If you notice an unusual bulge around your belly button, you may have an umbilical hernia. The hernia may be more prominent when you cough or strain your abdominal muscles.
Umbilical hernias are common in babies and children, but they happen in adults too.
At UPMC, our general surgeons treat umbilical hernias in adults with open or minimally invasive surgery.
On this page:
What Is an Umbilical Hernia?
Doctors define an umbilical hernia as an outward bulge of tissue around the navel (belly button).
Umbilical hernias are common in babies and children. They are usually harmless and go away on their own.
In adults, umbilical hernias are less common, but they do occur. They happen when part of the small intestine or some fatty tissue pushes through the muscles of the belly.
Herniated umbilical hernias occur more often in women than men. You may hear the condition called a “belly button hernia.”
Umbilical hernias are usually not serious, but they can sometimes lead to complications. If you think you have an umbilical hernia, you should see a doctor. More than half of umbilical hernias will need surgery.
What are the types of umbilical hernia?
There are a few categories of umbilical hernia. They include:
- Irreducible hernia — An umbilical hernia that can’t get pushed back into the opening. Doctors also call this an incarcerated umbilical hernia.
- Reducible hernia — An umbilical hernia that can get pushed back into the opening. It may also decrease in size when you’re lying down.
- Strangulated hernia — An umbilical hernia where the intestine gets trapped in the hernia pouch. This is a medical emergency because the blood supply to the intestine gets cut off. If this happens, you will need surgery right away.
How common are umbilical hernias?
Umbilical hernias make up about 10% of all abdominal hernias in adults. They are less common than inguinal hernias, which occur in the groin.
Umbilical hernias are three times more common in women than men. That’s because being pregnant increases your risk for getting an umbilical hernia.
Age also increases your risk of getting an umbilical hernia. They are equally common in men and women over 60.
About 20% of babies are born with an umbilical hernia.
What causes umbilical hernias?
In children, umbilical hernias occur because the umbilical cord attaches to the baby through a hole in the baby’s belly. When the muscles around the area don’t close completely after birth, the intestine can bulge through the hole. Umbilical hernias in children usually go away on their own.
In adults, an umbilical hernia usually forms with increased pressure on a weak abdominal wall. The small intestine and surrounding tissue bulge through the abdominal muscles.
Being pregnant, especially more than once, can be a factor. Obesity is another major cause of hernias in the umbilical area.
Umbilical hernia risk factors
You can’t always prevent getting an umbilical hernia. But it’s important to be aware of risk factors and complications of the condition.
You’re more likely to get an umbilical hernia if you:
- Are a woman — Females are more likely to develop umbilical hernias.
- Are an older adult — Both men and women over 60 tend to develop more hernias than younger people. That’s because the abdominal muscles start to weaken with age.
- Are overweight — Being obese can put extra strain on the abdominal muscles, making them weaker and more susceptible to hernias.
- Experience chronic straining — Frequent coughing or chronic constipation can put strain on the abdominal muscles and weaken them.
- Have a family history of abdominal hernias.
- Have alcohol-related problems — People with alcohol use disorder can develop liver cirrhosis. This may lead to ascites, a buildup of fluid in your belly. This condition puts a strain on all your abdominal organs.
- Have had previous surgeries — Any operation on your belly can weaken the abdominal wall.
- Have had one or more pregnancies — Being pregnant and giving birth puts a great deal of strain on the abdominal muscles. Multiple pregnancies increase your risk.
Complications of umbilical hernia
Leaving an umbilical hernia untreated can lead to further complications. Without surgery to repair it, it can get bigger.
If the bulging abdominal tissue gets trapped, it can reduce the blood supply to the intestine.
That can lead to:
- A blockage in your intestine.
- Sudden pain.
- Tissue damage.
- Vomiting.
If your umbilical hernia becomes strangulated (trapped) in the hernia pouch, it is a medical emergency. You will need emergency surgery. In the worst-case scenario, a strangulated hernia could be life-threatening.
How can I reduce my risk of having an umbilical hernia?
You can’t necessarily prevent getting an umbilical hernia.
But you can reduce your risk by making healthy lifestyle choices, including:
- Avoiding excess alcohol.
- Drinking plenty of water to avoid constipation.
- Eating a high-fiber diet to keep your bowels regular and avoid straining.
- Managing your weight.
- Quitting smoking.
- Strengthening your core muscles with abdominal workouts.
What Are the Signs and Symptoms of an Umbilical Hernia?
Umbilical hernia symptoms include:
- A noticeable bulge around your belly button. It may disappear when you lie down.
- Belly button pain.
- A burning sensation near the belly button.
- Discomfort or pain when lifting something heavy.
- Gurgling around your belly button.
- Redness around your belly button.
When should I see a doctor about my umbilical hernia symptoms?
You should see a doctor anytime your hernia symptoms get worse. If pain from your hernia is interfering with your daily activities, you should get it checked out.
You should go to the nearest emergency department (ED) if you have:
- A bluish color in the bulging area.
- Nausea.
- Severe or sudden pain.
- Vomiting.
Can an umbilical hernia heal itself?
In children, umbilical hernias may go away. But in an adult, an umbilical hernia will not go away on its own. It may, however, stay the same size and not cause you much discomfort.
