Umbilical Hernia: Symptoms, Diagnosis, Causes & Treatment

Updated in January 2024

An umbilical hernia is a protrusion that appears inside or around the belly button. It is formed by part of the intestine or other abdominal organs that manages to bulge through the abdominal muscles and sits between the muscles and skin in the navel area.

This type of hernia, also called navel hernia, is more common in children, but can also appear in adults. It can be noticed when the person exerts force when laughing, lifting weights, coughing or having a bowel movement, for example. This visible bulge may be accompanied by symptoms such as pain, discomfort or nausea.

Although an umbilical hernia is not considered serious, it is important that it is identified and treated to prevent complications like an intestinal infection, reduced circulation and tissue death.

Imagem ilustrativa número 1

Common symptoms

The main symptoms of an umbilical hernia are:

  • A protrusion in the belly button area, which generally becomes larger when exerting force
  • Pain or discomfort at the site of the hernia
  • Abdominal pain
  • Nausea
  • Constipation

In more serious cases or when the hernia causes strangulation of surrounding tissues located, other symptoms may be noted, likeskin color changes (which may turn red or purple), vomiting, fever, swelling, pain or tenderness in the abdomen. In these case, you should seek medical attention immediately.

Umbilical hernias in babies or children generally do not cause pain. They are often noticed when the child cries, coughs or makes some abdominal effort.

Also recommended: Hernia: What it Is, Symptoms, Types, & Treatment tuasaude.com/en/hernia

Confirming a diagnosis

The diagnosis of umbilical hernia is confirmed by a pediatrician or family doctor (depending on the age of the patient) through a physical examination, palpation of the bulge, and assessment of the other presenting symptoms.

Umbilical hernias that are difficult to diagnose may require further testing, like an abdominal ultrasound or CT scan. 

Possible causes

An umbilical hernia is caused by weakening of the abdominal muscles, which can cause part of the intestine or other abdominal organs to pass through the weak point of the muscle. This form bulge that is visible in or around the belly button.

Some factors that can increase the risk for developing an umbilical hernia include:

  • Obesity or overweight
  • Family history of hernias
  • Multiple pregnancy or several pregnancies
  • Ascites, which is the accumulation of fluid in the abdominal cavity
  • Previous surgery in the abdominal region
  • Peritoneal dialysis for the treatment of renal failure
  • Persistent cough
  • Premature birth (in babies)
  • History of a umbilical hernia as a baby

When the baby is developing in the uterus, a small opening is formed in its abdominal muscles, through which the umbilical cord passes, and when these muscles do not close properly after birth, an umbilical hernia can occur.

Umbilical hernias are common in babies, especially premature babies, and can appear around 6 months of age. They usually disappear on their own around 5 years of age, and are not associated with pain.

However, it is important to have the child assessed by a pediatrician so that the severity of the umbilical hernia can be assessed. Severe umbilical hernias that are left untreated can become trapped and cause strangulation in the area, which can be life-threatening for the child.

Umbilical hernia during pregnancy

An umbilical hernia during pregnancy is more common in women who had a hernia when they were children, as the increased pressure inside the pregnant woman's belly causes an opening to appear in the previously-weakened abdominal muscles.

Generally, an umbilical hernia is not dangerous for growing baby, and does not affect the mother's health or make labor more difficult. Depending on the size of the hernia, the general surgeon or abdominal surgeon may recommend the use of a brace during pregnancy and will evaluate the possibility of performing surgery to repair the umbilical hernia after childbirth or at the time of a cesarean section.

Treatment options

The treatment of an umbilical hernia should be guided by a doctor. Specific treatment is often not even needed, especially in babies and children, as their hernias typically resolve by the age of five.

However, if umbilical hernias in babies do not improve by this time, or if the hernia returns in adulthood or shows signs of strangulation, the doctor may recommended surgery. This surgery is aimed at preventing complications, such as intestinal infections or tissue death due from reduced circulation in the area.

This type of surgery is simple, can be performed on children from 5 years of age. The two common approaches include:

  • Videolaparoscopy, which is carried out under general anesthesia. Three small incisions are made in the abdomen to allow the entry of a microcamera and other medical instruments to repair the hernia.
  • Abdominal incision, which is done under epidural anesthesia. An incision is made in the abdomen so that the hernia is pushed into the belly. The abdominal wall is then closed with stitches.

Normally during surgery, the doctor places a protective mesh or net over the weakened muscles to strengthen the abdominal wall and prevent the hernia from bulging again. 

Possible complications

An umbilical hernia is not normally a cause for concern, but if it becomes stuck or fixed into place, it can lead to strangulation. This occurs when the intestine becomes trapped inside the hernia and can no longer return into the abdomen. It requires immediate emergency surgery so that blood circulation is not compromised. it.

This complication can affect people with large or small hernias in the navel, and cannot be predicted. It can happen in people who have had the hernia for one day or for many years.

Symptoms of a strangulated umbilical hernia include intense belly button pain that lasts for several hours. The intestines may stop working, leading to abdominal swelling. Nausea and vomiting are also often present.