Hernias are a relatively common reason why adults might need surgery. But what is a hernia, how do you know if you have one and when should you see a doctor? What is a hernia? A hernia occurs when part of your intestines, stomach or other internal organ pushes through a gap in a muscle wall. The most common type of hernia is called an inguinal hernia. It mostly affects men and causes a lump in the groin area. Different types of hernias can occur in various locations between the chest and hips. Hiatus hernias are less common and occur when part of the upper stomach pushes through an opening in your diaphragm muscle, or chest wall.   How do I know if I have a hernia? Depending on the size and location, a hernia may cause a lump or bulge you can see or feel. The lump may increase in size over time and protrude more with physical activity, laughing, coughing, or straining. It may be possible to push the lump back inside the body. Other symptoms include: ● Pain at site of the bulge ● Pain on exertion or while lifting ● Bloated sensation   Hiatus hernias do not cause a bulge on the outside of the body but may cause symptoms such as heartburn, indigestion and acid regurgitation.   What causes a hernia? A hernia is caused when pressure on your intestine or other organ in your body occurs in an area where there is a weak spot in muscle or tissue. Most often, muscles weaken with age or repeated strains although some people are born with weak or poorly developed muscles.   Factors that may increase your risk of developing a hernia include: ● Lifting weights incorrectly ● Excessive weight gain or obesity ● Pregnancy or childbirth ● Frequent, persistent coughing ● Straining on the toilet due to constipation.   When should I see a doctor? If you notice a lump or experience other symptoms such as pain while lifting, running or straining on the toilet, you should consult a doctor. Hernias tend to get worse over time, so it is better not to ignore it.   If you have a hernia and experience the following symptoms you should get emergency medical assistance right away: ● The hernia becomes firm or tender, or cannot be pushed back in ● sudden, severe pain ● being sick ● difficulty pooping or passing wind These symptoms can occur when the blood supply to a section of organ or tissue trapped in the hernia has become cut off (strangulated hernia), or if there is a bowel obstruction. A strangulated hernia and obstructed bowel are medical emergencies and need to be treated as soon as possible.   Does my hernia require treatment? If your hernia is large, increasing in size, causing pain or other symptoms then it will need treatment. A small hernia which is not causing any problems may not need immediate treatment, but it should still be monitored. Hernias do not get better on their own and tend to increase in size leading to potential complications and increased pain.   Is surgery needed? Surgery is often required to repair the defect in muscle or soft tissue. The surgery needed will depend on the type and size of the hernia. Surgical mesh is often used to repair larger defects in muscle or soft tissue. Early repair often gives better outcomes and reduces the risk of complications. For suitable cases, laparoscopic or keyhole surgery can reduce bleeding, scarring and other potential complications. Laparoscopic surgery is performed through very small incisions (cuts) using a flexible telescopic instrument, with a light and a video camera to guide the surgeon. Robotic assisted hernia repair is a type of laparoscopic surgery that uses robotic technology to help the surgeon perform complex procedures more precisely. Your surgeon will be able to advise you on the risks and benefits and which is most suitable for you.   Remember: If you think you may have a hernia, don’t ignore it. Left untreated, hernias can increase in size and lead to complications.