Umbilical Hernia
An umbilical hernia occurs when tissue or an organ bulges out through the belly button or navel area. These hernias are more common in babies, but they may also develop in adults. A common symptom in adults is abdominal discomfort. Umbilical hernias in adults are more likely to need surgery to fix.
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What Is an Umbilical Hernia?
An umbilical hernia happens when fat, tissue or an organ — usually part of the intestine — bulges through a weak opening in the abdominal wall near the bellybutton. Most of the time, umbilical hernias aren’t serious.
These hernias are common, especially in infants. About 10 percent of adult hernias are umbilical hernias, according to the American College of Surgeons. Most adults who have these hernias are 60 or older.
Umbilical Hernia Symptoms
Many umbilical hernias don’t cause symptoms. If symptoms are present, they are usually mild.
In babies, umbilical hernias may show as a bulge near the navel when they cough, cry or strain. These bulges don’t typically cause pain.
- Bulge in or near the bellybutton that usually gets bigger when straining, lifting or coughing
- Pressure or pain at the hernia site
- Constipation
- Sharp abdominal pain with vomiting — this can be a sign of a strangulated hernia and is a medical emergency
Serious Symptoms
While most umbilical hernias are not a medical emergency, certain symptoms in babies and adults could mean a hernia is strangulated. This means the blood supply gets cut off to an organ that has pushed through the bellybutton or navel.
Strangulated hernias may require emergency surgery to repair. If you or your child have these symptoms, seek immediate medical attention.
- Bloated, round abdomen
- Constipation
- Discolored bulge that may be purple, red or dark
- Fever
- Pain and tenderness in the abdomen
- Vomiting
Causes & Risk Factors
The causes of an umbilical hernia are different in infants and adults. In adults, women are more likely to get umbilical hernias than men — especially if they are pregnant or have had multiple pregnancies. But men are more likely to have a strangulated umbilical hernia.
Most umbilical hernias occur in infants. This happens because the muscle around the umbilical cord hasn’t completely closed yet. In babies, these hernias usually close up on their own.
Ninety percent of umbilical hernias in adults are acquired. Weakened abdominal muscles and excessive abdominal pressure cause them.
- Being overweight or obese
- Having several pregnancies
- Buildup of fluid in the abdominal cavity (ascites)
- Previous surgery in the abdominal area
- Receiving long-term dialysis through the abdomen (peritoneal dialysis)
Umbilical Hernia Diagnosis & Treatment
Doctors typically diagnose umbilical hernias with a physical examination. Imaging studies such as abdominal x-rays, ultrasounds or CT scans can determine the size of the hernia and search for potential complications.
Treatment for Children
Umbilical hernias in babies typically go away on their own as the hole closes up with age. By age two, the hole is completely closed and children don’t need further treatment.
- Doesn’t go away by age five
- Blocks the intestine
- Is painful
- Is larger than 1 to 2 centimeters in diameter
Treatment for Adults
In adults, surgery is the only way to repair a hernia. Umbilical hernias may become more painful and grow in size without treatment.
Most doctors recommend surgery for adults who have symptomatic hernias. Surgeons typically use hernia mesh to repair umbilical hernias in adults.
Recurrence was the most common complication before the hernia mesh’s invention. Research is mixed on how long a mesh hernia repair will last. A 2022 study followed 100 patients for ten years after a ventral abdominal hernia repair.
No recurrence was recorded after three years, while about 10% had a recurrence after roughly eight years. Two patients had a central breakdown of the mesh at about seven years. Mesh had stretched across the defect by an average of 21%. Mechanical testing showed that the mesh lost its elasticity at low forces.
Two types of surgery include: Open hernia repair and laparoscopic hernia repair.
Open Hernia Repair
In open hernia repair, doctors make an incision at the site and use mesh to strengthen the abdominal wall or use sutures to close the hernia. They will then suture the muscle layer closed.
Laparoscopic Hernia Repair
In laparoscopic hernia repair, doctors make small incisions and insert tools through the small holes to perform the surgery. Surgeons can use mesh or sutures to repair the hernia. This technique is more challenging to perform and expensive but may mean a quicker recovery for patients.
Surgical Complications
The prognosis for umbilical hernias is generally good after surgery. But like most surgical procedures, there are risks. Using mesh to repair a hernia lowers the risk of it coming back, but mesh can also cause rare but serious complications.
- Hernia mesh infection
- Wound infection at the surgery site
- Bowel injuries
- Scar tissue
- Hernia recurrence
- Chronic pain
- Mesh failure
- Organ injury (bladder, intestines)
- Nerve or blood vessel injuries
Umbilical Hernia Treatment without Surgery
Adult patients may be able to postpone surgery if they can be pushed back into the abdomen or are very small. This is called watchful waiting.
Doctors will monitor the hernia to see if it gets bigger or causes problems. There is a chance that intestines may slip through the hole and become strangulated. This will require immediate surgery.
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