Hernia Symptoms and Diagnosis
The classic hernia symptom is a bulge that appears when standing or coughing and disappears when lying down — but symptoms vary by hernia type and location, and some hernias cause no symptoms at all.
Contents
General symptoms
Whatever the type of hernia:
- A bulge or lump under the skin of the abdomen, groin or navel.
- It appears or grows with standing, coughing, sneezing, straining or lifting.
- It shrinks or disappears when lying down or with gentle pressure.
- Heaviness, pulling or pressure at the site.
- Pain or burning that worsens with exertion and at the end of the day.
- A gurgling sensation inside the bulge.
Symptoms by type
| Hernia | Typical symptoms |
|---|---|
| Inguinal | Groin bulge, may descend into scrotum; lower abdominal dragging |
| Femoral | Small lump in the inner upper thigh below the crease, mostly women |
| Umbilical | Protruding navel or bulge around it |
| Epigastric | Small painful lump in the upper abdomen, stomach-like pain |
| Incisional | Bulge in an old scar, may be large with multiple defects |
| Hiatal | Heartburn, reflux, swallowing difficulty, chest pain — no external bulge |
| Spigelian | Lateral abdominal pain with a vague lump |
| Obturator | Inner thigh/knee pain, bowel obstruction in a thin elderly woman |
Hernia symptoms in women
Hernias in women may be smaller and harder to detect: chronic lower abdominal or pelvic pain without an obvious bulge, pain linked to the menstrual cycle, or a small swelling in the labia or upper thigh. Ultrasound or MRI is often needed, with attention to the dangerous femoral hernia.
Self-check
- Stand in front of a mirror and expose your abdomen and groin.
- Look for any asymmetric bulge.
- Cough hard or strain and watch for a protrusion.
- Lie down and check whether it disappears.
- If you notice anything, see a doctor — never press forcefully on the bulge.
Warning signs
Go to the emergency department for: sudden severe hernia pain, a hard bulge that will not go back, red/purple/dark skin, nausea and vomiting, abdominal distension, no passage of gas or stool, or fever — signs of incarceration or strangulation.
Diagnosis
- Clinical examination — standing and lying, with cough or Valsalva. Sufficient in most cases.
- Dynamic ultrasound — quick, radiation-free; ideal for small or occult hernias and to differentiate lymph nodes, cysts and varicoceles.
- CT — best for large incisional, complex and rare hernias, surgical planning and emergencies.
- MRI — for unexplained groin pain, sportsman's hernia and occult hernias in women.
- Hiatal hernia tests — endoscopy, barium swallow, pH and manometry. See hiatal hernia.
Conditions that mimic a hernia
Enlarged lymph nodes, lipoma, hydrocele and varicocele, diastasis recti, muscle strain and adductor tendinopathy, cysts and abscesses. Assessment by a hernia specialist avoids misdiagnosis. Next: hernia causes and treatment options.
Frequently asked questions
Can I have a hernia without a bulge?
Is hernia pain constant?
How can I tell a hernia from a lipoma?
Scientific references
⚠ This website is for health education and does not replace a medical examination. If you develop sudden severe pain at a hernia, vomiting, or the bulge changes colour, go to the emergency department immediately.