conditions like COPD or long-term smoking can strain abdominal muscles.
• Chronic Constipation: Straining during bowel movements increases internal pressure and puts stress on the abdominal wall.
• Heavy Lifting: Frequent lifting without proper technique can cause or worsen abdominal wall weakness.
• Obesity: Excess weight increases constant pressure on abdominal tissues, making them more prone to herniation.
• Pregnancy: Multiple pregnancies or carrying large foetuses can stretch and weaken the abdominal muscles, especially around the midline, making them more prone to separation or herniation.

How Is an Abdominal (Ventral) Hernia Diagnosed?

• Physical Examination: During the consultation, your doctor will examine your abdomen and may ask you to stand, cough, or strain gently. These movements increase abdominal pressure, helping the hernia become more noticeable.
• Ultrasound: This non-invasive test uses sound waves to create images of the abdominal wall. It helps distinguish a hernia from other lumps, such as cysts or tumours, and is useful for detecting small or hidden hernias.
• CT Scan: For more detailed imaging, a CT scan can show cross-sectional views of the abdomen. It’s especially useful for identifying complex hernias or checking for blockages.
• MRI: MRI offers high-resolution images of soft tissues and is sometimes used for complex cases. It helps assess the size of the defect and surrounding structures, aiding in precise surgical planning.

How Is an Abdominal (Ventral) Hernia Treated?

Treatment options vary depending on the hernia’s size, location, symptoms, and your overall health. In most symptomatic or high-risk cases, hernia surgery is recommended to prevent serious complications.

• Conservative Management: If the hernia is small and not causing any pain, your doctor may suggest monitoring it with regular check-ups. However, using a truss or support belt is not usually recommended, as it doesn’t repair the weakness and can cause skin irritation.
• Open Repair: This traditional method involves making an incision over the hernia site, placing the tissue back in its proper position, and strengthening the area with a mesh to reduce the risk of recurrence.
• Laparoscopic Repair: Using several small incisions and a camera-guided laparoscope, the surgeon repairs the hernia internally with mesh placement. This minimally invasive approach typically results in less pain and a faster recovery.
• Robotic-Assisted Surgery: This advanced technique allows precise control and improved visualisation, making it ideal for complex or recurrent hernias. It ensures accurate mesh placement and a more targeted repair.

Potential Risks and Complications

• Incarceration
  This happens when the hernia’s contents become trapped and cannot be pushed back into the abdominal cavity. It often causes pain, swelling and discomfort. Although not immediately life-threatening, it can quickly worsen if blood flow to the trapped tissue becomes restricted.
• Strangulation
  Strangulation is a medical emergency. When the blood supply to the trapped tissue is cut off, the tissue can die (necrosis) within hours. This leads to severe abdominal pain, fever and nausea, and if left untreated, can result in bowel perforation, infection or even sepsis.
• Intestinal Obstruction
  A trapped section of the bowel can block the passage of food and gas, leading to cramping, bloating, nausea and vomiting. This condition requires urgent medical attention to prevent further complications.

If you notice a persistent bulge, discomfort or pain in your abdomen, it's best not to wait. Early evaluation can help prevent complications and ensure you get the right treatment. Reach out today to discuss your symptoms and explore options for your recovery.