Umbilical Hernia
A bulge at the belly button from a weak spot in the abdominal wall
Quick Facts
- Type: Abdominal wall hernia
- Location: At or near the navel
- In infants: Often closes on its own by age 1–2
- Warning sign: Painful, firm, or discolored bulge
Overview
An umbilical hernia happens when part of the intestine or fatty tissue pushes through a weak area in the abdominal wall near the belly button, creating a soft bulge. It is one of the most common types of hernia.
Umbilical hernias are especially common in infants, where the opening through which the umbilical cord passed has not fully closed. Many of these close on their own as the child grows. In adults, umbilical hernias usually need surgical repair because they do not resolve and can enlarge over time. Most are not dangerous, but occasionally tissue can become trapped, which is an emergency.
Symptoms
The main sign is a soft bulge or swelling at or near the navel.
- A bulge at the belly button that may become more noticeable with crying, coughing, straining, or standing
- In infants, the bulge often appears when the baby cries and shrinks when they are calm and lying down
- In adults, discomfort or aching in the area, especially with lifting or straining
- The bulge can often be gently pushed back in when relaxed
Warning signs of a trapped (strangulated) hernia include a bulge that becomes firm, painful, and cannot be pushed back in, along with redness or discoloration, vomiting, fever, or severe abdominal pain. These require emergency care.
Causes
An umbilical hernia forms at a natural weak point in the abdominal wall where the umbilical cord passed through.
- In infants: The opening normally closes after birth, but if it does not close completely, tissue can push through.
- In adults: The area can weaken or reopen due to factors that increase pressure inside the abdomen, such as obesity, multiple pregnancies, fluid in the abdomen, or heavy lifting and chronic straining.
Risk Factors
- Premature birth or low birth weight in infants
- Being overweight or obese
- Multiple pregnancies
- Conditions that cause fluid buildup in the abdomen
- Persistent coughing or straining, such as with constipation
- Previous abdominal surgery in the area
Diagnosis
An umbilical hernia is usually diagnosed by a physical exam. A clinician can see and feel the bulge and may ask the person to cough or strain to make it more noticeable, and may gently try to push it back in.
Imaging such as ultrasound or CT is not always needed but may be used to confirm the diagnosis, measure the hernia, or check for complications, particularly if the bulge is painful or cannot be pushed back in.
Treatment
Treatment depends on age, size, symptoms, and whether complications are present.
- Watchful waiting in infants: Most umbilical hernias in babies close on their own, often by age 1 to 2, and simply need monitoring. Home remedies such as taping or strapping the area are not recommended.
- Surgery in children: Considered if the hernia is large, has not closed by a few years of age, or causes problems.
- Surgery in adults: Usually recommended, since adult umbilical hernias rarely close on their own and can grow or become trapped. Repair is a common, generally straightforward operation.
- Emergency surgery: Needed promptly if tissue becomes trapped or its blood supply is cut off.
Prevention
Umbilical hernias in infants cannot be prevented. In adults, lowering pressure on the abdominal wall may reduce the risk or keep a hernia from worsening:
- Maintain a healthy weight
- Use proper technique and avoid straining when lifting heavy objects
- Treat persistent coughing and prevent constipation to avoid straining
- Seek evaluation for a new bulge before it enlarges
When to See a Doctor
See a doctor if you or your child develop a bulge at the belly button, so it can be evaluated and monitored. Adults with an umbilical hernia should discuss whether repair is advisable.
Seek emergency care immediately if a hernia bulge becomes firm, painful, and cannot be pushed back in, or if there is redness or discoloration over it, vomiting, fever, or severe abdominal pain. These can signal trapped tissue that has lost its blood supply, which is a surgical emergency.
Frequently Asked Questions
Do umbilical hernias go away on their own?
In infants, most umbilical hernias close on their own, often by age 1 to 2, and only need monitoring. In adults, they usually do not resolve on their own and are generally repaired with surgery because they can enlarge or become trapped over time.
Is an umbilical hernia dangerous?
Most are not dangerous and cause only a bulge or mild discomfort. The main concern is strangulation, when tissue becomes trapped and loses its blood supply. A bulge that turns firm, painful, and cannot be pushed back in, with redness, vomiting, or fever, is an emergency.
Should I tape or strap my baby's umbilical hernia?
No. Taping, strapping, or placing coins or bandages over the bulge is not recommended and does not help it close. Most resolve on their own with simple monitoring. Talk to your child's doctor about what to watch for and when repair might be needed.
What does umbilical hernia surgery involve?
Repair is a common operation in which the surgeon pushes the tissue back into place and closes the weak spot in the abdominal wall, sometimes reinforcing it with mesh. It is usually straightforward, and most people recover well, though your surgeon can explain the specifics.
What makes an umbilical hernia more likely in adults?
Factors that raise pressure inside the abdomen increase the risk, including being overweight, multiple pregnancies, fluid buildup in the abdomen, chronic coughing, constipation with straining, and heavy lifting. Managing these can help prevent a hernia or keep it from worsening.
References
- MedlinePlus, U.S. National Library of Medicine. Umbilical hernia.
- Mayo Clinic. Umbilical hernia — Symptoms and causes.
- American College of Surgeons. Hernia.
- Nemours KidsHealth. Umbilical Hernias.