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Thursday, September 24, 2020

Direct and Indirect Hernia: Causes, Symptoms and Treatment

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A hernia has become one health condition that makes life almost unbearable for suffers. It occurs when an internal organ or body part bulges through the surrounding tissues that protect it.

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A hernia can show up in different areas of the abdomen. The most common type of hernias is the inguinal hernias.

This kind of hernia forms when there is a thin spot of the wall of your abdomen.An inguinal hernia can either be labelled direct or indirect. The classification depends on when and how it forms.

There is also a chance that the sex and age of the person dealing with a hernia will contribute to determining what kind of a hernia it is.


Both a direct and an indirect hernia can trigger a bulge on either side of the groin depending on how big the hernia is. The hernia bulge can be noticed easily when coughing, straining, or standing.

In a lot of cases, hernias do not cause any pain until they grow larger. Men can sometimes feel the pain in the scrotum if the intestine pushes low enough into that region.

An indirect hernia occurs first during infancy most of the time. The reason for this is that hernia is usually a congenital condition. An indirect hernia is usually more noticeable in babies when they cry.

A direct hernia develops majorly during adulthood; later in life in most cases except when the issue is a result of a specific injury.


A direct hernia usually happens when the wall formed by the abdominal muscles become weak. The weakness will allow a portion of the intestine bulge through the stomach wall. The abdominal weakness can happen over time gradually, due to ageing and also the nature of daily activities a person engages in.

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There are cases where heavy lifting of objects the wrong way puts extra pressure on those stomach wall muscles, and it allows them to weaken and tear. An indirect hernia is neither caused by injured or weakened abdominal muscle.

However, it happens when the inguinal ring (an area of abdominal muscle tissue) doesn’t close up while the baby is still in its mother’s womb.

In male children, the inguinal ring allows their testicles to drop into the scrotum before it proceeds to close up. However, when it fails to close up, a part of the child’s intestine can push through the opening.

Risk factors

The risk factors for a direct hernia includes

  1. Having a family history of people with a hernia
  2. Being a man, even though women can also get a hernia
  3. Smoking
  4. Having a low body max index
  5. Having a condition that causes you to cough seriously
  6. Having collagen vascular disease

Even though it has been noticed that weightlifters who do not engage in lifting their weights correctly, usually report having a hernia, it remains unclear if indeed heavy lifting increases the chances that people will develop a hernia.

For an indirect hernia, there are no significant risk factor asides being a man. It has been discovered that a male is nine times more likely to develop an indirect hernia than a female.


Doctors usually diagnose a hernia through physical examination. Your doctor might be able to feel for a bulge in the groin and identify it as a hernia.

It can be difficult to tell the difference between a direct and an indirect hernia. Most individuals who have a hernia and are in their early 20s or younger, most likely have an indirect inguinal hernia.

If a doctor finds that a man’s hernia has extended into his scrotum, the diagnosis will be an indirect hernia most of the time. A direct hernia never follows the opening of the inguinal ring into a person’s scrotum.

What that means is that any a hernia that forms on one side or the other of the groin is likely to be a direct hernia.

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There are cases where an indirect hernia may cause bowel obstruction. This can occur when a part of the intestine slips into the inguinal ring and gets swollen in the abdomen.

The condition can become worse and get into the phase called “strangulation” which can affect the flow of blood in the intestine. It is extremely rare for a direct hernia to cause bowel strangulation.


If the hernia you have is mild and it causes no symptoms, there might be no need for you to do anything except to wait. Hernias are not like other conditions that heal on their own, so you have to undergo a surgery in future whether a hernia is direct or indirect.

Surgeries done to fix indirect hernias in babies and young children are safe most of the time. In fact, it is an outpatient procedure. The doctor moves the hernia sac away from any sensitive part or the scrotum and proceeds to close up with sutures.

A few of the children who have an indirect hernia on one side may develop one on the other side as well. This is an ongoing debate in the medical community on the need to investigate the possibility of a second hernia. If you have any inquiry on the benefits and risks of the procedure, speak with a surgeon ahead of time.

In adults, open surgery is carried out to fix a direct hernia. The surgeon makes a large incision and then moves the hernia back into place. After the hernia has been moved back in place, the surgeon repairs the abdominal wall by sometimes adding a small mesh device to provide added strength to the wall.

A growing option for different types of abdominal surgeries is laparoscopic surgery, and that includes hernia operation. To carry out this procedure, a doctor has to make a few tiny incisions through which he will insert the instruments to be used.

One of the instruments to be inserted is a small camera that will allow the surgeon to see the problem and fix it.

Laparoscopic surgery is the best option for a recurrent hernia because it involves less scarring of the abdominal muscles.

You can prevent the condition of your hernia from getting worse by avoiding heavy lifting, smoking, and other activities that will strain your abdominal muscle.

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Surgeries for a hernia are usually successful however it will take a few weeks for you to get back to living your life as usual.

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Disclaimer: This article is purely informative & educational in nature and should not be construed as medical advice. Please use the content only in consultation with an appropriate certified medical or healthcare professional.

Emmanuella Ekokotu
Ekokotu Emmanuella is a sociologist and Anthropologist, writer, and fashion model who lives in Benin city, Edo state,Nigeria.
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