What is Umbilical Hernia?

Hernia is a common condition in which part of an internal organ or tissue bulges through a muscle.

An umbilical hernia occurs when the intestines or fat from the abdomen bulge through umbilicus (belly button or navel).

1. How common is Umbilical hernia?

Umbilical hernias are common. In adults, umbilical hernia comprises of 10 percent of all abdominal hernias. In children the umbilical hernia is more common, occurring in 10 to 20 percent of all children. Low birth weight and premature infants are at increased risk to develop umbilical hernia.

2. Symptoms of Umbilical hernia

Many persons only notice a small bulge at or around belly button (or navel). It typically increases in size on standing and disappears when lying down. It becomes prominent on coughing and straining as the pressure increases inside the abdomen. You may also experience pressure or dragging sensations at the site of hernia.

3. Causes of Umbilical hernia

Umbilical hernia basically occurs when there is a weakness in the muscles of abdominal wall. When baby is inside the mother’s uterus, an umbilical cord passes through a hole in the baby’s abdomen, where belly button is present. This hole closes soon after birth, but in some babies it remains open and a gap persists through which abdominal contents can bulge out spontaneously or whenever the pressure inside the abdomen increases.

4. Risk Factors of Umbilical hernia

Congenital defects
Preterm babies or babies with low birth weight
Lifting heavy objects
Fluid in the abdominal cavity (ascites)
Obesity
Pregnancy
Chronic constipation and straining
Chronic coughing
Previous hernia repair or abdominal surgery
Trauma

5. Prevention of Umbilical Hernia

The risk of umbilical hernia can be reduced by decreasing the intra-abdominal pressure. It can be achieved by:

Maintaining a healthy weight
Preventing constipation by consuming high-fiber foot.
Avoiding heavy lifting
Stopping smoking

6. Complications of Umbilical hernia

Most cases of Umbilical hernia are not life threatening. Rarely, umbilical hernia may become strangulated or incarcerated. In these cases, a part of intestine becomes trapped within the hernia and the bulge does not go back inside abdomen. The blood supply to the trapped part of intestine is also reduced resulting in ischemia and gangrene of the part of intestine. It is a surgical emergency and a surgery is needed to relieve the trapped part of intestine. The common symptoms of a strangulated or incarcerated umbilical hernia are:

Extreme pain, tenderness and redness in the area of the bulge
Nausea and vomiting
Constipation
Fever
Rapid heart rate

7. Diagnosis of Umbilical hernia

Your doctor will make a diagnosis of umbilical hernia by taking a detailed history and physical examination. Your doctor will ask you to stand and cough to feel the hernia as it bulges out from or around the umbilicus. Your doctor may also check to see if the hernia can be gently massaged back into its proper position in the abdomen. The diagnosis of umbilical hernia is made on clinical grounds and usually no other tests are required.

8. Treatment of Umbilical hernia

If your umbilical hernia is not causing any symptoms and is not uncomfortable, your doctor may advise for a “wait and watch” approach. In most children, umbilical hernia disappears without treatment. In adults, the cause is usually secondary to any condition that weakens the muscle wall or constantly raises the pressure within the abdomen. These cases often do not resolve spontaneously. If you are having constipation or cough, they will be adequately managed to prevent a further increase in the umbilical hernia.

Surgical Management of Umbilical hernia

Surgery is the only treatment to get rid of umbilical hernia and prevent trapping and strangulation. Hernia surgery is also called herniorrhaphy. There are two main types of surgery to repair hernias. These are open hernia repair and laparoscopic hernia repair.

Open hernia repair:

In open hernia repair, your doctor will give an incision in the abdominal wall at or around the umbilicus. After incision, your doctor will move the hernia back into the abdomen, then close the abdominal wall with stitches to prevent the hernia from occurring again. The doctor may also place a synthetic mesh to provide additional support.

Laparoscopic hernia repair:

In laparoscopic hernia repair, your doctor will make several small, half-inch incisions in the abdominal wall at or around the umbilicus . Your doctor will then insert a laparoscope (a thin tube with a tiny video camera attached). Your doctor will then push the hernia back into the abdomen and will repair the defect using a synthetic mesh.

9. Diet and Exercise

To prevent constipation, increase your water intake, use stool softeners, and increase dietary fiber intake. No limitations on physical activity. A standard moderate physical activity of at least 30 minutes for at least five days per week is recommended.

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