SYMPTOMS OF HERNIA A hernia may first appear as a new lump or bulge in the groin or in the abdominal area. There may be an associated dull ache but usually it is not painful on touch. The lump increases in size on standing, coughing and may be pushed back/disappear on lying down. A small painless hernia if left untreated, usually increases in size. Occasionally, the hernia may become irreducible i.e. it cannot return to the abdominal cavity on lying down or with manual pushing. At this stage it also becomes painful. Sometimes the loop of bowel that has herniated becomes obstructed. This can cause extreme pain, nausea, vomiting, constipation and needs immediate treatment. At times the hernia becomes 'strangulated' (explained further below) in which the person appears ill with/without fever, nausea, vomiting and extreme pain even to touch. This condition is life threatening and thus a surgical emergency. Best piles hernia surgeon in Pune.