Difference Between Direct and Indirect Hernia

Have you ever noticed lumps or bulges in your belly/groin, appearing when you are standing, coughing, bending or lifting heavy weights? It may be a sign of an inguinal hernia. It is the most common type of abdominal hernia, accounting for nearly 75% of all cases.

An inguinal hernia occurs when a part of your intestine, fatty tissue or other abdominal contents pushes through a weak spot in the lower abdominal muscle, entering the inguinal canal (a passage running down your inner thighs). But did you know not all inguinal hernias are the same? These hernias are further classified into direct and indirect inguinal hernias. The difference lies in their underlying causes and ways of formation. Keep reading to discover the key differences between direct vs indirect inguinal hernia in detail. 

How Do Direct Vs Indirect Inguinal Hernia Differ?

Direct and indirect hernias can be identified on the basis of their anatomical locations. While direct hernias protrude through a weak area in the back wall of the inguinal canal, indirect hernias enter through a natural opening in the lower belly called the deep inguinal ring. This is often congenital and more commonly seen in younger males.

Direct Inguinal Hernia

This type of hernia emerges through a weak spot in the lower belly muscles. This area is called Hesselbach’s triangle. Unlike direct hernias, indirect ones take a shorter route through the abdominal wall. It is a cause of muscle weakening, especially in older adults.

Direct hernia symptoms are much like other hernias. You will notice a bulge in your lower abdomen. Pain and discomfort are also prominent during straining. But, there are certain cases where direct hernia is not a visible symptomatically. Only a routine physical checkup can help discover the condition. 

Indirect Inguinal Hernia

The type of hernia where a part of the intestine protrudes through the deep inguinal ring is known as an indirect hernia. Indirect hernia causes the bulging tissue to enter the inguinal canal. This is actually an indirect route to the superficial ring rather than pushing straight through the abdominal wall. That's why this condition is called an indirect inguinal hernia. 

This congenital defect results from the weakness in the abdominal wall not fully closing during fetal development. Since the inguinal canal is the passageway through which the testicles descend before birth, young males are more prone to indirect hernia. However, adult males and females also experience hernia due to aging, straining on the toilet during constipation and chronic coughing as the muscles surrounding their abdomen become weaker. 

Here's a summarised version of the difference between the two types of inguinal hernia

Inguinal Hernia Diagnosis

Inguinal hernia diagnosis occurs through a physical exam. Sometimes, it is also done through radiological tests. The doctor begins by diagnosing your medical history. During the physical evaluation, doctors visually observe and touch the area to try to feel the hernia. 

Doctors may ask male patients to cough or strain to help detect the hernia during physical examination. This helps them to feel the patient's hernia move in and out. They also ask patients to diagnose the hernia for further confirmation. Tests used for inguinal hernia diagnosis include: 

• Ultrasound
• Computed tomography (CT) Scan
• Magnetic resonance imaging (MRI)

Also Read: Laparoscopic Hernia Surgery

How is an Inguinal Hernia Treated?

Inguinal hernia is usually treated with surgery. Being the most effective treatment, more than 20 million people undergo inguinal hernia surgery every year. During the operation, the surgeon pushes the bulging tissue back into place, repairing the weak spot in the abdominal wall. They generally use a surgical mesh for added support. The surgery is recommended when the hernia causes severe discomfort, pain or poses an array of complications. Possible complications associated with an untreated inguinal hernia include: 

• Obstruction: It is a condition under which a portion of the bowel gets stuck in the inguinal canal, causing nausea, stomach pain, vomiting and a painful lump in the groin. 
• Strangulation: It is a condition under which a trapped portion of the bowel cuts off its blood supply. In that case, emergency surgery must be done within hours, preventing tissue death and restoring blood supply. 

Surgery is the most successful treatment for direct and indirect hernia. However, there are still chances of recurrence in some cases.

How to Prevent Inguinal Hernia?

While an indirect hernia occurs during birth, it is unlikely to prevent this condition. But, there are some precautions that you can take to lower your risk of direct inguinal hernia. 

• Stay careful while lifting heavy things
• Don't strain too much while having a bowel movement 
• Treat constipation
• Treat a chronic cough
• Maintain your optimal weight 

Consult Trusted Hernia Specialists for Consultation! 

With a better understanding of the difference between direct vs indirect inguinal hernia, you can take the right steps to manage the condition effectively. Moreover, you should go for regular checkups to detect such conditions early. The best course of action is to consult the doctor to identify the type of hernia you have easily. Therefore, you should follow the doctor's instructions and take all the necessary precautions to avoid recurrence and get personalised advice. 

If you need more information on inguinal hernia diagnosis and treatment, connect with our experienced team at Apollo Spectra. Book your appointment and schedule your visit today!