Almost every week, a patient walks in with a small bulge near the groin or belly button, tells me it doesn't hurt much, and asks if they really need surgery for "just this." My answer is always yes and here's the conversation I wish more people had before it turns into an emergency.
It never stays the same size
A hernia is a weak spot in the abdominal wall where tissue pushes through. It doesn't heal on its own, and it doesn't stay put. Over months or years, that small bulge gets bigger, and the opening it's pushing through gets more strained. I've had patients tell me they'd been "managing" a hernia for two years before it finally caught up with them.
The real danger is strangulation
This is the word I use with patients to make them take it seriously. If the protruding tissue gets trapped and its blood supply is cut off, that's a strangulated hernia, a surgical emergency, not a scheduling decision. Once blood flow stops, tissue can die within hours, and what would've been a straightforward planned surgery becomes a race against gangrene and infection.
Waiting makes the surgery harder, not easier
This is what people don't realise. A hernia left alone for years develops adhesions and scar tissue around it. I've operated on neglected cases where a simple mesh repair turned into a complex procedure because the tissue had been stuck and inflamed for so long. Delay doesn't just risk complications; it makes the eventual surgery riskier too.
Emergency repairs carry real risk
Elective hernia surgery, done on your schedule, is safe and usually has patients home the same or next day. Emergency repairs for strangulated hernias are a different story altogether: done under pressure, often on a compromised bowel, with significantly higher complication rates. I always tell patients: the surgery you're avoiding now is far safer than the one you'll need later.
The warning signs can appear suddenly
A hernia that was soft and reducible for years can turn dangerous with almost no warning: sudden severe pain, a bulge that won't push back in, nausea, or vomiting. That's not a "wait and see" situation. That's an ER visit.
My honest advice to anyone with a hernia, however minor it feels: get it assessed and repaired on your terms, while it's still simple. Don't let it decide the timeline for you.
The author is a consultant, Surgical Gastroenterology, Pancreatic & Colorectal Surgery, Robotic GI Surgery & GI Oncology at Manipal Hospital Sarjapur.
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
