What Is an Umbilical Hernia?
The umbilical cord connects a mother and her foetus while in the womb. Babies’ umbilical cords pass through a small opening in their stomach muscles. In most cases, the hole closes soon after birth. An umbilical hernia occurs when the stomach muscles don’t join completely and the intestine or other tissues bulge through this weak spot around the belly button (umbilicus).
What Causes Umbilical Hernias?
An umbilical hernia occurs when the opening in the stomach muscle that allows the umbilical cord to pass through fails to close completely. Umbilical hernias are most common in babies, but they can also occur in adults. Both male and female African babies, premature babies and babies born at a low birth weight are at a higher risk of developing an umbilical hernia.
An umbilical hernia in adults usually occurs when too much pressure is put on a weak section of the stomach muscles, due to factors including:
- Being overweight
- Frequent pregnancies
- Multiple gestation pregnancies (having twins, triplets, etc.)
- Fluid in the abdominal cavity
- Stomach surgery
- Having a persistent, heavy cough
What are the Symptoms of an Umbilical Hernia?
Umbilical hernias can usually be seen when your baby is crying, laughing or straining to pass a bowel movement. The telltale symptom is a swelling or bulge near the umbilical area — a symptom that isn’t present when your baby is relaxed.Adults can get umbilical hernias as well. The symptoms are the same — a swelling or bulge near the navel area that can be very painful. Treatment usually is required.
The following symptoms may indicate a more serious situation that requires medical treatment:
- The baby is in obvious pain
- The baby is vomiting
- The bulge (in both children and adults) is tender, swollen or discoloured
How Doctors Diagnose Umbilical Hernias
A doctor will perform a physical exam to determine if an infant or adult has an umbilical hernia. The doctor will see if the hernia can be pushed back into the abdominal cavity (reducible). He will also examine the baby or adult to determine if the umbilical cord is trapped, or incarcerated. This is a serious complication because the trapped part of the intestine may be deprived of a blood supply.
Your doctor may take an X-ray or perform an ultrasound on the stomach area to ensure that there are no complications. They may order blood tests to look for infections, especially if the intestine is blocked or incarcerated.
The majority of cases in babies will resolve on their own by age 3 or 4. If you think your baby may have an umbilical hernia, speak with your paediatrician. Seek emergency care if your baby seems to be in pain or the bulge becomes very swollen or discoloured. Adults with a bulge on their stomach should also see a doctor.
Can Umbilical Hernias be Repaired?
Surgery is usually suggested to make sure that no complications develop in adults. Umbilical hernias in children often fix themselves.
Surgery may be ordered if the hernia:
- Becomes painful
- Is bigger than one-half inch in diameter
- Doesn’t go away by the time your child is 3 or 4 years old
- Becomes trapped or blocks the intestines
- The hernia grows after the child is 1-2 years old
- If the intestines are within the hernial sac, preventing or reducing the movement of the intestines (called peristalsis)
- If the hernia becomes trapped
- In the case of adults, to prevent potential complications, especially if the hernia grows or starts to hurt
Preparation for this surgery is minimal. You can continue to drink clear liquids up to three hours before surgery.
The surgery will last about an hour. The doctor will make an incision at the belly button where the bulge is. He will then push the intestinal tissue back through the stomach wall. In children, the opening is closed with stitches. Doctors will often strengthen the stomach wall in adults with mesh.
Recovering from Surgery
Hernia surgery is a fairly simple and common procedure. While all surgeries have risks, most children are able to return home from an umbilical hernia surgery within a few hours. Activities for the next week or so should be limited, and you shouldn’t return to school or work during this time. Sponge baths are suggested until three days have passed.