Umbilical Hernia: Identifying Symptoms and Weighing Surgery
Medically reviewed by Oluseun Olufade, MD
An umbilical hernia is a section of intestinal tissue that bulges out of place near the navel (belly button), where the umbilical cord is attached before birth. It is most common in newborns or babies under 6 months old, but older children and adults can also have one.
Most umbilical hernias are not serious. But in certain cases, surgery is recommended to repair them, and they can be dangerous.
This article will discuss the symptoms of an umbilical hernia and when nonsurgical or surgical treatment is recommended.
Illustration by Julie Bang for Verywell Health
Is an Umbilical Hernia Serious?
Umbilical hernias can go away on their own in babies but not in adults. They are not considered serious in most cases, but there are times when they need medical treatment. In certain cases, they can even be life-threatening.
The two serious types of umbilical hernias are:
Incarcerated hernia: A bulge in tissue that cannot be pushed back into place
Strangulated hernia: A tissue bulge that cuts off blood supply to the intestines.
If tissue begins to die due to a lack of blood supply from a strangulated hernia, toxins could be released to other parts of the body. This is a medical emergency that can be fatal within hours if not treated.
Emergency Symptoms
Many hernias do not cause symptoms, but if you or someone you know has an umbilical hernia and is experiencing any of the following, seek medical advice, as emergency treatment may be necessary:
Abdominal pain, tenderness, or bloating
Red, purple, dark, or discolored bulge
Vomiting or nausea
Fever
Sudden, severe abdominal pain
Stool containing blood
Bulge that grows larger
Related: Why Does My Belly Button Hurt?
Risks in Infants and Children
About 20% of babies are born with an umbilical hernias, but most close on their own by the time a child is 1 year old. Almost all hernias in children close by age 5. If they are large, don't close, or there are complications, surgery can repair the hernia.
Complications include an incarcerated or strangulated hernia. If your baby has an umbilical hernia and develops a fever, shows signs of distress, or the bulge gets bigger when they cry or cough, call your healthcare provider.
Risk factors for umbilical hernias in babies include:
Premature and underweight at birth
Family history of hernia as an infant
Umbilical hernias are diagnosed a little more often in African American children than in those of other ethnic groups in the United States.
Risks in Adults
About 2% of adults in the United States develop an umbilical hernia. Some factors that increase risk include:
Having obesity
Ascites (accumulation of peritoneal fluid in the abdomen, often from liver disease)
Multiple pregnancies, straining in childbirth
Straining in weight-lifting
What Does an Umbilical Hernia Look and Feel Like?
A lump or bulge near the navel that you can see and feel is a sign of an umbilical hernia. Hernias feel soft and you may only be able to see them when the abdomen is pressed. They are generally painless, but in adults they are more likely to cause some tenderness or a feeling of pressure.
Nonsurgical Umbilical Hernia Treatment
If a child or adult has a reducible hernia, a healthcare provider can gently push it back into place. If you do it yourself, you could cause an injury or overlook a serious hernia that needs medical treatment. Taping a hernia down will not make it go away.
Surgical Umbilical Hernia Removal
If a hernia is causing pain or is incarcerated or strangulated, surgery is generally needed to repair it. In some cases, it may be emergency surgery. The surgery may be minimally invasive, requiring only a small incision, or you may need an open surgery, which needs a larger incision.
Surgical Techniques
Surgeons may use a surgical mesh to keep the tissue in place, or they may use stitches to repair the hernia. It can depend on the size of the hernia or other factors.
In children, repair is usually done with stitches to draw the muscles together, and mesh is not used. In adults, a smaller defect may be closed with stitches, but plastic mesh is used for larger defects.
Mesh has been used in surgery for over a century, but in 2000, a mesh was introduced that had a high rate of serious complications. The Food and Drug Administration (FDA) issued a warning about it in 2005. The mesh was recalled in 2010, and mesh developed a negative reputation.
Newer types of mesh can be synthetic and permanent or made from animals and absorbed by the body over time.
The debate over the pros and cons of mesh continues, however. Mesh can reduce the chance of the hernia coming back.
A complication that can be associated with mesh is that it migrates into the tissues or shrinks (contracts). This can lead to further complications, including infection or seroma (buildup of fluid at the surgical site).
The choice of mesh is important in reducing the risk of these complications, so talk to your provider about the type of mesh they are using and why. The mesh should be chosen depending on the characteristics of the hernia, and when inserted, it should lay flat and not be placed near any nerves.
Surgical risks with or without mesh include:
Infection
Adhesions (scar-like tissue that sticks tissues together)
Recurrence
Bleeding
Fistula (an abnormal connection between organs, blood vessels, or tissues)
Seroma
Perforation (a hole in tissues or organs)
Post-Op Healing From Umbilical Hernia
Most people go home the same day they have a surgical hernia repair. You may feel pain for a few days which fades to a feeling of soreness for about a week. By four weeks after surgery, the pain should be gone. Ice is useful for handling postoperative pain.
Most hernia repairs do not lead to complications, but call your healthcare provider if you notice the following:
Persistent fever over 100.4 degrees F
Redness or draining around the incision
Bleeding from the incision
Nausea or vomiting
Inability to urinate
Significant pain
Not improving or feeling worse
Risk of Umbilical Hernia Recurrence
According to a review of articles between 2014 and 2019, the risk of a hernia coming back after surgery is wide-ranging. When mesh is used, the study found that the recurrence rate approximates 2.7%, and is estimated at 27% when mesh is not used.
Summary
Umbilical hernias are common in babies but may also affect adults. Many hernias in young children will close on their own, but if they don't, they may need surgery. Hernias will not close in adults. If a hernia cannot be pushed back into place—a procedure that should be done only by a healthcare provider—or if it's cutting off blood supply, surgery is needed.
If blood is being cut off to other tissue, it can be a medical emergency. In some cases, surgeons may use surgical mesh to repair the hernia. Make sure you understand the pros and cons of mesh, which leads to less recurrence but a higher rate of other complications. Most hernia repairs go smoothly, and full recovery takes about a month.
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