Overview
An umbilical hernia occurs when a part of the intestine protrudes through the opening in the abdominal muscles near the bellybutton (navel). Umbilical hernias are common, particularly in infants, and usually harmless. They may be more noticeable when a baby cries or strains, and in children, they often close on their own within the first two years of life. In adults, increased abdominal pressure due to factors like obesity, multiple pregnancies, or previous surgery can contribute to the development of umbilical hernias. Umbilical hernias in adults may cause abdominal discomfort and require surgical repair.
Understanding the disease
Symptoms
Symptoms of umbilical hernia include a soft swelling or bulge near the navel, which is most noticeable when the infant cries, coughs, or strains. In adults, the bulge may be more apparent when coughing, straining during a bowel movement, or standing for extended periods. Umbilical hernias in children are usually painless, while those in adults may cause abdominal discomfort. If the hernia becomes incarcerated or strangulated, it can lead to nausea, vomiting, fever, pain, tenderness, swelling, or discoloration at the site of the hernia. Seek emergency care if you experience these symptoms.
Risk Factors
Risk factors for developing an umbilical hernia include being an infant, with umbilical hernias being most common in premature babies and those with low birth weights. In the United States, black infants appear to have a slightly increased risk. For adults, being overweight or having multiple pregnancies may increase the risk. Complications for children are rare but can occur when the protruding abdominal tissue becomes trapped, leading to blood supply reduction, tissue damage, and infection. Adults with umbilical hernias are more likely to experience a blockage of the intestines, requiring emergency surgery.
Development
Umbilical hernias develop when part of the intestine protrudes through a weak spot or opening in the abdominal muscle wall near the navel. The most common cause of umbilical hernias is a weakness in the abdominal muscles that occurs during pregnancy or gestation. This is especially common in infants who are born prematurely or with low birth weights. In adults, increased abdominal pressure from factors such as obesity, multiple pregnancies, fluid in the abdominal cavity, or previous abdominal surgery can contribute to the development of an umbilical hernia.
Assessment and Diagnosis
Triage
You should see a doctor if you suspect that your baby has an umbilical hernia. If your baby has an umbilical hernia and shows any of the following symptoms, seek emergency care:
- Begins to vomit
- Appears to be in pain
- Has tenderness, swelling, or discoloration at the site of the hernia Similar guidelines apply to adults. If you have a bulge near your navel and experience any of these symptoms, talk with your doctor. Seek emergency care if the bulge becomes painful or tender. Prompt diagnosis and treatment can help prevent complications.
Diagnosis
Umbilical hernias can be diagnosed during a physical exam by a healthcare professional. During the examination, the healthcare provider will visually inspect the area around the bellybutton for a bulge or swelling. They may also gently push on the bulge to check if it can be pushed back into the abdomen. Imaging studies, such as abdominal ultrasounds or CT scans, may be used to screen for complications, but they are not typically used for diagnosing umbilical hernias. If you suspect you or your child has an umbilical hernia, it is recommended to consult with a family doctor or pediatrician for proper evaluation and guidance.
Management and Treatment
Complications
Complications of an umbilical hernia can arise when the protruding abdominal tissue becomes trapped (incarcerated) and can no longer be pushed back into the abdominal cavity. This reduces the blood supply to the section of trapped intestine and can lead to abdominal pain and tissue damage. If the trapped portion of intestine is completely cut off from the blood supply, it can lead to tissue death, and infection may spread throughout the abdominal cavity, causing a life-threatening situation. Adults with umbilical hernias are somewhat more likely to experience a blockage of the intestines, which may require emergency surgery to treat.
Home Remedies
It is important to consult with a healthcare professional for proper diagnosis and treatment recommendations for an umbilical hernia.
Treatment
Treatments for umbilical hernias typically involve surgery, as they do not usually close on their own in adults. In infants, umbilical hernias may close on their own without intervention, but it's important to monitor them for any signs of complications. If a complication arises, emergency surgery may be required. Surgery for umbilical hernias is generally safe and effective. It involves repairing the weakened area of the abdominal muscle, usually by pushing the protruding tissue back into the abdominal cavity and closing the opening with stitches.
Preparing for medical consultation
To prepare for an appointment if there are suspicions that your baby may have an umbilical hernia, you should:
- Be aware of any pre-appointment instructions. When you schedule the appointment, ask if there's anything you need to do in advance, such as avoiding solid foods before the exam.
- Make a list of any symptoms you or your baby is experiencing, including any that might seem unrelated to the reason for the appointment.
- Write down your or your baby's family history, including details from both the maternal and paternal sides of the family.
- Ask a family member or friend to come with you, if possible. Sometimes it can be difficult to remember all of the information provided to you during an appointment.
- Write down questions to ask the doctor. Some basic questions to ask include:
- What is the most likely diagnosis?
- What are the treatment options?
- What are the risks and benefits of each treatment option?
- What is the expected course and prognosis for an umbilical hernia? Remember to bring your baby's medical history and any relevant test results to the appointment. This information will help the doctor make an accurate diagnosis and create a personalized treatment plan.