What is Umbilical Hernia

Umbilical hernia happens in the abdomen, near the belly button (umbilicus). A hernia is a bulge of tissue that pushes through an opening between muscles. The hernia may contain tissues from the small intestine, large intestine, or fatty tissue covering the intestines (omentum). Umbilical hernias in adults tend to get worse over time, and they require surgical treatment.

There are several types of umbilical hernias. You may have:

• A hernia located just above or below the umbilicus (indirect hernia). This is the most common type of umbilical hernia in adults.
• A hernia that forms through an opening formed by the umbilicus (direct hernia).
• A hernia that comes and goes (reducible hernia). A reducible hernia may be visible only when you strain, lift something heavy, or cough. This type of hernia can be pushed back into the abdomen (reduced).
• A hernia that traps abdominal tissue inside the hernia (incarcerated hernia). This type of hernia cannot be reduced.
• A hernia that cuts off blood flow to the tissues inside the hernia (strangulated hernia). The tissues can start to die if this happens. This type of hernia requires emergency treatment.

What are the causes?

An umbilical hernia happens when tissue inside the abdomen presses on a weak area of the abdominal muscles.

What increases the risk?

You may have a greater risk of this condition if you:

• Are obese.
• Have had several pregnancies.
• Have a buildup of fluid inside your abdomen (ascites).
• Have had surgery that weakens the abdominal muscles.

What are the signs or symptoms?

The main symptom of this condition is a painless bulge at or near the belly button. A reducible hernia may be visible only when you strain, lift something heavy, or cough. Other symptoms may include:

• Dull pain.
• A feeling of pressure.

Symptoms of a strangulated hernia may include:

• Pain that gets increasingly worse.
• Nausea and vomiting.
• Pain when pressing on the hernia.
• Skin over the hernia becoming red or purple.
• Constipation.
• Blood in the stool.

How is this diagnosed?

This condition may be diagnosed based on:

• A physical exam. You may be asked to cough or strain while standing. These actions increase the pressure inside your abdomen and force the hernia through the opening in your muscles. Your health care provider may try to reduce the hernia by pressing on it.
• Your symptoms and medical history.

How is this treated?

Surgery is the only treatment for an umbilical hernia. Surgery for a strangulated hernia is done as soon as possible. If you have a small hernia that is not incarcerated, you may need to lose weight before having surgery.

Follow these instructions at home:

• Lose weight, if told by your health care provider.
• Do not try to push the hernia back in.
• Watch your hernia for any changes in color or size. Tell your health care provider if any changes occur.
• You may need to avoid activities that increase pressure on your hernia.
• Do not lift anything that is heavier than 10 lb (4.5 kg) until your health care provider says that this is safe.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your hernia gets larger.
• Your hernia becomes painful.

Get help right away if:

• You develop sudden, severe pain near the area of your hernia.
• You have pain as well as nausea or vomiting.
• You have pain and the skin over your hernia changes color.
• You develop a fever.

Umbilical Hernia in Children

A hernia is a bulge of tissue that pushes through an opening between muscles. An umbilical hernia happens in the abdomen, near the belly button (umbilicus). It may contain tissues from the small intestine, large intestine, or fatty tissue covering the intestines (omentum). Most umbilical hernias in children close and go away on their own eventually. If the hernia does not go away on its own, surgery may be needed.

There are several types of umbilical hernias:

• A hernia that forms through an opening formed by the umbilicus (direct hernia).
• A hernia that comes and goes (reducible hernia). A reducible hernia may be visible only when your child strains, lifts something heavy, or coughs. This type of hernia can be pushed back into the abdomen (reduced).
• A hernia that traps abdominal tissue inside the hernia (incarcerated hernia). This type of hernia cannot be reduced.
• A hernia that cuts off blood flow to the tissues inside the hernia (strangulated hernia). The tissues can start to die if this happens. This type of hernia is rare in children but requires emergency treatment if it occurs.

What are the causes?

An umbilical hernia happens when tissue inside the abdomen pushes through an opening in the abdominal muscles that did not close properly.

What increases the risk?

This condition is more likely to develop in:

• Infants who are underweight at birth.
• Infants who are born before the 37th week of pregnancy (prematurely).
• Children of African-American descent.

What are the signs or symptoms?

The main symptom of this condition is a painless bulge at or near the belly button. If the hernia is reducible, the bulge may only be visible when your child strains, lifts something heavy, or coughs.

Symptoms of a strangulated hernia may include:

• Pain that gets increasingly worse.
• Nausea and vomiting.
• Pain when pressing on the hernia.
• Skin over the hernia becoming red or purple.
• Constipation.
• Blood in the stool.

How is this diagnosed?

This condition is diagnosed based on:

• A physical exam. Your child may be asked to cough or strain while standing. These actions increase the pressure inside the abdomen and force the hernia through the opening in the muscles. Your child’s health care provider may try to reduce the hernia by pressing on it.
• Imaging tests, such as:
  • Ultrasound.
  • CT scan.
• Your child’s symptoms and medical history.

How is this treated?

Treatment for this condition may depend on the type of hernia and whether your child’s umbilical hernia closes on its own. This condition may be treated with surgery if:

• Your child’s hernia does not close on its own by the time your child is 4 years old.
• Your child’s hernia is larger than 2 cm across.
• Your child has an incarcerated hernia.
• Your child has a strangulated hernia.

Follow these instructions at home:

• Do not try to push the hernia back in.
• Watch your child’s hernia for any changes in color or size. Tell your child’s health care provider if any changes occur.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

• Your child has a fever.
• Your child has a cough or congestion.
• Your child is irritable.
• Your child will not eat.
• Your child’s hernia does not go away on its own by the time your child is 4 years old.

Get help right away if:

• Your child begins vomiting.
• Your child develops severe pain or swelling in the abdomen.
• Your child who is younger than 3 months has a temperature of 100°F (38°C) or higher.