Are Hernias Hereditary?

Instructor: Kaitlin Baker

Kaitlin has taught nursing students and has a master's degree in nursing leaderhsip, as well as a bachelor's degree in English literature.

This lesson will discuss the definition of a hernia, types of hernias, and their causes. The main focuses of this lesson will be on whether hernias are hereditary.

What is a Hernia?

Joe has had a busy weekend. He has been working in the hospital as a nurse as well as playing on his community hockey team at night. While moving a heavy patient at the hospital, Joe noticed a ''popping'' feeling in his lower abdomen, near his groin. When he got home that night, he noticed a lump in that area that would pop out further when he coughed. Joe is concerned because his father had two hernias, and he is worried that the condition might be hereditary. Joe decides to make an appointment with his doctor.

Later that week, Joe's doctor confirms that he indeed has a hernia: a weakness or tear in the muscles of the abdomen that causes a protrusion (bulging) of fatty tissue or the intestines through that weak spot.

Each hernia is different, the doctor explains, and the symptoms can come on suddenly (like Joe's did) or gradually worsen. Symptoms may include: the feeling of something ''giving way'' or rupturing; a feeling of weakness, pressure, or burning in the abdomen, groin, or scrotum; a bulge or lump in these areas that is easier to see when you cough and disappears when lying down; or cause pain with straining, coughing, or laughing (although some people have no pain).

Types of Hernias

Not all hernias are created equal. They can actually occur anywhere within the abdominal wall: layers of skin, tissue, and muscle that enclose and keep the abdominal organs in place and protect them from outside injury.

The abdominal wall

The most common types of hernias are:

  • Umbilical Hernia - Fatty tissue or intestine pushes through the abdomen near the navel (belly button).These hernias are most common in infants and often resolve on their own. In adults, however, these hernias do not resolve on their own and usually need surgical repair.

An umbilical hernia

  • Hiatal Hernia - Part of the stomach protrudes through the abdominal wall upward into the chest cavity. These hernias often lead to acid reflux and heartburn.

A hiatal hernia

  • Femoral Hernia - Femoral hernias are a type of groin hernia. Groin hernias in the groin area: the area where the inner thigh and torso meet the genital region. In femoral hernias, tissue drops into the femoral canal: a space in the upper, inner thigh. This type of hernia is most common in older women.
  • Inguinal Hernia - This second type of type of groin hernia is more common in men. The location of these hernias is the inguinal canal, which consists of 2 passageways that deliver sperm to the testicles in men, and contain ligaments of the uterus in women. In men, these passageways are larger and more vulnerable to injury. In inguinal hernias, fatty tissue from the inguinal canal or intestine pushes into the groin at the upper, inner thigh

A large groin hernia

  • Incisional Hernias - These hernias occur when tissue pushes through the incision site of a previous surgery, usually in the abdomen.

Hernias may occur at the area of an abdominal incision

What Causes a Hernia?

Hernias may have several different causes, but most involve some type of weakness in the abdominal wall that allows abdominal tissue to push through the place where it is usually enclosed in the abdominal wall. Once the hernia pushes through the abdominal wall, it will often continue to get bigger until it is repaired.

  • Umbilical Hernia - These are usually caused by straining (such as with lifting heavy objects, straining with bowel movements, frequent strong coughing, or childbirth). Babies have a natural weakness in this area at birth from where umbilical cord was attached, and are more likely to have umbilical hernias.
  • Hiatal Hernia - These hernias result from a weakness in the diaphragm (the muscle that separates the chest from the abdomen and helps the lungs expand).
  • Femoral Hernia - These hernias (more common in women) are often caused by pregnancy or childbirth.
  • Inguinal Hernia - Weakened muscles, either as a result of aging or repeated strain, allow these hernias to occur. Examples of strain include: obesity, lifting weights, pregnancy, frequent coughing, or constipation.
  • Incisional Hernia - The tissue of the site of a surgical incision is weakened often even after it fully heals, making hernias in these areas more common.

Are Hernias Hereditary?

Joe's doctor diagnoses him with an inguinal hernia, and suggests that it is probably a result of frequent straining to lift patients and lifting heavy weights to improve his hockey game. Joe asks his doctor, 'But is this hereditary? Do I have a hernia because my dad had them?'

'It's a bit of a complicated answer,' Joe's doctor says, and begins to explain:

Hernias themselves are not hereditary, which is defined as genetically transmissible from parent to child. The direct cause of hernias is weakness in the muscles that support the abdominal area. Activities such as heavy lifting can aggravate that weakness and result in a hernia.

Age, injury, and surgery can contribute to weakening those muscles. Men are more prone to hernias than women due to differences in anatomy. Some hernias are congenital, which means that they are present at birth at a point of weakness in the abdominal wall, which is different from being hereditary. However, adults may also present with congenital hernias that were previously too small to detect.

While hernias are not hereditary, weak muscles can be! Certain families are genetically more prone to weak muscles, which are the underlying cause of hernias.

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