Umbilical hernia

An umbilical hernia appears when fat, tissue or a loop of the bowel pushes through the muscles around your navel. These muscles sometimes have a weakness at the navel, allowing an umbilical hernia to push through.

An umbilical hernia can affect adults, children and babies. Umbilical hernias in adults tend to be above or below the navel, these are sometimes called paraumbilical hernias.

Umbilical hernias are common in babies and young children, particularly in babies who are born prematurely. The hernia usually appears as a painless lump in the centre of the navel and disappears naturally by the age of two.

In adults and older children, an umbilical hernia will probably get worse over time. It won’t go away without treatment and can be successfully repaired with surgery.

There are very few umbilical hernia symptoms, other than a bulge (hernia) around the centre of your abdomen (stomach). This bulge may disappear when pressed or when you lie down and you may also notice discomfort around your navel. It may get bigger when laughing, coughing, crying or going to the toilet.

Occasionally, an umbilical hernia can become trapped (incarcerated) and/or the blood supply cut off (strangulated). Symptoms of an incarcerated or strangulated umbilical hernia include:

• Pain and tenderness around the hernia’s bulge
• Nausea and vomiting
• A change in the colour of your hernia

If you or your child has any of these symptoms, seek urgent medical assistance. Incarcerated hernias and strangulated hernias are serious complications which can cause severe pain and damage and require emergency treatment.

If you suspect your baby has an umbilical hernia, ask your GP for a diagnosis. If the lump is still there when your child’s approaching school age, your GP may recommend an umbilical hernia repair.

Umbilical hernias in adults usually require surgery to reduce the risk of complications. If you think you have an umbilical hernia, make an appointment to see your GP.

Your GP will examine your abdomen and may refer you for a CT scan or ultrasound to check for complications.

If your GP recommends umbilical hernia repair, they’ll refer you to a consultant surgeon, who’ll discuss your options with you.

In adults, surgery is often recommended because the hernia is unlikely to get better on its own and the risk of complications without treatment, such as obstruction and strangulation, is higher. Surgery will get rid of the hernia, but there’s still a chance of it returning in the future.

Surgery may be recommended for a child if the hernia:

• Is large
• Hasn’t disappeared by the age of three or four

During pregnancy, the umbilical cord passes through an opening in the baby’s abdomen and carries oxygen and nutrients to the baby. This opening should fully close after birth, but sometimes a weak spot may be left in the abdominal wall where the muscles haven’t sealed completely. An umbilical hernia can develop when fatty tissues, or part of the bowel, push through the weakened area.

In adults, umbilical hernias usually develop when there is too much pressure on the abdominal wall and fatty tissues or part of the bowel push through. You’re more likely to develop an umbilical hernia if you’re:

• Pregnant – especially if you’re pregnant with more than one baby or have had multiple pregnancies
• Overweight
• Suffering from a long-term (chronic) cough
• Regularly lifting or pushing heavy objects

The only treatment for an umbilical hernia is umbilical surgery repair.

This is a relatively simple surgical procedure which is sometimes carried out with keyhole surgery. During umbilical hernia repair, your surgeon will remove the hernia and strengthen the weakness in your abdominal muscles with mesh.

In children, the surgeon will remove the hernia and close the weakness in the abdominal muscles with stitches.

The procedure is performed under general anaesthetic and takes around 30 minutes.

You should be able to go home on the same day as your surgery. You may feel some discomfort during your recovery but this will soon disappear. You’ll need to stop strenuous activities for a couple of weeks after surgery. Your doctor may recommend up to two weeks off work or school. You should be able to return to your normal activities after a month of recovery.

As with many procedures, there are some risks with umbilical hernia surgery. Complications are uncommon but may include:

• Infection to the wound
• Bleeding
• Wound rupture
• Return of the hernia
• Different appearance of the navel

Do umbilical hernias get bigger?

In babies and young children, you may find that the lump gets bigger when they’re laughing, crying, coughing or going to the toilet.

In older children and adults, an umbilical hernia may continue to grow over a couple of months to the size where it may cause some complications. Most umbilical hernias are less than 2cm across but they can enlarge to the size of a plum or grapefruit. In these circumstances, there is a risk of developing a strangulated hernia.

Do umbilical hernias go away?

In babies and young children, an umbilical hernia usually goes away by the age of two. If it persists until they’re three or four, then surgery may be required.

In older children and adults, umbilical hernias won’t go away without treatment and can be successfully repaired with surgery.

When should I be concerned about an umbilical hernia?

If you think you or your child has an umbilical hernia, you should see your GP.

Occasionally, an umbilical hernia can become trapped (incarcerated) and cut off the blood supply to healthy tissues. You should seek medical attention if you have:

• Pain and tenderness around the hernia’s bulge
• Nausea and vomiting
• A change in the colour of your hernia

Can I push my umbilical hernia back in?

You may find that you’re able to push your hernia back into your abdomen, or that it disappears when you’re lying down, but this doesn’t treat it. The only way to fully get rid of an umbilical hernia is surgery.

What foods should you eat with an umbilical hernia?

You may find that straining on the toilet because of constipation causes pain around your hernia. Eating large amounts of vegetables, fruit and food high in fibre, such as brown rice, wholemeal bread and pasta, can help with this.

Can you exercise with an umbilical hernia?

You should be able to exercise with an umbilical hernia, but avoid workouts that put a lot of pressure on your abdomen and always stop if you’re in pain. You may find it helpful to speak to a physiotherapist for more advice.