But if the umbilical hernia gets worse or more painful, you will need surgery to repair it.
How Do You Diagnose an Umbilical Hernia?
If you think you may have an umbilical hernia, you should make an appointment with your primary care provider (PCP). They may refer you to a gastroenterologist or a general surgeon.
To diagnose an umbilical hernia, your provider will ask you about your medical history. They will perform a physical exam, pressing on your belly to check for the hernia. Usually, a physical exam is enough to diagnose an umbilical hernia.
Tests to diagnose umbilical hernia
If your doctor isn’t certain whether you have an umbilical hernia, they may order one or more of the following tests:
- Blood tests.
- CT scan.
- Electrocardiogram (ECG) for people over 45 or at high risk of heart problems.
- Ultrasound.
- Urine tests.
How Do You Treat an Umbilical Hernia?
The goal of hernia treatment is to remove the hernia and prevent it from coming back.
If your hernia doesn’t bother you, and it’s not getting any bigger, your provider may recommend delaying treatment. This strategy is referred to as “watchful waiting”.
Surgery is the only treatment for an umbilical hernia. There are no medicines or lifestyle changes that can cure it.
Your surgeon may recommend an open or laparoscopic procedure. Both methods work well.
The type of repair may depend on the size of the hernia, and whether you’ve had hernia surgery before. Your age and overall health are also factors.
For both types of surgery, your surgeon may use sutures to close the incision. Sutures alone are generally used for smaller hernias.
For larger hernias, your surgeon may use a piece of surgical mesh to reinforce the abdominal wall. The mesh will help keep another hernia from forming.
Open surgery for umbilical hernia
You will receive anesthesia before the surgery. Your provider will talk to you about what type of anesthesia is right for your procedure.
With general anesthesia, you will be asleep and pain-free for the operation.
With local anesthesia, you will be awake but pain-free during the surgery. Your provider will give you a different kind of medicine to relax you.
With large or complicated hernias, your surgeon may place a small drain running from inside to outside the abdomen.
If you have a strangulated hernia, you will need open surgery.
During sutures-only open surgery, the surgeon will:
- Make an incision (cut) under the belly button. The curved incision will follow the skin lines underneath the belly button.
- Find the hernia and separate it from the tissues around it.
- Remove the hernia sac.
- Gently push the bulging tissue — fat or intestine — back into the abdomen.
- Sew the tissue along the muscle edge together.
For open mesh hernia repair, the surgeon will:
- Remove the hernia sac and push the bulging tissue back into the abdomen.
- Place a mesh patch over the weak area.
- Using sutures, attach the mesh to the tissue around the hernia. The mesh will extend an inch or more beyond the hernia’s edges. It will make the abdominal wall stronger and a hernia less like to happen again.
Minimally invasive (laparoscopic) hernia repair
Your surgeon may recommend minimally invasive surgery, especially if you have a large umbilical hernia. Your chance of wound complication may be less than with open surgery. If you have a high risk of wound infection, your doctor will talk to you about a laparoscopic procedure.
For minimally invasive hernia repair, your doctor will:
- Make several small cuts in the belly.
- Insert hollow tubes or ports into the openings.
- Place a lighted camera and small surgical tools into the tubes.
- Inflate the belly with carbon dioxide gas to make it easier for doctors to see the hernia.
- Monitor the operation from a video screen.
- If needed, sew a mesh patch over the hernia site.
- Close the port openings.
Robotic surgery for umbilical hernia
Your doctor may recommend a robotic approach to your hernia surgery.
Robotic procedures are very similar to regular laparoscopic operations. The difference is that robotic arms handle the surgical instruments. The surgeon controls the robotic device from a computer monitor in the operating room.
Robotic surgery allows for greater precision in certain procedures.
How effective is treatment for an umbilical hernia?
Your doctor will recommend the best type of surgery for your umbilical hernia. It may depend on the size and location of your hernia. Both open and laparoscopic surgeries have similar long-term results.
Most people recover well after surgery for an umbilical hernia, with very few problems. It's a common, effective procedure. The risk of the hernia returning is low.
How long does it take to recover after surgery for umbilical hernia?
Most hernia surgeries are outpatient procedures. That means you’ll go home the same day as the surgery. If the hernia was very large or there were any complications, you might need to stay in the hospital overnight.
Your doctor will give you instructions on how to care for your wound. They will let you know when you can shower, drive, and go back to work.
Most people can resume normal activities two to four weeks after the operation.
Potential risks of umbilical hernia surgery
Umbilical hernia surgery is a common, safe procedure. But there are risks involved in any surgery with anesthesia.
They include:
- Bleeding.
- Blood clots.
- Breathing difficulties.
- Infection.
- Pneumonia.
- Urinary tract infection (UTI).
It’s possible — but rare — for the umbilical hernia to come back after surgery. You can reduce your risk of recurrence by choosing healthy lifestyle options. Maintaining a healthy weight, not smoking, and exercising can all help.
When should I call the doctor after umbilical hernia surgery?
Recovery from umbilical hernia surgery is usually routine.
However, you should call your doctor if you have any of the following symptoms:
- A bad smell from your incision.
- Chills.
- Cramps in your stomach.
- High fever (over 101 F).
- Increased drainage from your incision.
- No bowel movements for three days.
- Severe pain.
