Umbilical Hernia

Overview

An umbilical hernia is a soft bulge near the belly button (navel). It happens when part of the intestine or fatty tissue pushes through a weak spot in the abdominal wall muscles. In babies, this spot is where the umbilical cord was attached. In adults, it can happen when pressure inside the abdomen increases.

Yes, umbilical hernias are common. About 1 in 10 babies are born with one, and they also affect many adults, especially people who are overweight or have had multiple pregnancies.

Umbilical hernias can affect anyone, but they are most common in infants, especially premature babies. In adults, they are more frequent in people who are overweight, in women during or after pregnancy, and in people who strain their abdominal muscles often.

Symptoms

Common symptoms

• A soft bulge or swelling near the belly button
• The bulge is more visible when you cough, strain, or stand up
• The bulge may flatten or go away when you lie down
• Mild discomfort or pressure at the site

Symptoms in children

• A bulge that appears when the baby cries, coughs, or strains
• The bulge usually goes away when the baby is calm and lying down
• The area is usually painless and soft to the touch

Symptoms in older adults

• A bulge near the belly button that may become more noticeable with activity
• A feeling of heaviness, dragging, or pressure in the abdomen
• Constipation or difficulty passing stool due to the bulge
• Intermittent pain or soreness around the navel

Causes

Main causes

• A natural weakness in the abdominal wall at the site where the umbilical cord was attached during pregnancy
• Increased pressure in the abdomen from heavy lifting, coughing, or straining
• Excess belly fat or fluid in the abdomen
• Pregnancy, especially multiple pregnancies

Risk factors

• Being overweight or obese
• Having a history of umbilical hernia in the family
• Being born prematurely
• Having chronic constipation or a persistent cough
• Undergoing abdominal surgery in the past
• Experiencing multiple pregnancies or giving birth to twins or triplets

When to see a doctor

See a doctor urgently if:

• If you have severe pain or tenderness at the hernia site
• If the bulge becomes red, purple, or darkened
• If you have nausea, vomiting, or cannot pass gas or stool
• If the bulge cannot be pushed back in easily

Book a routine appointment if:

• If you notice a new bulge near your belly button that does not hurt
• If you have a hernia and it begins to cause mild discomfort or changes in size
• If your child still has an umbilical hernia after age 4
• If you are unsure whether you have a hernia or another condition

Diagnosis

A healthcare provider can usually diagnose an umbilical hernia with a simple physical exam. They will look at your belly button and feel the bulge. They may ask you to cough or strain to make the bulge more visible.

Tests that may be done

• Usually no tests are needed for a straightforward umbilical hernia
• An ultrasound scan can help if the diagnosis is unclear
• A CT scan may be ordered in adults if there are concerns about complications or if the hernia is unusual

What to expect at your appointment

The exam is quick and painless. You may be asked to stand, lie down, cough, or strain. The provider will tell you whether the hernia is reducible (able to be pushed back in) and whether there are any signs that require urgent treatment. They will also explain your options, which may include watchful waiting or referral for surgery.

Treatment

Treatment depends on age, symptoms, and whether the hernia can be pushed back easily. In babies, most umbilical hernias close on their own. In adults, surgery is often recommended to prevent the hernia from becoming trapped or strangulated, especially if it is bothersome.

Self-care at home

• Keep the area clean and dry, just like normal skin care
• Avoid lifting heavy objects or straining if you have pain
• Take regular breaks from standing for long periods
• Do not try to use strips, tape, or homemade binders to hold the hernia in — they do not help and can irritate the skin

Medical treatments

For adults, surgery is the main treatment. It can be done with open surgery or laparoscopically (keyhole surgery). The surgeon pushes the bulge back and repairs the weak spot in the abdominal wall, often using a mesh to make it stronger. The choice of technique depends on your health, the size of the hernia, and your surgeon's expertise. Medications are not used to treat hernias.

When is surgery considered?

Surgery is usually recommended for adults when the hernia causes pain, grows larger, or cannot be pushed back easily. Surgery is also advised if there is a risk of complications, or if the hernia is getting in the way of daily life. In children, surgery is only needed if the hernia does not close by around age 4 to 5, or if it causes problems earlier.

Living with this condition

Most people with an umbilical hernia can live normally. Watch for any changes in the size or comfort of the hernia. Do not ignore new pain or tenderness. Keep your doctor's advice in mind and seek help quickly if something feels different.

Lifestyle tips

• Maintain a healthy weight to reduce pressure on the abdomen
• Avoid heavy lifting or use proper technique if you must lift something
• Manage chronic cough or constipation with medical help
• If you smoke, consider quitting, because coughing can strain the hernia

Diet and exercise

Eat a balanced diet rich in fiber to prevent constipation and straining. Drink plenty of water. Exercise regularly, but avoid exercises that strain the belly, like heavy weightlifting, until you have checked with your doctor. Walking, swimming, and light stretching are usually safe.

Mental health and emotional wellbeing

Living with a hernia can cause worry about potential pain or needing surgery. These feelings are normal. Talk to your healthcare provider about your concerns. If anxiety becomes overwhelming, consider speaking with a counselor or mental health professional.

Prevention

You cannot always prevent an umbilical hernia, especially in babies. In adults, you can reduce pressure on your abdominal wall by maintaining a healthy weight, avoiding heavy lifting, treating constipation, preventing coughing fits, and using good posture when lifting or standing.

Complications

If left untreated

• Incarceration: the hernia becomes trapped and cannot be pushed back in
• Strangulation: the blood supply to the trapped tissue is cut off, leading to tissue death
• Bowel obstruction: a blocked intestine causing severe pain, vomiting, and inability to pass gas
• Peritonitis: an infection inside the abdomen, which is a life-threatening emergency

Long-term outlook

For babies, the outlook is very good: most umbilical hernias close by themselves. For adults, surgery is very effective and usually solves the problem permanently. Even if you choose to wait, regular monitoring and quick action in an emergency can keep you safe. The vast majority of people with an umbilical hernia recover fully with proper care.

Find support

International organisations

• NHS.UK ↗
• Mayo Clinic ↗

Local organisations

• Your local health service or clinic · Many countries

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