Umbilical Hernia: Causes, Symptoms, And Treatment

An umbilical hernia occurs when there is a gap in the connective tissue sheaths of the abdominal wall, behind the belly button. This gap is called a hernial orifice. Tissue leaks through this weak spot.

Externally, an umbilical hernia is visible by an outpouching.

An umbilical hernia is noticeable with a bulge on the navel. In babies, an umbilical hernia is often congenital and recedes on its own.

Learn more about umbilical hernia here.

What Is An Umbilical Hernia?

An umbilical hernia is a tear in the muscle skin located behind the navel. The navel is a natural weak spot. Tissue leaks through the tear in the muscle skin and the umbilicus.

This is noticeable with a bulge at the navel. The gap through which the tissue exits is called a hernial orifice, while the bulge on the abdomen is called a hernial sac.

Such a hernia does not always cause discomfort. Often the bulge is hardly visible so that the hernia of the abdomen is not noticeable or only after some time. There may be loops of the intestine in the hernia sac.

If these loops of intestine push through the hernial orifice and become trapped, this can lead to life-threatening complications. This is associated with severe abdominal pain.

If an umbilical hernia occurs in adults, the risk of complications is about 30 percent. Therefore, umbilical hernia surgery is almost always required in adults.

Umbilical Hernia In Babies

An umbilical hernia is relatively common in babies. If your baby’s belly button bulges outwards, this is no cause for alarm.

An umbilical hernia often occurs immediately after birth. During pregnancy, the unborn baby is connected to the placenta via the umbilical cord. There is a small opening under the umbilical cord, in the baby’s abdominal wall.

If the umbilical cord has fallen off after birth, the belly button is formed, under which there is a small gap. This gap closes as the abdominal muscles become stronger.

If connective tissue passes through this gap, a hernia develops, which is noticeable with a small bulge. Umbilical hernia in babies can be congenital or acquired.

Congenital Umbilical Hernia In The Baby

A natural umbilical hernia develops during the baby’s development in the womb. Beginning on the 32nd day of pregnancy, the baby’s intestines extend into the umbilical cord skin and form an umbilical loop.

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The umbilical loop grows larger and larger. It twists and expands until it is forced out of the abdominal cavity. This physiological umbilical hernia persists until about the ninth week of pregnancy.

If it does not regress, the baby has a congenital umbilical hernia after birth.

The Acquired Umbilical Hernia In The Infant

If the umbilical cord falls off in the baby, the original passage point of the umbilical cord becomes scarred. This results in the development of the belly button. The navel requires careful care to prevent infection.

If the belly button is inflamed, you should show it to the pediatrician. If the point where the umbilical cord passes through does, not scar, an acquired umbilical hernia will develop. Loops of the large or small intestines can be pushed out through this gap in the abdominal wall.

Because the abdominal wall and connective tissue are still very weak in premature birth s, this type of acquired umbilical hernia often occurs in premature births.

Coughing or crying increases pressure into the abdomen, which can lead to an umbilical hernia.

Acquired umbilical hernia may also occur in association with metabolic disorders such as hypothyroidism or mucopolysaccharidoses, as well as trisomy.

Umbilical Hernia – Not To Be Confused With Umbilical Cord Hernia

Mostly harmless, umbilical hernia is different from umbilical cord hernia.

The umbilical cord hernia is much more dangerous and is a congenital malformation. Several organs are turned inside out and are located in the umbilical cord skin. Surgery is required to move the organs into the abdominal cavity.

Symptoms Of Umbilical Hernia

Umbilical hernia is characterized by swelling or protrusion of the belly button. The umbilical hernia often remains undetected for a long time because the swelling is barely visible and it does not cause any discomfort.

If the hernia is smaller than 1.5 centimeters, it causes little discomfort. However, it may cause pain when coughing, during bowel movements or later during physical exertion. The umbilicus may then become more prominent.

How An Incarcerated Umbilical Hernia Becomes Noticeable

It is rare for intestinal loops to become trapped in the baby’s umbilical hernia. This is noticeable with severe pain and often vomiting.

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The following symptoms may occur:

  • Fever.
  • Palpitations.
  • Bowel movements.
  • Reddening of the navel.

Unlike a small umbilical hernia, which presents with a bulging navel, an umbilical hernia with trapped intestinal loops cannot be pushed back. A life-threatening intestinal obstruction can result.

If the trapped part of the intestine is no longer supplied with sufficient blood and oxygen, the umbilical hernia may turn blue.

The trapped intestine may die. Because a pinched umbilical hernia is life-threatening, umbilical hernia surgery must always be performed.

How To Treat An Umbilical Hernia In A Baby

You should present your baby to the pediatrician if he or she has an umbilical hernia or if the belly button is inflamed. In most cases, the umbilical hernia is harmless. The pediatrician will keep the umbilical hernia under control during checkups.

The pediatrician will always push the umbilical hernia back. This is usually accomplished without any problems. If the abdominal muscles become stronger, the hernia usually regresses on its own.

