What’s an Umbilical Hernia?

An umbilical hernia in adults can produce a bulging belly button.

An umbilical hernia is the name for a small loop of your intestine bulging out of your belly button. Your belly button (or umbilicus) is the small opening among the muscles that cover your belly. It’s where the umbilical cord attaches the fetus to its mother during pregnancy.

The umbilical opening should close soon after birth. Sometimes, it doesn’t fully seal and an umbilical hernia occurs. Umbilical hernias often make the belly button stick out.

Here’s information about umbilical hernias that explains what they are and where they come from. It also explains when they can be dangerous, when they need surgery, how adult surgery differs from surgery for kids, and what to expect after the hernia is treated.

About 1 in every 6 kids develops an umbilical hernia. Boys and girls are at equal risk. They’re more common in African American children, premature babies, and babies born at a low birth weight.

These hernias can crop up years later in adults for other reasons. Pressure may build up in your belly and push the tissue out. This can happen if you have fluid buildup in your belly called ascites that may result from alcoholism.

Pressure can also build up in your belly from:

• Chronic cough
• Chronic constipation
• Repeated vomiting
• An enlarged prostate gland in men (which can also make you strain to pee)

Umbilical hernias can also happen if you’re obese or if you strain your muscles in childbirth. They can also result from lifting heavy weights.

Women who have multiple pregnancies are more at risk for umbilical hernias. Past abdominal surgery can also raise risk.

Umbilical hernias are usually harmless. In children, they often close on their own by the time the child is 4.

Rarely, umbilical hernias cause health-threatening complications. The opening in the abdominal muscle wall can trap the intestinal tissue that pokes through. This is an incarcerated hernia. Trapped tissue may not be able to get enough blood. This can cause pain and damage to the tissue.

If the trapped tissue gets no blood, the tissue dies. This is a strangulated hernia. Dead tissue can cause a serious infection. In those cases, surgery is usually necessary.

Incarcerated and strangulated umbilical hernias are more common in adults than kids.

Babies With Umbilical Hernia

Umbilical hernias form a bulge around your belly button. In babies, you may only see the bulge when they cry, cough, or strain their muscles. When your baby lies down or relaxes, the bulge may shrink or disappear.

When babies have umbilical hernias, they rarely hurt. If the bulge looks red, swollen, or changes color, or if your baby is vomiting and seems to be in pain, it may be a sign of an incarcerated hernia. These are rare. But if you notice these signs, see your pediatrician at once.

Umbilical Hernia in Adults

Adults with umbilical hernias may feel discomfort. You may also have signs of a strangulated hernia. Seek medical care right away if you notice:

• Your hernia bulge has turned red, purple, or darker in color
• Pain and tenderness in your stomach
• A swollen, full, or very rounded belly
• Fever
• Constipation
• Vomiting

Your doctor will perform a physical exam and ask a lot of questions to make a diagnosis. You may need an abdominal ultrasound or CT scan to check for any complications.

In babies, the pediatrician will examine the bulge around the belly button. She’ll see if the bulge sticks out when your baby cries and softens at rest. The pediatrician will gently push the bulge inward to see if the tissue can go back into the abdominal cavity.

She’ll also check to see if the hernia has trapped any contents of your baby’s intestines.

If you’re an adult with signs of a strangulated hernia, you may need blood tests to check for infection. You could also need an X-ray, abdominal ultrasound, MRI, or CT scan to examine your intestines for problems.

Kids with umbilical hernias typically won’t need treatment. Your child might need surgery for an incarcerated hernia or a hernia larger than three-quarters of an inch across. This outpatient surgery only takes about an hour. Your child won’t need to stay overnight.

If your child does need surgery, follow directions about eating and drinking on the day of the surgery. This can reduce your child’s chance of vomiting or breathing in fluids during the procedure.

Your child will have general anesthesia. He will sleep through the surgery and not have any pain. The surgeon will make a small cut below the belly button. Next, he will push the protruding piece of intestine back inside the muscle tissue. Then the surgeon removes the hernia sac -- abdominal lining that pushed through the hole.

The surgeon then stitches the muscle tissue wall to strengthen it and sews the skin around your child’s belly button to the muscle. Your child should be able to go home a few hours later. Premature babies may need to spend the night in the hospital.

Adults with umbilical hernias often need surgery. Surgery may either be open or laparoscopic. You may have either general or local anesthesia.

For open surgery, your doctor will make a small cut below your belly button, push the tissue back into your abdomen, and remove the hernia sac. The surgeon will use stitches to sew up the opening and attach the belly button to the abdominal muscles.

For laparoscopic surgery, your surgeon will make a few tiny cuts around your belly, then pump in gas to inflate your belly. She will then insert a laparoscope -- a long, thin tube with a camera on one end to show where to cut. She will insert instruments in the other cuts to perform the surgery.

Your surgeon may install mesh to strengthen your abdominal muscles and help prevent hernias from returning.

After hernia surgery, your child should feel good the next day. He may need a few doses of pain medicine. He can eat normally.

For a few days after surgery, sponge-bathe your child. Your surgeon will let you know how long to wait before tub bathing.

Your child shouldn’t do any strenuous activity like riding bikes, climbing, or team sports until your surgeon says it’s OK.

Adults can eat and drink water after waking up from their anesthesia. Your health care provider will likely tell you to get up and walk soon after surgery to prevent blood clots. You may be able to go home the same day.

You can go back to work in a few days. But, don’t lift anything heavier than 10 pounds or do any strenuous activities for 6 weeks.

Eat high-fiber foods to make bowel movements easier after surgery.

You may be able to take a shower the day after surgery, but don’t soak in a tub until your surgeon says it’s OK.