A hernia occurs when an internal organ or fatty tissue pushes through a weak spot in the surrounding muscle or fascia. This protrusion creates a visible bulge, often in the abdomen or groin area. Many people notice a strange noise or gurgling sensation when they apply gentle pressure to the bulge. This phenomenon offers important clues about the composition and condition of the hernia, helping to clarify its nature and potential seriousness.
The Mechanism of the Sound
The noise heard when a hernia is manually pressed results from the contents within the hernia sac being displaced back into the abdominal cavity. This sound is medically termed borborygmi, which describes the rumbling or gurgling sounds made by the movement of fluid and gas in the intestines. When a loop of the small or large intestine pushes through the fascial defect, it carries the normal contents of the digestive tract: gas, partially digested food, and liquid.
Applying pressure to the external bulge squeezes these mobile contents, forcing them to rush through the constricted space as the bowel loop is pushed back through the opening. The characteristic gurgling or squishing sound is the acoustic result of this rapid displacement of gas and liquid through the bowel lumen.
This audible confirmation indicates that the hernia contains loops of the intestine. If the hernia contained only fat, such as omentum, the sound would be a soft, often silent, squish. The distinctive gurgling noise verifies the presence of mobile, fluid-filled structures within the hernia sac that are capable of being returned to their correct anatomical position.
Identifying Hernias That Make Noise
The noise phenomenon is specific to hernias that involve the visceral organs of the abdominal cavity, primarily the bowel. The most common types of abdominal wall hernias are the most likely candidates to produce the gurgling sound when manipulated, including the inguinal hernia, which appears in the groin area.
Umbilical hernias, occurring around the belly button, and incisional hernias, forming at the site of a previous surgical scar, also commonly contain bowel loops. These hernias represent defects in the abdominal wall fascia, allowing the intestines to push into the subcutaneous space. The presence of gas and fluid within the intestinal loops generates the acoustic effect upon reduction.
Conversely, hernias that do not typically contain mobile bowel loops rarely make this sound. A femoral hernia, located lower in the groin, or a hernia containing only fatty tissue like the omentum, may not be audible even if reducible. A hiatal hernia, where a portion of the stomach protrudes through the diaphragm, is located far from the external abdominal wall and would not produce a gurgling noise when the abdominal bulge is pressed.
The Clinical Significance of Reducibility
The ability to successfully push the hernia contents back into the abdominal cavity is known as reducibility. The gurgling sound confirms that the hernia is reducible. This state is generally considered a less complicated presentation, meaning the opening in the muscle wall is wide enough to allow the protruding tissue to move freely. This is a reassuring sign that the blood supply to the tissue is likely not compromised.
The opposite is an incarcerated hernia, where the tissue is trapped and cannot be manually returned to the abdomen. An incarcerated hernia is silent upon attempted manipulation because the contents are stuck fast. This inability to reduce the hernia increases the risk of a more serious complication.
The most dangerous state is a strangulated hernia, which occurs when the neck of the hernia sac is so tight that it cuts off the blood flow to the trapped tissue, most often a section of the bowel. Strangulation is a surgical emergency and is also irreducible and silent, but it is accompanied by systemic symptoms. The presence of the gurgling noise indicates that the tissue is not tightly constricted or cut off from circulation.
When to Seek Medical Attention
While the gurgling sound indicates reducibility and a less urgent state, all hernias represent a physical defect that requires medical evaluation. The underlying weakness in the muscle wall will not spontaneously heal, and the hernia is likely to grow larger or become more problematic. Consulting a healthcare provider allows for proper diagnosis, monitoring, and planning for definitive treatment, which is typically surgical repair.
Certain changes in the hernia’s condition warrant immediate, emergency medical care:
- The sudden inability to reduce the hernia, especially if accompanied by severe, sharp, or rapidly progressing pain.
- Systemic signs of distress, such as fever, nausea, or vomiting, which can indicate a bowel obstruction or strangulation.
- Any visible change in the skin over the hernia, such as developing a purple, red, or dark discoloration.
These signs suggest the blood supply to the trapped tissue has been cut off and require immediate surgical intervention.