What Is an Umbilical Hernia?
Key takeaways:
An umbilical hernia happens when a piece of bowel pushes through the belly button.
Umbilical hernias are very common in small children, but they can also happen in adults.
Adults need surgery to repair their umbilical hernias. But most hernias in children don’t need treatment and will go away on their own with time.
Your belly button is actually a scar. The belly button, or umbilicus, is where your umbilical cord used to be. Once you’re born, you don’t need your umbilical cord anymore, so it falls off and your skin heals over — forming a belly button.
For many people, the last time their belly button needs any medical attention is right after birth, when it’s still healing. But some people develop an umbilical hernia. An umbilical hernia happens when a piece of the bowel pushes through the belly button, creating a bulge.
If you or your loved one has a bulge around or through the belly button — an umbilical hernia could be the cause. Here’s everything you need to know about umbilical hernias.
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What causes an umbilical hernia?
Right underneath the belly button are the abdominal muscles and fascia — thick pieces of tissue that help hold in your organs. Muscles and fascia grow together to fill in the space where the umbilical cord used to be, forming the umbilical ring.
The umbilical ring usually finishes closing right after birth. But sometimes the process takes longer. And sometimes the ring doesn’t close completely. When this happens, infants develop an umbilical hernia.
Umbilical hernias are very common in young children — almost 20% of children have one.
Can adults develop umbilical hernias?
Adults can also get umbilical hernias, even if they didn’t have one as a child. Adults usually develop an umbilical hernia because of increased pressure in the abdominal cavity — the space that contains the organs. Over time, this pressure weakens the umbilical ring and the bowel can push through.
What are the symptoms of an umbilical hernia?
The main symptom of an umbilical hernia is a soft, squishy bulge through or near the belly button.
The bugle may come and go. It usually looks bigger when you’re crying, laughing, or straining to go to the bathroom. That’s because all these actions increase the pressure in the abdominal cavity.
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Umbilical hernias should not cause pain. And you should be able to push the bulge in with just gentle pressure (but it will pop right back out).
Who’s most at risk for an umbilical hernia?
Some children are more likely to develop an umbilical hernia, including those who:
Are born prematurely
Have Down syndrome (trisomy 21) or Edwards syndrome (trisomy 18)
Have congenital hypothyroidism
Have Beckwith-Weidemann syndrome
Adults are more likely to develop an umbilical hernia if they have certain medical conditions like:
Many people who are pregnant also develop umbilical hernias.
How do you treat an umbilical hernia?
Surgery is the only treatment for umbilical hernias. Surgery will repair the umbilical ring so that it closes.
Most umbilical hernias in children don’t need any treatment and go away on their own over time. If the umbilical hernia hasn’t gone away by the time a child is 5 years old, the next step is usually surgery.
In adults, umbilical hernias need to be repaired with surgery. But often, the surgery doesn’t have to be done immediately.
When should you wait to treat an umbilical hernia?
Healthcare providers often recommend waiting on surgery to repair an umbilical hernia in children. That’s because, most of the time, they go away on their own. Studies show that 90% of the time, the umbilical hernia goes away by the time a child is 4 years old.
What happens if you don’t treat an umbilical hernia?
If you don’t repair an umbilical hernia, there’s a risk for complications.
The main complications are:
Incarceration: This is when the bowel gets trapped inside of the hernia. Incarceration can lead to strangulation. It needs to be repaired with surgery right away.
Strangulation: This is when the bowel is trapped inside of the hernia and the blood flow to the bowel gets cut off. Strangulation can be life-threatening. It needs immediate treatment with surgery to save the bowel.
If the hernia is stuck, or you can’t push it back in, it may mean you have one of these complications. Other signs of incarceration or strangulation include:
Pain
Nausea
Vomiting
In children, complications are rare — under 1% of children develop complications.
But for adults, that number goes up to 17%. That’s why healthcare providers recommend surgery for adults — but not always for children.
The bottom line
Umbilical hernias are when a piece of bowel pushes through the belly button. An umbilical hernia looks like a bulge near or in the belly button that feels soft and squishy. Umbilical hernias are common in young children, but adults can have them as well. Umbilical hernias usually don’t cause problems for kids and will go away on their own most of the time. But adults need surgery to repair their umbilical hernias.
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References
American College of Surgeons. (2016). Adult umbilical hernia repair.
Bedewi, M. A., et al. (2012). Prevalence of adult paraumbilical hernia. Assessment by high-resolution sonography: A hospital-based study. Hernia: The Journal of Hernias and Abdominal Wall Surgery.
Chang, H. (2020). Umbilical hernias in babies & children. HealthyChildren.org.
Kokotovic, D., et al. (2016). Watchful waiting as a treatment strategy for patients with a ventral hernia appears to be safe. Hernia: The Journal of Hernias and Abdominal Wall Surgery.
Konaté, I., et al. (2020). Umbilical hernias in adults: Epidemiology, diagnosis and treatment. The Art and Science of Abdominal Hernia.
Troullioud Lucas A. G., et al. (2021). Pediatric umbilical hernia. StatPearls.
