Umbilical Hernia
A bulge at or near the belly button where tissue pushes through the abdominal wall.
An umbilical hernia is a bulge at or around the navel that appears when fat or bowel pushes through a weak spot in the abdominal wall behind the belly button. It causes a soft lump that may ache when you cough or strain. In adults it does not resolve on its own and is treated with surgical repair, often using mesh.
An umbilical hernia appears as a bulge at or just beside the belly button. It is very common in babies, where it usually closes on its own, but in adults it tends to persist and slowly enlarge. While often small and harmless at first, an adult umbilical hernia will not disappear and is best repaired in a planned way before it grows or its contents become trapped.
अम्बिलिकल हर्निया भनेको नाइटोको वरिपरि पेटको भित्तामा भएको कमजोर ठाउँबाट आन्द्रा वा बोसो बाहिर निस्केर डल्लो देखिने अवस्था हो, जसको उपचार शल्यक्रियाबाट गरिन्छ।
Understanding Umbilical Hernia
The navel is a naturally thin spot in the abdominal wall — the point where the umbilical cord passed through before birth. If this area does not close fully, or later weakens, a sac of abdominal lining can push through, allowing fat or a loop of bowel to bulge outward. This creates a soft swelling at the belly button that may pop out when you strain and settle back when you relax or lie down.
In infants, the opening usually seals itself within the first few years of life. In adults, the defect does not close on its own and pressure inside the abdomen — from weight gain, pregnancy or straining — tends to make it larger over time.
Symptoms
- A soft bulge or swelling at or near the belly button
- A lump that becomes more obvious on coughing, standing or straining
- Aching or dragging discomfort around the navel
- A bulge that can often be gently pushed back in when lying down
- Skin changes or tenderness over a large or long-standing hernia
- Sudden pain, a firm irreducible lump, nausea or vomiting (a warning of strangulation)
Causes & risk factors
- A natural weakness where the umbilical cord once passed through
- Being overweight or obese
- Pregnancy, especially multiple pregnancies
- Repeated heavy lifting or straining
- Chronic cough or long-standing constipation
- Fluid in the abdomen (ascites) or previous abdominal surgery
Possible complications
- Incarceration — the contents become stuck and cannot be pushed back
- Strangulation — trapped tissue loses its blood supply, a surgical emergency
- Bowel obstruction with pain, vomiting and abdominal swelling
- Progressive enlargement, making the eventual repair larger
How it is diagnosed
An umbilical hernia is usually diagnosed on physical examination — the surgeon feels the swelling at the navel while you cough or strain to judge its size and whether it can be reduced. If the hernia is deep, large or the diagnosis is uncertain, an ultrasound or CT scan can confirm the defect and help plan the repair.
Treatment options
In children, most umbilical hernias are simply watched, as they close naturally with time. In adults the hernia will not resolve, so surgical repair is recommended — ideally before it enlarges or becomes trapped. Very small, symptom-free hernias may sometimes be monitored, but any that grow, ache or cause concern should be repaired.
Surgical treatment
Repair involves pushing the contents back and closing the wall, usually reinforced with a soft mesh to greatly reduce the chance of recurrence. Dr. Sujan Shrestha performs both open and keyhole (laparoscopic) umbilical hernia repairs, tailored to the size of the defect and the patient.
Small hernias are often repaired through a single tiny incision hidden near the navel. Larger or recurrent hernias may be better suited to a laparoscopic approach, which places mesh through a few small cuts, typically meaning less pain and a quicker recovery.
Recovery & aftercare
Umbilical hernia repair is commonly a day-care procedure. You can walk the same day and return to light activities within a few days. Heavy lifting and strenuous exercise are usually avoided for a few weeks while healing is completed and the mesh settles. Keeping to a healthy weight and avoiding straining help protect the repair.
When to see a doctor
See a doctor if you notice a bulge or ache at the navel, so it can be assessed and repaired before it grows. Seek emergency care immediately if the lump becomes hard, painful or cannot be pushed back in, particularly with nausea, vomiting or discolouration of the skin — these can indicate strangulation.
Frequently asked questions
In babies it usually closes naturally within the first few years. In adults the defect does not heal by itself and tends to enlarge, so surgical repair is the only lasting solution.
Very small, painless hernias in adults may sometimes be watched. However, most are repaired to prevent enlargement and the risk of the contents becoming trapped or strangulated.
It is usually a straightforward, common procedure done as day-care surgery. Small hernias are repaired through a tiny incision, while larger ones may use a keyhole approach with mesh reinforcement.
Most people return to light activity within a few days and resume normal routine over one to two weeks. Heavy lifting is usually avoided for a few weeks to protect the repair.
Recurrence is uncommon with modern mesh repair. Maintaining a healthy weight and avoiding straining, chronic cough and constipation further reduce the small chance of it returning.
Get a clear answer from a specialist
Dr. Sujan Shrestha (MBBS, MS, MCh) offers evidence-based, minimally invasive care for umbilical hernia and the full range of GI conditions.