Hernia, umbilical

A hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall.

An umbilical hernia appears as a painless lump in or near the navel (belly button) that may get bigger when you laugh, cough, cry or go to the toilet. It may shrink when you are relaxed or lying down.

Umbilical hernias are very common in infants and young children, especially in babies born prematurely. In many of these cases, the umbilical hernia goes back in and the muscles reseal before the child's first birthday.

Umbilical hernias can develop in adults, in which case the hernia will probably get worse over time if not treated.

What causes an umbilical hernia?

During pregnancy, the umbilical cord passes through an opening in the baby's abdomen (tummy). This opening should close shortly after birth, but in some cases the muscles do not seal completely.

This leaves a weak spot in the surrounding muscle wall (abdominal wall). An umbilical hernia can develop when fatty tissue or a part of the bowel pokes through into an area near the navel.

In adults, factors that can contribute to developing an umbilical hernia include being overweight or obese, straining while moving or lifting heavy objects, having a persistent, heavy cough and having a multiple pregnancy (such as twins or triplets).

When is surgery needed?

If necessary, umbilical hernias can be treated with surgery to push the bulge back into place and strengthen the weakness in the abdominal wall.

This operation may be recommended for your child if the hernia is large or has not disappeared by the time they reach four or five years old.

You will usually be advised to wait for your child to reach this age because the operation is not essential unless there are complications (see below) and the risk of your child developing complications is very low.

However, surgery is recommended for most adults with an umbilical hernia, because the hernia is unlikely to get better by itself when you are older and the risk of complications is higher.

Complications that can develop as a result of an umbilical hernia include:

obstruction – where a section of the bowel becomes stuck outside the abdomen, causing nausea, vomiting and pain
strangulation – where a section of bowel becomes trapped and its blood supply is cut off; this requires emergency surgery within hours to release the trapped tissue and restore its blood supply so it does not die

Surgery will get rid of the hernia and prevent any serious complications, although there is a chance of it returning after the operation.

Repairing an umbilical hernia

An umbilical hernia repair is a relatively simple procedure that normally takes about 20-30 minutes to perform. General anaesthetic is usually used, so you or your child will not feel any pain while the operation is carried out.

The weak spot in the abdominal wall is usually closed with stitches, but if the hernia is large, a special mesh may be used to strengthen the area.

You or your child should be able to go home the same day the operation is carried out, but you may feel a bit sore and uncomfortable while you recover.

Strenuous activities will need for be limited for a few weeks after the operation and a week or two off school or work is often advised. Most people are able to return to all their normal activities within a month of surgery.

Are there any risks from surgery?

Complications from an umbilical hernia repair are uncommon but can include:

the wound becoming infected and needing antibiotics
the hernia returning
feeling sick and having a headache or numbness in the legs a few hours after the operation

The belly button will often look normal after surgery, but there is a chance that its appearance may change as a result of the operation.