About Umbilical Hernia
Umbilical hernias are associated with a weak area of the abdominal wall behind the belly button. A number of factors increase the risk of developing an umbilical hernia, including:
- Age: Infants, especially those born prematurely, have a higher risk of developing an umbilical hernia compared to adults. Infants and young children are more susceptible to umbilical hernias due to the nature of their abdominal wall development.
- Obesity: Children and adults who are overweight or obese are at a significantly higher risk of developing an umbilical hernia compared to individuals with a healthy weight.
- Coughing: Prolonged and forceful coughing can increase the risk of hernias because it puts pressure on the abdominal wall.
- Pregnancy: Pregnant individuals have a higher risk of developing an umbilical hernia, and multiple pregnancies further increase this risk. The changes in the abdominal muscles during pregnancy can contribute to the development of umbilical hernias.
The most common symptom of an umbilical hernia is a bulge or lump near the belly button. This bulge may be more noticeable when the person is coughing, laughing, or straining during activities like using the bathroom. It can vary in size, ranging from as small as a grape to as large as a grapefruit.
As the umbilical hernia progresses or becomes more severe, other symptoms may occur, including:
- Discomfort or pain: In most cases, umbilical hernias are painless. However, in adults, they can cause discomfort and be very painful. The pain can range from mild to severe.
- Pressure around the belly button: People with an umbilical hernia may feel pressure or heaviness around their belly button area.
- Swelling or tenderness: The bulge associated with an umbilical hernia may become swollen, tender, or discolored. This can indicate a more serious situation that requires medical treatment.
- Severe pain: In rare cases, an umbilical hernia can cause severe pain. This should be taken seriously and requires immediate medical attention.
- Vomiting: If the umbilical hernia is causing complications such as constricted blood flow or intestinal obstruction, it may lead to vomiting.
It's important to note that during pregnancy, an umbilical hernia might not cause any symptoms at all. However, if symptoms do occur, they may include a noticeable bulge or swelling around the belly button, pressure around the belly button, and pain or tenderness in that area.
If you or someone you know is experiencing any of these symptoms associated with an umbilical hernia, it's advisable to seek medical attention for proper diagnosis and appropriate treatment options.
To diagnose an umbilical hernia, healthcare providers typically use a combination of physical examinations and medical tests, including:
- Physical Examination: A healthcare provider will perform a physical exam to check for the presence of an umbilical hernia. They will carefully examine the area around the belly button to look for any bulging or protrusion.
- Push Test: During the physical examination, the healthcare provider may try to gently push the hernia back into the abdominal cavity. If it can be easily pushed back, it is referred to as "reducible." If it cannot be pushed back or is trapped in its place, it is called "incarcerated."
- Ultrasound: An abdominal ultrasound may be ordered by the healthcare provider to get a clearer image of the umbilical hernia. This non-invasive test uses sound waves to create images of the abdominal area and can help determine the size and location of the hernia.
- X-ray: In some cases, an X-ray may be requested by the healthcare provider to rule out any complications associated with the umbilical hernia. An X-ray can help identify if there is a risk of obstruction or if there are any other underlying issues.
- Blood Tests: Blood tests may be ordered by the healthcare provider to check for infection or ischemia (lack of blood supply) in cases where there is a concern about complications, especially if part of the herniated contents is trapped or strangulated.
The goals of treatment for umbilical hernia are to alleviate symptoms, prevent complications, and improve overall quality of life for individuals with this condition.
In some instances where the umbilical hernia is small, not bothersome, and reducible, a “watch and wait” approach may be advised.
In other cases, treatment may involve surgery to relieve the incarceration (when the hernia contents get trapped) and to close the hernial orifice (the hole in the abdominal wall).
- Early relief of incarceration: This procedure aims to free any trapped hernia contents. Various approaches can be used, such as laparoscopic or laparotomic methods. Laparoscopic hernia repair is a less invasive procedure where smaller incisions are made, and a camera is inserted to visualize the abdominal cavity. The surgeon gently places the bulging tissue back through the hole in the abdominal wall.
- Closure of the hernial orifice: Once the incarceration is relieved, the next step is to close the hole in the abdominal wall. Some methods include simple suture closure or using a mesh material to reinforce the area. The goal is to securely sew the hole closed and strengthen the abdominal wall.
These treatments are typically performed as one-stage procedures, meaning both steps (relieving incarceration and closing the hernial orifice) are done in a single operation. In some cases, laparotomy (open surgery) may be necessary instead of laparoscopy. The choice of procedure depends on factors such as individual patient characteristics and surgeon preference.
Most umbilical hernias stay the same size or slowly get larger over time. However, there is a special situation with umbilical hernias in babies. Small umbilical hernias that appear before a baby is 6 months old will often disappear before their first birthday. Even larger umbilical hernias may go away before age 3 or 4.
Complications from umbilical hernias rarely occur in children. However, there can be additional complications in both children and adults if the umbilical cord becomes incarcerated. This means that the intestines cannot be pushed back through the abdominal wall and may not receive enough blood supply. This can cause pain and even lead to tissue death, which can result in a dangerous infection or even death. If the intestine becomes obstructed or strangulated, it requires emergency surgery.
Symptoms of a strangulated umbilical hernia include:
- Fever
- Constipation
- Severe abdominal pain and tenderness
- Nausea and vomiting
- A bulging lump in the abdomen
- Redness or discoloration
It's important to note that each individual's situation is unique, so it's always best to consult with a healthcare provider for personalized advice and guidance regarding the natural progression of an umbilical hernia, potential complications, and appropriate treatment options.