A Review of Inguinal and Hiatal Hernia Management

Colter G. Sheveland, PharmD; Caitlin N. Edwards, PharmD; Jeffrey A. Kyle, PharmD, BCPS


US Pharmacist. 2022;47(6):HS-2-HS-6. 

In This Article

Abstract and Introduction


A hernia is the protrusion of a visceral organ through a weakened area of tissue that normally holds it in. Common risk factors for hernia development include advanced age, obesity, pregnancy, malignancy, abdominal surgery, and intense physical activity. Hernias are classified based on their location and etiology, with abdominal hernia being the most prevalent type in the United States. Inguinal hernia and hiatal hernia offer opportunities for pharmacists to be involved in patient care. Although hernias are usually repaired surgically, in some cases nonsurgical therapies may be used. Regardless of the approach taken, pharmacists can play a role in medication optimization, selection of self-care products, counseling on lifestyle modifications, and postsurgical wound-care management.


A hernia occurs when a visceral organ, such as the bowel or stomach, protrudes through a weakened area of musculature and/or connective tissue that normally keeps it contained.[1] There are many different types of hernia. Although the exact prevalence of all hernia types in the United States is unknown, the estimated prevalence of abdominal hernia—the most common form of hernia—is 1.7%, with more than 700,000 surgical repairs performed annually.[2,3] Generally, the risk factors for developing a hernia depend on the hernia type, and hernia development is associated with the presence of congenital abnormalities of underlying tissue; the existence of comorbidities such as malignancy, chronic obstructive lung disease, ascites, and chronic intestinal obstruction; diet; pregnancy; and intense or repetitive physical activity.[4,5]

There is not one classification system for all hernias; instead, most hernias are classified based on their anatomical location (e.g., abdominal, diaphragmatic, perineal, lumbar) and characteristics (e.g., size, severity, etiology). As stated above, most hernias occur in the abdomen. The two most common forms of abdominal hernia are inguinal hernia (IH) and femoral hernia, which are generally treated and managed similarly. A common diaphragmatic hernia is the hiatal hernia (HH). Although the cornerstone of treatment for the various types of hernias is surgery, this article will focus on IH and HH, as they offer opportunities for pharmacists to be involved in patient care.[6,7]