The belly button hernia disappears on its own in about 90 percent of babies in the first year of life.

What You Should Not Do Under Any Circumstances

The doctor can push a harmless umbilical hernia back into the abdominal cavity. However, you should never do this yourself, as this can lead to injuries.

You should also not tape the umbilical hernia so that it remains in the abdominal cavity. Instead, you should avoid long periods of crying and try to calm your baby. This way you can prevent the umbilical hernia from getting worse.

Baby Care For An Umbilical Hernia

If your baby has an umbilical hernia, care is not a problem. Since the hernia is not an open wound, you can wash, bathe and change your baby as usual. Umbilical care can be done as usual.

When Should A Hernia Be Operated On?

In adults, umbilical hernia surgery should be performed in any case. In a baby, surgery is only necessary if:

  • The umbilical hernia is incarcerated and life is in danger
  • The umbilical hernia is larger than 2 centimeters
  • The umbilical hernia causes pain
  • the umbilical hernia does not regress at preschool age.

In girls, umbilical hernia surgery is often performed to prevent possible problems during pregnancy. If it is a large umbilical hernia, the skin over it is usually very thin.

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Injuries may occur. If the hernia does not regress on its own, umbilical hernia surgery should be performed at the latest before your child starts school. This way, there will be no discomfort during sports and other physical activities.

How The Operation For Umbilical Hernia Is Performed

How the umbilical hernia surgery is done depends on the size of the hernia. The surgery is performed under general anesthesia. The surgical methods are open and closed surgery.

In open surgery, the doctor opens the abdominal wall with an arch-shaped incision around the navel. He pushes the contents of the hernia sac into the abdominal cavity. In the case of a large umbilical hernia, the abdominal wall can be stabilized with a mesh.

The hernial orifice is then closed. Closed surgery is performed as an abdominal endoscopy. Only a small incision is required for this. Closed surgery is gentler for the patient.

It is performed when the umbilical hernia is only small. The contents of the hernia sac are pushed back into the abdominal cavity. The risk of wound infection is lower with closed surgery.

Aftercare After Umbilical Hernia Surgery

After umbilical hernia surgery, your child may be given pain medication. This will prevent him or her from crying out in pain and possibly rupturing the scar. After the operation, several check-ups are necessary.

During these, the doctor will change the plaster. The wound is usually healed after one week. You must not bathe your baby during this time. If the wound has healed well, bathing, showering or baby swimming are possible again without any problems.

Umbilical Hernia During Pregnancy

An umbilical hernia can also occur in pregnant women. The abdomen is greatly stretched during pregnancy. The muscles can stretch out.

Such a gap forms most often at the navel, since the muscle layers there are connected only by connective tissue. If tissue passes through this hernial orifice, the result is an abdominal umbilical hernia.

In most cases, such an umbilical hernia is harmless during pregnancy. However, loops of the intestine can also become trapped in the hernial orifice during pregnancy. The umbilical hernia in pregnancy is noticeable with a bump on the belly button.

It does not usually cause pain and therefore does not pose a risk to the mother and child. It usually disappears after delivery.

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Factors That Promote An Umbilical Hernia During Pregnancy

An umbilical hernia in pregnancy can be favored by various factors, just like any umbilical hernia in children or adults:

  • Congenital connective tissue weakness.
  • Heavy lifting and carrying.
  • Heavy physical exertion.
  • Excess weight.

When An Umbilical Hernia Should Be Operated On During Pregnancy

An incarcerated umbilical hernia during pregnancy is rare. If the umbilicus hurts or is blue or reddish in color, it may indicate an incarcerated umbilical hernia.

This is dangerous because pinched sections of intestine are no longer supplied with blood and could die. The umbilical hernia must then be operated on.

If you experience pain or discoloration of the navel during pregnancy, you should consult a doctor. An operation must then be performed during pregnancy. If the umbilical hernia does not recede after pregnancy, it should be operated on.

Again, depending on the size of the umbilical hernia, open or closed surgery can be performed. You can help the gap between the muscles in the navel area to close again with good postnatal exercises.

How You Can Prevent An Umbilical Hernia

You can prevent an umbilical hernia in your baby, but also in yourself. You should make sure that your baby does not cry too much and calm it down during the crying phases. You should also avoid being overweight in your baby.

You can prevent an umbilical hernia in yourself during pregnancy, but also independently of pregnancy, by not lifting and carrying heavy, avoiding physical exertion, and reducing excess weight.

Umbilical Hernia: Conclusion

An umbilical hernia occurs when the connective tissue below the navel gives way, creating a gap. Tissue leaks through this gap. If intestinal loops are pinched off in the hernial orifice, immediate umbilical hernia surgery is required because there is a risk of death.

An umbilical hernia in a baby can be congenital or acquired. It recedes by itself in most cases and does not cause any discomfort. Surgery is required if intestinal loops are entrapped.

Surgery should also be performed if it is a major hernia or if the hernia does not regress by preschool age. An umbilical hernia can also occur during pregnancy. It is harmless and usually regresses on its own.


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