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In some cases, groin hernias can become very dangerous and require surgery stat.

May 02, 2017

If you’ve been binging on Netflix’s new original series Girlboss—based on Sophia Amoruso’s journey from selling vintage clothes on eBay to launching her own super successful clothing line, Nasty Gal—then you probably have some questions about the (spolier alert!) scary medical emergency she faces.

In episode two Sophia, who's played by Britt Robertson, discovers a small protrusion in her lower abdomen, which turns out to be an inguinal hernia. This type of hernia (there are many different kinds) occurs when internal tissues or part of the intestines bulge through an open or weak spot in the muscles of the groin.

You can be born with an inguinal hernia or like Sophia, get one later in life. It can by caused by straining your core muscles (while lifting something too heavy, for example). Or it can happen during pregnancy or as you get older, in an area where you had a prior injury or surgery.

Hernias of the groin tend to be more common in people who smoke, have major abdominal wall injuries, or suffer from chronic constipation. They're also more likely to occur in men: "The overall risk of getting a groin hernia is 25% in men, but only 5% in women," says Natasha Bhuyan, MD, a physician with One Medical in Phoenix.

Groin hernias can be repaired with surgery; but in some cases, surgery may not even be necessary. “If you don’t fix a hernia, it won’t get better on it’s own. But some hernias don’t bother people and they are small and harmless. These usually can be watched in order to avoid the risks of surgery,” Dr. Bhuyan explains.

If you think you've got one, talk to your doc about the best course of action. The classic sign is the sensation of a bulge along your groin that becomes more noticeable when you cough, sneeze, or lift something. You might be able to see it, or you might not.

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Sophia's hernia (more spoilers ahead!) does become a serious medical risk in episode six. She says her hernia “exploded”—but that’s not exactly accurate.

Technically speaking, she has an incarcerated hernia, which means the hernia has become trapped outside the weak point in the muscle wall.  “It happens the same way kittens get their heads stuck in jars. They are initially able to maneuver their way through the opening, but then can’t get out,” says Dr. Bhuyan.

If a bit of intestine is sticking through, it can cause a block in digestion, as well as severe pain, nausea and vomiting. An incarcerated hernia is so risky because the blood and oxygen supply to the tissue can get cut off. Emergency surgery is required ASAP. 

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But in most cases, hernia surgery is a simple outpatient procedure to repair the weakness in the abdominal wall. Most people can go home the same day and keep activity to a minimum for a few weeks. “As in, it’s okay to work, but no heavy lifting,” Dr. Bhuyan adds.

Unfortunately, the risk of a recurrence after surgery can be fairly high. But as more research emerges, the surgeries are improving, says Dr. Bhuyan, and recurrence rates are going down.