Understanding hiatal, umbilical and inguinal hernias

The body has three main cavities – the chest and ribcage (thoracic), abdomen and pelvis. When pressure builds up in one area, it can go up, out, or down pushing your organs into the neighbouring space.

When pressure goes up

Pressure will exert itself up into the diaphragm, which is how a hiatus/hiatal hernia is born, where a section of the stomach pushes up into the chest cavity.

Symptoms of a hiatal hernia include:

• Acid reflux/heartburn
• Food returning up into the mouth after swallowing
• Trouble swallowing
• Chest pain
• Abdominal pain
• Burping
• Changes to voice or breathing
• May need to swallow a lot of saliva
• Feeling full soon after you eat, even small amounts
• Feeling short of breath
• Waking up gasping for air
• Vomiting blood
• Passing black stools (indicates bleeding in the gastrointestinal tract)
• Urinary tract/bladder/pelvic issues that may seem unrelated

When pressure goes out

The belly button is the weakest spot on the front of your body, and when pressure is exerted outwards, the result can be abdominal separation and umbilical hernia.

An umbilical hernia in adults is caused by a build-up of abdominal pressure that forces outwards. Umbilical hernias can be driven by pregnancies, fluid build-up, previous abdominal surgery (weakening tissue), obesity and those on long-term peritoneal dialysis for kidney failure.

Symptoms of an umbilical hernia include:

• Abdominal pain
• A bulge or swelling near the belly button
• Tenderness around the belly button
• Discolouration around the belly button
• Urinary tract/bladder/pelvic issues that may seem unrelated
• Vomiting

When pressure goes down

When pressure is exerted downwards, the result is a dysfunctional pelvic floor or inguinal/femoral hernia.

Symptoms of an inguinal hernia include:

• Bulging around the edge of the pubic bone, worse for sitting or standing upright, cough or strain
• The bulge aches or burns
• Pain in the groin area, worse for bending over, when lifting or coughing
• Heavy feeling in the groin
• Weakness in the groin
• Pressure in the groin
• Pain and swelling around testicles
• Urinary tract/bladder/pelvic issues that may seem unrelated

Why is pressure unbalanced?

When our organs and cavities are in the right position, and all is functioning well, pressure is evenly distributed. When something is off – breathing, alignment, posture, etc. – one section of organs is not able to fully inhabit its space.

Breathing

Breathing might seem like something we do without thinking, but how we breathe impacts our whole body. Stand up and take a breath – does your chest or belly (or both) lift and distend on that first breath? You’re breathing wrong.

The breath where you fill your lungs and rib cage is the most effective way to get oxygen into your lungs. Breathing into the chest or abdomen is putting more pressure on your pelvic floor, abdomen or hernia, exacerbating the problem.

Alignment of shoulders, ribs and pelvis

If you sit in front of a computer all day or use equipment that requires your arms being held out in front of you, you’ll end up with rounded shoulders, a tight chest and a head that leans forward.

If you sit down with your tailbone underneath you on the back of your pelvis, you’ll end up with tight pelvic floor muscles. A tight muscle doesn’t mean a strong muscle, it just means a dysfunctional muscle, so if you have a tight pelvic floor, you can end up with a weak pelvic floor.

When you slump in a seated position (or standing), you might lift the chest automatically to reset your position, known as rib thrusting. We upset the abdominal system by pushing the base of the rib cage forwards and out. The result can be back pain from moving the rib cage away from the pelvis, preventing your core from activating.

How to get help with hernias, pelvic floor dysfunction and alignment

The best practitioners to help are a pelvic physiotherapist or an osteopath. Find one locally who has experience with what ails you, if you have such luxuries. If you live in an area without access to osteopathic, chiropractic or pelvic physiotherapy services, find someone online who can advise you on the next best steps.

Deal with these problems quickly! They usually don’t fix themselves, and can lead to worse problems down the track.