If you decide not to have the hernia repaired, it is important to understand the possible progression of a hernia. A hernia usually starts off as being REDUCIBLE, where the bulge can be pushed back inside when it protrudes out. It can progress to become INCARCERATED, where you are unable to push the bulge back inside. At this stage, you may notice increased pressure and pain in the area.
Finally, an incarcerated hernia can progress to a STRANGULATED hernia. At this point, the hernia will be very tender, and irreducible, and the skin can become red. In this stage, the blood supply to the contents of the hernia is cut off which can lead to a gangrenous (dead) bowel in as little as 6-8 hours. This mandates you go to the hospital because you likely need an emergent operation.