# Association between constipation and inguinal hernia: a case-control study in an adult population

## TL;DR

This study finds that constipation is a significant risk factor for inguinal hernia in adults, along with age, male sex, and high BMI.

## Contribution

The study identifies constipation as an independent risk factor for inguinal hernia through a case-control analysis.

## Key findings

- Constipation is significantly associated with inguinal hernia after adjusting for other factors.
- Age, male sex, BMI, and hypertension are independent risk factors for inguinal hernia.
- The study highlights the clinical relevance of constipation in hernia prevention and management.

## Abstract

Inguinal hernia is the most frequently diagnosed hernia and affects approximately one-third of the male population. Several risk factors have been identified, including advanced age, limited physical activity, smoking, and increased intra-abdominal pressure, among others.

The aim of the study was to determine whether constipation is a risk factor for inguinal hernia in the adult population.

A case-control study was conducted at the Department of Surgery of one hospital in the north of Peru, including 121 patients with a confirmed diagnosis of inguinal hernia as cases and 242 patients without such a diagnosis as controls. Inclusion and exclusion criteria were applied, and data were collected through individual interviews using a structured questionnaire that addressed clinical aspects, lifestyles, and the presence of constipation, assessed according to the Rome IV criteria.

The results revealed significant differences between the groups of patients with and without inguinal hernia in terms of age, sex, and anthropometric characteristics. In addition, statistically significant associations were found between the presence of an inguinal hernia and type 2 diabetes, smoking, and constipation. A multivariate analysis showed that age, male sex, body mass index, high blood pressure, and constipation were significant and independent factors associated with the presence of inguinal hernia.

Constipation is a significant risk factor for inguinal hernia in the adult population. These results support the importance of considering constipation as a risk factor in the evaluation and management of patients with inguinal hernia, highlighting the relevance of adequate clinical care in this group of patients.

The global burden of inguinal hernia remains significant, with a higher prevalence in older men and underserved populations.

Risk factors such as collagen disorders, chronic constipation, and prior surgeries contribute to the development of inguinal hernias.

Surgical repair remains the definitive treatment, with growing interest in robotic and laparoscopic techniques for better quality-of-life outcomes.

Despite advances, disparities in diagnosis, management, and postoperative outcomes persist across geographic and socioeconomic settings.

Constipation is a clinically relevant and independent risk factor for inguinal hernia. This association, identified through multivariate analysis in a case–control study of adult patients, underscores the impact of elevated intra-abdominal pressure on abdominal wall integrity. The image provided visually reinforces the strength of this association and the distribution of risk factors.

The findings from this study highlight constipation as an independent and significant risk factor for inguinal hernia, alongside age, male sex, high body mass index, and hypertension. These results are clinically relevant and may influence future risk stratification and preventive strategies in general surgery and primary care. By addressing modifiable factors such as constipation, healthcare providers could reduce the incidence or delay the onset of inguinal hernias, especially in high-risk populations. This could lead to improvements in patient outcomes, resource use, and surgical burden.