An expert’s guide to hernias

Written by: Mr Timothy Rees Worthington
Edited by: Cal Murphy

Hernias are a relatively common condition that many of us will experience in our lifetimes. However, it is surprising how little most of us understand about what hernias are, how they occur, and how many different varieties there are. We turned to leading surgeon Mr Tim Worthington, who answered the most common questions about hernias.

What is a hernia?

A hernia is a weakness, usually in the muscular wall of a cavity (either the chest or abdomen) which allows for some of the contents of the cavity to pass through it.


How do you know if you have a hernia?

The symptoms of a hernia are a lump, which may be intermittent, and pain. Occasionally, hernias can cause obstruction of their contents, such as in the case of bowel hernias. Hiatus hernias (the stomach herniating near the oesophagus) can cause symptoms such as heartburn and acid reflux.


What different types of hernia are there?

There are many different types of hernia. The most common are in the groin, either being inguinal or femoral hernias.

Inguinal hernias occur when part of the tissue inside the abdomen, such as the intestine, pushes through a weak spot in the lower abdominal wall. They are seen more frequently in men and may appear as a lump in the groin or scrotum.

Femoral hernias are similar but less common, with fatty tissue or part of the bowel herniating through the groin near the top of the thigh. They are more common in women.

A hiatus hernia is where part of the stomach moves upwards into the chest. It occurs due to weakness of the diaphragm between the abdomen and the chest. 


What are the commonest types of hernia and how are they repaired?

The commonest types are groin hernias and the commonest type of groin hernia is an inguinal hernia. Generally speaking, we tend to recommend surgical repair for inguinal hernias, because they can lead to complications. Increasingly, we perform this surgery with minimally invasive or laparoscopic surgery, whereby patients can be treated either as a day case or an overnight stay.


Do hernias go away on their own?

It is unusual for hernias to resolve spontaneously and often an operation is required.


How do you treat a hernia?

Often the best treatment for a hernia is an operative repair, but occasionally, if patients are frail or infirm, a truss or support can be used.


If you are experiencing symptoms of a hernia, pay a visit to your doctor or a specialist.

By Mr Timothy Rees Worthington

Timothy Rees Worthington is a top general surgeon based in Guildford. He specialises in removing gallstones and hernias and treating the liver and pancreas. He is an expert in laparoscopic surgery, holding the position of Laparoscopic Tutor at the Minimal Access Therapy and Training Unit at the University of Surrey.

After graduating from the University of Birmingham, Mr Worthington was awarded the Royal College of Surgeons Simpson Research Fellowship and studied the biology of pancreatic cancer. He earned his MD in 2001, after which he underwent higher surgical training in London and undertook further specialist training at Flinders University, Adelaide, Australia. He became a consultant surgeon at University College Hospital, London in 2004, before later moving to the Royal Surrey County Hospital.

Mr Worthington leads the Hepatopancreaticobiliary Unit at the Royal Surrey County Hospital and University of Surrey in the development of minimally-invasive surgery for pancreatic and liver disease and is an acknowledged expert in the field. 

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