Hernias large or small … can happen to anyone

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The bulge in your stomach started small, so you ignored it and hoped it would go away. Unfortunately, over time it became larger and more painful. You have all the classic signs of a hernia — it is time to see a doctor.

What is a hernia?

A hernia is caused by a weakening or tear of the abdominal wall. This weak spot can allow an internal organ or tissue to push through the wall.

Washington University physician Jeffrey Blatnik, MD, specializes in minimally invasive surgery. He explains, “Hernias come in all different shapes and sizes. The simplest hernias are called primary hernias. They can occur in anyone and at any time in life. They tend to get larger with time.  

More complicated hernias tend to occur after other surgical procedures and are called incisional hernias. These can also vary tremendously from very small to incredibly large and can happen in over 40% of individuals undergoing other surgical procedures. We know there are certain factors that increase the risk for forming hernias after surgery which include smoking, being overweight and wound infection. They can occur any time from a couple months to several years after surgery.”


Most people will first notice a lump or bulge in the area of the hernia. This may happen around the same time they notice some discomfort, such as pain, burning or tingling. This tends to be worse with physical activity such as lifting or standing for long periods. Hernias tend to enlarge with time. This can happen very slowly or very rapidly. As they get larger, the repair process gets more complicated.


There is no medication to make hernias go away. The only method for correcting hernias (especially in adult patients) is surgery. Most patients diagnosed with a hernia do not need emergency surgery and have time to schedule an elective procedure. The signs and symptoms that make surgery more urgent include enlargement of the hernia, worsening symptoms of pain and discomfort and history of obstructions or bowel blockages.

There are cases in which the hernia gets stuck in the tear in the abdominal wall and may have some of the blood supply cut off. This is called acute incarceration or strangulation. Patients will often notice really bad pain in the area and the hernia will be hard and unable to be pushed back in. This can be a surgical emergency, and anyone experiencing these symptoms should seek urgent medical attention.”

Each patient and hernia requires a unique approach for the best long-term outcome. The type of surgery needed is based on:

  • The patient’s past medical and surgical history
  • Characteristics of the hernia
  • If the patient has had any previous hernia repairs

There are two types of hernia repair surgery: minimally invasive (several small incisions) and open repair (one large incision). Advances in robotic techniques for hernia repair mean many patients are now candidates for minimally invasive procedures which reduce the amount of time in the hospital and overall recovery time.

Dr. Blatnik adds, “The typical downtime after hernia surgery depends on the type of hernia and repair technique. Simpler hernias can often be done as an outpatient, and many patients can get back to some of their normal activities in as little as a couple weeks. Many of the larger and more complex hernias require hospitalization and a longer recovery.”

For more information, or to make an appointment with Dr. Blatnik or one his Washington University Hernia Center colleagues, Sara Holden, MD, and Arnab Majumder, MD, please call 314-362-9000 or schedule online.

Center for Advanced Medicine
Gastrointestinal Center, Suite 12B
4921 Parkview Place
St. Louis, MO 63110

Barnes-Jewish West County Hospital
Medical Building 4, Suite 310
1044 N. Mason Road
Creve Coeur, MO 63141