Understanding Umbilical Hernias
An umbilical hernia is a condition where part of the intestine or abdominal fat pushes through a weak spot in the abdominal wall near the belly button (umbilicus). It often appears as a soft bulge and may become more noticeable when coughing, straining, or standing.
This article focuses on umbilical hernias in adults. Unlike in infants, adult umbilical hernias do not resolve on their own and often enlarge or become more symptomatic over time.
What Causes an Umbilical Hernia?
In adults, the hernia typically develops due to increased pressure inside the abdomen. Common contributing factors include:
- Obesity
- Pregnancy (especially multiple pregnancies)
- Chronic constipation or straining
- Persistent coughing
- Smoking, vaping, or other nicotine intake
- Fluid buildup in the abdomen (ascites)
- Previous abdominal surgery
Symptoms
- A bulge or soft swelling near the belly button
- Discomfort or pain during activities like lifting, coughing, or straining
- Bulge that becomes more noticeable at the end of the day or with physical activity
- The bulge may flatten or disappear when lying down
In some cases, the hernia can become tender or more painful, which may suggest a complication.
What Can Go Wrong If Left Untreated?
In adults, umbilical hernias tend to increase in size over time. Potential complications include:
- Incarceration: The contents of the hernia become trapped and cannot be pushed back in
- Strangulation: Blood supply to the trapped bowel is cut off, leading to tissue death. This is a surgical emergency
- Bowel obstruction: If part of the bowel becomes stuck, it may lead to blockage
These complications are uncommon but serious. Larger hernias are also more difficult to repair.
Diagnosis
Umbilical hernias are usually diagnosed during a physical examination. Your GP or surgeon will examine the area and may ask you to cough or strain to make the hernia more prominent.
- Ultrasound may be used if the diagnosis is uncertain or if there is concern about complications
- CT scan is occasionally used for large or complex hernias, or when symptoms suggest another issue
When to Seek Medical Advice
You should speak to your GP or a specialist if:
- You notice a bulge near your belly button that persists or increases in size
- You experience pain, tenderness, or a change in the appearance of the bulge
- The bulge becomes red or firm, or you experience nausea and vomiting
These symptoms may indicate a complication such as strangulation and should be assessed urgently.
Living with an Umbilical Hernia
Small, painless umbilical hernias can sometimes be monitored, particularly if you are not experiencing symptoms and are not a candidate for surgery. However, hernias tend to enlarge over time.
Maintaining a healthy weight, avoiding heavy lifting, and addressing constipation or chronic cough can help reduce abdominal pressure and slow progression.
Support garments may provide temporary relief in some cases but do not treat the hernia. Ultimately, surgical repair is the only definitive treatment.
As with all hernias, early assessment and treatment offer the best outcomes.
