Q. My doctor diagnosed a hernia in my abdomen but said that I don’t need treatment. I barely feel it. Will it simply go away?

A: A hernia occurs when part of an internal organ or fat tissue bulges through a hole, tear or weak area of muscle, most commonly in the abdomen or groin. Once a hernia appears, it will not go away on its own. But if you are not experiencing symptoms or if your pain is only very mild, the best approach may indeed be “watchful waiting,” keeping an eye out for signs of trouble yet not resorting to surgery (which requires anesthesia and has its own risks) unless symptoms worsen.

In the meantime, to help keep your hernia from getting worse, take steps to minimize abdominal pressure. Get treatment for any recurrent constipation or chronic cough (and, of course, do not smoke)… lose weight if necessary… always use proper lifting techniques… and talk with your doctor about an exercise regimen to safely strengthen abdominal muscles and reduce abdominal fat.

If you do develop constant or intermittent sharp or burning pain in the affected area, it is likely that fat tissue or an organ is being pinched and/or nerves compressed. Pain typically worsens when there is an increase in abdominal pressure, such as when you bend over, and can be reproduced by pressing directly on the spot… pain lessens when you lie flat on your back. There may or may not be a visible bulge in the skin over the affected area.

Such a worsening of symptoms indicates that surgery is needed. Otherwise, the blood supply to the tissue can be cut off (a complication called strangulation) and lead to infection and tissue death. If this happens, there is excruciating pain… the external bulge (if there is one) becomes rock hard… and/or the overlying skin becomes red, purple or otherwise discolored. This would require immediate emergency surgery.

Hernia surgery usually consists of an open or laparoscopic procedure in which mesh is used to patch the hole. Fortunately, once a hernia is surgically corrected, the pain typically disappears quickly and completely.