There are more than a half-dozen distinct types of hernias, each named for the spot in the body where tissue pushes through a weak point in muscle or connective tissue. Most hernias involve part of the intestine or stomach bulging through a gap in the abdominal wall or diaphragm. Some are extremely common, others are rare, and a few require emergency treatment. Here’s what sets each type apart.
Inguinal Hernia
Inguinal hernias are the most common type overall. They occur when part of the bowel pushes into the inguinal canal, a passageway that runs from the abdomen down into the inner thigh. You’ll typically notice a bulge in the groin area that may ache or burn, especially when you cough, bend over, or lift something heavy.
There are two subtypes. An indirect inguinal hernia enters the canal through an opening at the top that was supposed to close before birth but didn’t seal completely. This is why indirect hernias are especially common in children: they affect up to 4.5% of kids, including about 2% of baby boys and 1% of baby girls. Premature babies are up to 30% more likely to develop one. A direct inguinal hernia, by contrast, pushes straight through the wall of the canal itself. It develops over time as abdominal muscles weaken with age and repeated strain, making it far more common in middle-aged and older men.
Femoral Hernia
A femoral hernia is a less common groin hernia that appears in the femoral canal, which runs just below the inguinal canal along the upper thigh. It shows up as a bulge near the crease of the groin or the top of the inner thigh. Femoral hernias occur roughly 10 times more often in women than in men, largely because the wider bone structure of the female pelvis leaves more space in the femoral canal for tissue to slip through.
Anything that increases pressure inside the abdomen can contribute: obesity, heavy lifting, chronic coughing, straining during bowel movements, or conditions like COPD. Femoral hernias deserve attention because they carry a higher risk of becoming trapped and cutting off blood supply to the protruding tissue compared to other groin hernias.
Umbilical Hernia
An umbilical hernia occurs when part of the intestine pokes through an opening in the abdominal wall near the belly button. In babies, this often appears as a soft bulge at the navel, especially when the child cries or strains. The good news for parents: most close on their own. Research published in the New England Journal of Medicine found that 90% of small umbilical hernias (1 cm or less) and 80% of larger ones closed spontaneously within five years, with most resolving by age three.
Adults can develop umbilical hernias too, particularly with obesity, pregnancy, or repeated strain on the abdominal wall. Adult umbilical hernias don’t close on their own and generally require surgical repair if they cause pain or grow larger.
Hiatal Hernia
Unlike other hernias on this list, a hiatal hernia doesn’t involve the abdominal wall. It happens when the opening in the diaphragm where the esophagus passes through widens, allowing the top of the stomach to push up into the chest cavity. There are two main varieties.
A sliding hiatal hernia is by far the more common one. The stomach and the lower portion of the esophagus slide upward through the opening together. Many people with sliding hiatal hernias have no symptoms at all; when symptoms do appear, they usually involve acid reflux and heartburn.
A paraesophageal hiatal hernia is less common but more concerning. Part of the stomach pushes up alongside the esophagus rather than sliding with it, which can cause the stomach to twist or become compressed. Symptoms include chest pain, upper abdominal pain, difficulty swallowing, shortness of breath, and feeling full very quickly after eating. In some cases, the twisted stomach develops ulcers. Because these hernias can mimic heart-related chest pain, your doctor will typically want to rule out cardiac causes before attributing symptoms to the hernia.
Epigastric Hernia
An epigastric hernia forms in the midline of the abdomen between the breastbone and the belly button. It results from a defect or weakness in the abdominal wall that allows inner tissue or fat to protrude, creating a small bump. These hernias are often small, sometimes barely noticeable, and may only cause discomfort when you strain or press on the area. They don’t resolve without surgery, but repair is straightforward when symptoms become bothersome.
Incisional Hernia
An incisional hernia develops at the site of a previous surgical incision in the abdomen. Scar tissue is never as strong as the original muscle, and over time the abdominal contents can bulge through the weak spot. A large study tracking over 3,900 patients after abdominal surgery found that about 5% developed an incisional hernia within the first year and roughly 10% within two years. Risk factors include infection at the surgical site, obesity, and activities that put pressure on the healing incision. The hernia typically appears as a bulge along or near the scar line that becomes more prominent when you stand, cough, or lift.
Spigelian Hernia
A spigelian hernia is rare and can be tricky to diagnose. It occurs when part of the intestine pushes through a gap between the front abdominal muscles in the lower belly, typically appearing as a lump about two to three inches to the side of the belly button. Because the bulge can sit between layers of muscle rather than pushing outward visibly, small spigelian hernias sometimes cause no noticeable lump at all. Doctors may need a CT scan or ultrasound to confirm the diagnosis, and they may ask you to stand, stretch, or bear down to see if a bulge appears under pressure.
When a Hernia Becomes an Emergency
Most hernias are uncomfortable but not immediately dangerous. The two complications that change that are incarceration and strangulation. An incarcerated hernia means the protruding tissue has become trapped and can no longer be pushed back into place. It requires surgical repair. A strangulated hernia is worse: the trapped tissue loses its blood supply entirely, which can lead to tissue death. Strangulation is a medical emergency.
Warning signs include sudden, severe pain at the hernia site, nausea or vomiting, a bulge that turns red or dark, and the inability to pass gas or have a bowel movement. These symptoms call for immediate medical attention regardless of the hernia type.