Umbilical Hernia: Symptoms, Causes, & Treatment Options

When tissues, intestine or fluid bulges through weak muscles of the abdominal area near the opening of the belly button it causes a Umbilical Hernia condition. Umbilical hernia is common in newborn but it can affect adults too. Umbilical hernia is easily curable, however on rare occasions they create serious issues that require surgical procedure and medical attention

What is an Umbilical Hernia?

Abdominal wall weakness gives space to form a lump around the navel area and causes umbilical hernia. This condition is generally inherited in babies; it appears shortly after birth when the opening for the umbilical cord in the abdominal muscles does not close up properly. In adults, it may appear later also due to increased pressure on the abdomen.

While umbilical hernia cases in infants resolve naturally, surgical or medical procedure is required in adult umbilical hernias as they are less likely to heal on their own.

Symptoms of Umbilical Hernia

The symptoms of an umbilical hernia depend on the severity and size of hernia. Common signs include:

1. Visible Knot

Swelling near the belly button or soft lump, which is clearly visible when sitting, standing, coughing, or straining.

2. Pain or Discomfort

Mild pain or discomfort around the hernia site, especially lifting heavy objects, coughing, or doing something that involves physical activity.

3. Nausea and Vomiting

These can occur when the case is severe; this happens especially when the hernia turns out to be strangulated-that is, when the blood flow to the herniated tissue is cut off.

Symptoms of an umbilical hernia in adults include a noticeable bulge or swelling near the belly button, which may become more pronounced when coughing, straining, or standing. Some individuals experience discomfort or pain around the hernia site, especially during physical activity. In severe cases, symptoms like nausea, vomiting, or redness at the site may indicate complications requiring urgent medical attention.

Also Read: What Size Hernia Needs Surgery?

Causes of Umbilical Hernia

Umbilical hernias can develop due to several factors, affecting both children and adults. Understanding these causes can help in identifying risks and taking preventative measures where possible.

1. Congenital Weakness

In infants, an umbilical hernia often results from a congenital weakness in the abdominal wall. After birth, the umbilical cord is cut, and the opening in the abdominal muscles where the cord was attached should naturally close. However, in some cases, this closure is incomplete, leaving a weak spot that allows the intestine or other tissues to protrude.

2. Increased Abdominal Pressure

In adults, increased abdominal pressure is a primary trigger for umbilical hernia development. Various conditions can elevate pressure in the abdomen, including:

• Obesity: Excess weight places additional strain on the abdominal muscles, increasing the likelihood of a hernia.
• Pregnancy: Repeated or multiple pregnancies can weaken the abdominal wall and lead to hernia formation.
• Heavy Lifting: Straining the abdominal muscles during improper lifting can contribute to hernias.
• Persistent Coughing: Chronic respiratory conditions or smoking-induced coughing exert repeated pressure on the abdominal area.
• Chronic Constipation: Straining during bowel movements repeatedly stresses the abdominal wall, heightening the risk of hernias.

3. Abdominal Surgery

Previous surgical procedures involving the abdominal area can leave the muscles weakened, creating a predisposition to hernia formation. Scar tissue from surgery may also affect muscle strength, increasing the risk.

4. Aging

As people age, the muscles of the abdominal wall naturally weaken, making older adults more susceptible to umbilical hernias. Combined with other factors like chronic illnesses or reduced physical activity, aging significantly contributes to hernia risk.

Also Read: Do I Need Hernia Surgery?

Diagnosis of Umbilical Hernia

Accurate diagnosis of an umbilical hernia involves a combination of clinical evaluation and imaging studies to assess the condition and its severity.

1. Physical Examination

The diagnostic process typically begins with a physical examination by a healthcare provider. The doctor observes and palpates the bulge near the belly button, assessing its size, location, and whether it can be pushed back into the abdominal cavity (reducible hernia). They may also check for tenderness, swelling, or other signs of complications, such as redness or discomfort. Physical examination is often sufficient for straightforward cases.

2. Imaging Tests

For more complex or unclear cases, imaging studies are utilized:

• Ultrasound: This non-invasive test provides detailed images of the hernia and surrounding soft tissues, helping to confirm the diagnosis.
• CT scan or MRI: These advanced imaging modalities are recommended for complicated cases, such as when strangulation or incarceration of the hernia is suspected. They offer detailed insights into the extent of the hernia and guide treatment planning.

Complications of Umbilical Hernia

While many umbilical hernias are harmless and may resolve without treatment, especially in infants, some can lead to serious complications if left untreated. These complications require immediate medical attention to prevent long-term health issues.

1. Strangulation
   Strangulation occurs when a portion of the intestine becomes trapped, cutting off blood flow and leading to severe complications like tissue death and infection. Symptoms include intense pain, nausea, vomiting, and discoloration. Urgent surgical intervention is needed.
2. Incarceration
   Incarceration happens when the hernia becomes stuck, causing persistent pain and swelling. If untreated, it may progress to strangulation.
3. Infection
   Prolonged hernias can cause irritation and infection, presenting with redness, swelling, and fever. Prompt medical care is necessary to manage complications.

