And if one is not realizing what’s going on it can continue to grow correct and that’s what will happen see what happens as your the years progress and you get older the tissues get weaker the intra-abdominal forces that we’re gonna talk about in a little while that lead to progression of hernia that will allow the honey to grow with time it’ll go from a small little belly button hernia over to a big one it’ll turn into a golf ball and and eventually an orange sized ball it’s just by chance or hereditary so it’s a combination of both of course the incisional hernia has occurred because you’ve had surgery but the ones that you are born with like an umbilical hernia or a baby that’s born with an inguinal hernia it is it is you know how to it is something that’s coming from birth you know we have risk factors to look out for in case you are at risk for hernias let’s take a look at some of these male gender really well it’s just that hernias are more common in men okay so that’s what it is but I think the basic principle that you have to take back is anything that would increase your pressure in your abdomen so of course pregnancy which is increases your interrupt down more pressure obesity when you have a lot of fat inside your abdomen as well smoking and because of the chronic coughing so smokers have a chronic cough and if you’re coughing all the time you’re increasing your intra-abdominal pressure and that of course will lead to hernia or allow your hernia to progress much more rapidly those who are have constipation whether they have just chronic constipation because of colonic disease or because God forbid they have a tumor in their colon or something like that they can lead to as well to a hernia or progression of a hernia you may be you have a small hole is what we call subclinical a small little hole in your abdominal wall not really noticed but because of the coughing and because of the straining it progresses over years and then it becomes evident you