A hernia occurs when an internal organ or fatty tissue pushes through a weak spot in the surrounding muscle or connective tissue, creating a noticeable bulge. Many hernias develop in the abdominal area. While some hernias might not cause significant symptoms, they can lead to discomfort or pain, especially during physical activity or straining. This article focuses on umbilical hernias, which appear around the belly button.
What is an Umbilical Hernia?
An umbilical hernia occurs when a portion of the intestine or fatty tissue protrudes through a weak spot in the abdominal wall near the belly button. This weakness develops at the site where the umbilical cord passed through the abdominal muscles during fetal development. In infants, if this opening does not fully close shortly after birth, a weak spot remains, allowing a hernia to form.
Umbilical hernias are common in newborns, especially preterm infants, with up to 84% of those born with low birth weight developing one. The hernia usually appears as a soft bulge around the belly button, which may become more prominent when the infant cries or strains. While often associated with childhood, adults can also develop umbilical hernias due to acquired weaknesses in the abdominal wall later in life. This type accounts for 6% to 14% of all adult abdominal wall hernias, making it the second most common form in adults.
Recognizing Symptoms and Common Causes
Identifying an umbilical hernia often begins with noticing a visible bulge or swelling near the belly button. This protrusion might become more apparent during activities that increase abdominal pressure, such as coughing, straining, or lifting, and may diminish or disappear when lying down. Adults might report discomfort, a dull ache, pressure, a burning sensation, or gurgling near the belly button. In contrast, umbilical hernias in infants are typically painless, with the bulge primarily noticeable during crying or coughing episodes.
The underlying causes of umbilical hernias differ between infants and adults. For adults, hernias generally develop from increased abdominal pressure combined with existing weak points in the abdominal wall. Common risk factors include obesity, multiple pregnancies, heavy lifting, chronic coughing, persistent constipation, and straining during bowel movements. Approximately 90% of adult umbilical hernias are acquired later in life.
Diagnosis, Treatment, and When to Seek Medical Attention
Diagnosing an umbilical hernia typically involves a physical examination by a healthcare provider. They will visually inspect and feel for a bulge around the belly button. For larger or more complex cases, imaging techniques like an ultrasound or CT scan might be used to gain a clearer view.
Treatment varies depending on age and the hernia’s characteristics. For infants, many umbilical hernias resolve on their own, often by age two, with some closing later, up to age five. Medical observation is a common initial strategy. Surgical repair may be considered for children if the hernia is large or causes symptoms.
In adults, surgery is more frequently recommended due to a lower likelihood of spontaneous closure and a higher risk of complications. This surgery involves repositioning the tissue and reinforcing the abdominal wall, sometimes with mesh.
Seek immediate medical attention if certain symptoms appear. These include sudden, severe, or worsening pain at the hernia site, or if the bulge becomes firm, tender, discolored, or cannot be gently pushed back in. Nausea, vomiting, or an inability to pass gas or have a bowel movement also warrant urgent evaluation. These indicators can suggest serious complications like incarceration or strangulation, where the blood supply to the trapped tissue is compromised.