Treatment Options for Umbilical Hernia

Treatment depends on the size, severity, and presence of symptoms or complications.

1. Non-Surgical Management

For infants, most umbilical hernias resolve on their own as the abdominal muscles strengthen over time. Regular monitoring by a pediatrician is sufficient in such cases.

In adults, small hernias without symptoms may not require immediate surgery but should be monitored closely. Lifestyle changes, such as weight management and avoiding heavy lifting, can help prevent the condition from worsening.

2. Umbilical Hernia Surgery 

Surgery is the definitive treatment for umbilical hernias in adults and in cases where complications arise. Let’s find out which surgery is best for umbilical hernia

a. Open Hernia Repair

• Involves making an incision near the hernia site to push the protruding tissue back into the abdominal cavity. The abdominal wall is then repaired using sutures or synthetic mesh for reinforcement.

b. Laparoscopic Hernia Repair

• A minimally invasive procedure that uses small incisions and a laparoscope (a thin tube with a camera) to repair the hernia. Mesh is often used to strengthen the abdominal wall.
• Benefits include shorter recovery time, reduced pain, and minimal scarring.

3. Post-Surgical Recovery

After surgery, patients typically experience:

• Mild discomfort or soreness around the surgical site.
• A recovery period of 2-4 weeks for open surgery and 1-2 weeks for laparoscopic surgery.
• Recommendations to avoid heavy lifting and strenuous activities during recovery.

While it is not possible to prevent all cases of umbilical hernias, especially congenital ones, adopting certain lifestyle practices can significantly reduce the risk of developing a hernia or prevent existing ones from worsening.

1. Maintain a Healthy Weight
   Obesity increases abdominal pressure, placing strain on the muscles of the abdominal wall. Maintaining a healthy weight through regular physical activity and a balanced diet helps minimize this risk.
2. Avoid Heavy Lifting
   Improper lifting techniques or lifting objects that are too heavy can lead to excessive strain on the abdominal muscles. Use proper techniques by bending your knees and engaging your core to prevent hernia formation.
3. Manage Chronic Cough or Constipation
   Chronic coughing and straining during bowel movements can create repeated pressure on the abdominal wall. Treating underlying conditions can help reduce this strain, lowering the risk of hernia development.

Conclusion

Umbilical hernias are common and often harmless conditions that can occur in both children and adults. Understanding the symptoms, causes, and treatment options can help individuals make informed decisions about their health. By maintaining a healthy lifestyle and seeking timely medical advice, individuals can manage and prevent umbilical hernias effectively, ensuring long-term abdominal health.

For expert care in treating umbilical hernias and other gastrointestinal issues, Dr. Vikas Singhal is a highly trusted and experienced surgeon. Specializing in advanced laparoscopic and bariatric procedures, Dr. Singhal is committed to delivering personalized, patient-centric care. With a reputation for excellence and a focus on minimally invasive techniques, he ensures optimal outcomes for his patients. Visit his clinic at Obesity Surgeon India to explore comprehensive treatment options and take a confident step towards better health.

FAQ

Q1. Can umbilical hernia be treated without surgery?

In many cases, small umbilical hernias may not require immediate surgery. For infants, many umbilical hernias close on their own as they grow. In adults, non-surgical approaches like lifestyle changes, managing risk factors (e.g., weight loss, avoiding heavy lifting), and wearing a supportive belt can help reduce discomfort. However, larger or symptomatic hernias often require surgical intervention for proper repair and to prevent complications.

Q2. What size of umbilical hernia needs surgery?

Umbilical hernias larger than 1-2 centimeters are typically considered for surgical repair, especially if they cause symptoms such as pain, discomfort, or increase in size over time. Additionally, hernias that are incarcerated or show signs of strangulation require immediate surgical attention regardless of size.

Q3. What exercises are good for umbilical hernia?

Low-impact exercises such as walking, gentle stretching, and core-strengthening exercises (like Pilates or yoga) are recommended for individuals with umbilical hernias. Avoid heavy lifting, intense abdominal strain, and high-impact exercises that may exacerbate the hernia.

Q4 Will a CT scan show an umbilical hernia?

Yes, a CT scan is an effective imaging tool for diagnosing and assessing umbilical hernias, especially in complex cases. It provides detailed images of the hernia and surrounding tissues, helping to identify the extent and severity of the condition.

Q5. Which doctor is best for umbilical hernia?

For umbilical hernia treatment, consulting a skilled surgeon, preferably a general surgeon or a specialist in minimally invasive or laparoscopic surgery, is the best option. These professionals have the expertise to diagnose and effectively manage hernias through both surgical and non-surgical methods.