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Overview

What Is an Umbilical Hernia?

An umbilical hernia is a bulge that develops when tissue pushes through a weak spot in the abdominal wall near the belly button. It may look or feel like a soft swelling in the umbilical region. An umbilical hernia can occur in newborns, children, or adults. In babies and children, it is often related to an opening that has not fully closed, while adult hernias are more often linked to abdominal-wall weakness or pressure.

Symptoms

Umbilical Hernia Symptoms

  • A soft or firm bulge may appear at or next to the belly button.
  • The bulge may become more noticeable when a baby cries or when an older child or adult coughs, lifts, or strains.
  • Mild discomfort or aching may occur around the umbilical hernia.
  • The area may feel tender when touched or pressed.
  • Redness over the bulge can indicate irritation or a more serious problem.
  • Vomiting may occur if the hernia affects the bowel.
  • Difficulty passing stool or gas may occur with a bowel-related complication.

Seek prompt care

Changes that need attention

A painless bulge that can be gently pushed back or disappears when lying down can be common. A bulge that is painful, firm, discolored, or cannot be gently reduced needs prompt medical assessment.

Causes

Causes of Umbilical Hernias

In a newborn, an umbilical hernia develops when the opening used by the umbilical cord does not fully close after birth. In adults, a hernia may form when the abdominal wall around the belly button becomes weak or when increased pressure pushes tissue through that weak area. The protruding tissue may include fat or part of the intestine.

  • Persistent weakness in the umbilical ring can leave an opening through which tissue may protrude.
  • Increased pressure inside the abdomen can push tissue through a weak belly button area.
  • Stretching or separation of the abdominal muscles can reduce support around the umbilical opening.

Risk Factors

Umbilical Hernia Risk Factors

DEVELOPMENTAL FACTORS

Prematurity can increase the chance of an umbilical hernia because the abdominal wall may be less developed at birth. A congenital abdominal-wall weakness or a persistent opening at the umbilicus can also contribute.

ACQUIRED FACTORS

Factors that can increase abdominal pressure or stretch the abdominal wall include obesity, pregnancy, ascites, chronic coughing, and repeated heavy straining. These factors are especially relevant when considering an umbilical hernia in adults.

Having a risk factor does not guarantee that someone will develop a hernia umbilical. Some factors, such as weight management and a smoking-related cough, may be addressable with appropriate clinical support. A clinician can help identify safe ways to reduce pressure on the abdominal wall.

Complications

Umbilical Hernia Complications

  • Incarceration occurs when herniated tissue becomes trapped and cannot be pushed back into the abdomen.
  • Strangulation occurs when trapped tissue loses part of its blood supply and can become a medical emergency.
  • A bowel obstruction can develop if intestine is trapped in the hernia and the normal passage of intestinal contents is blocked.
  • Loss of blood supply can cause tissue damage and may require urgent surgery.
  • An umbilical hernia can recur after repair, particularly when abdominal-wall weakness or pressure continues.

Emergency warning

When complications may be developing

Seek urgent medical care for severe or worsening pain, a hard or discolored bulge, persistent vomiting, abdominal swelling, or inability to pass stool or gas. These symptoms may indicate trapped tissue, strangulation, or bowel obstruction.

Diagnosis

How Is an Umbilical Hernia Diagnosed?

A clinician usually diagnoses an umbilical hernia by examining the belly-button area while the patient is relaxed, coughing, or straining. The clinician may check whether the bulge changes with position and whether it can be gently reduced. The examination also helps assess pain, tenderness, skin changes, and signs of complications.

  • Ultrasound may be considered when the examination is unclear or a clinician needs to view the tissues beneath the skin.
  • CT may be used when complications are suspected or when more detailed information about the abdominal wall and bowel is needed.
  • Additional testing may be considered in people with obesity when the hernia is difficult to examine.
  • Imaging or other tests may help plan surgery when the hernia is large, complex, or associated with other abdominal concerns.

Treatment & Management

Umbilical Hernia Treatment and Management

Observation and Nonoperative Care

Small, painless, reducible hernias may be observed rather than treated immediately, with follow-up to monitor changes. Avoiding activities that clearly worsen symptoms may help, but belts, patches, or other devices should not be used without medical advice. Many childhood hernias are monitored because they may close naturally as the child grows. In adults, the decision depends on symptoms, size, growth, work or activity demands, and overall health.

Surgical Repair

ApproachWhen it may be usedKey considerations
ObservationA small, painless, reducible hernia, especially in a childRequires follow-up and attention to growth, pain, firmness, or changes in the bulge; it is not individualized medical advice.
Elective surgical repairA persistent, enlarging, painful, or bothersome hernia, or one unlikely to close on its ownUmbilical hernia repair, also called hernioplasty, closes the weak area and may reinforce it; open and minimally invasive approaches may be considered based on the hernia and the patient's health.
Urgent repairA hernia that is trapped, strangulated, or associated with obstruction or severe symptomsUrgent assessment and surgery may be needed to protect bowel or other tissue; treatment decisions are made by the emergency and surgical teams.

Outlook and Prognosis

Outlook for an Umbilical Hernia

CHILDREN

Many hernias in children become smaller or close as the abdominal wall develops. Regular monitoring is used to check that the bulge remains soft and does not develop concerning symptoms.

ADULTS

An umbilical hernia in adults is less likely to close spontaneously. An adult may need repair if the hernia grows, causes discomfort, limits activities, or has a risk of complications.

Outcomes are usually good when complications are absent. After repair, recurrence risk and recovery depend on the hernia’s size, the repair method, other health conditions, and how closely postoperative instructions are followed.

When Should You See a Doctor

When Should You See a Doctor for an Umbilical Hernia?

Get urgent help

Possible trapped or strangulated hernia

Seek emergency care for severe or increasing pain, a firm bulge that cannot be pushed back, skin discoloration, repeated vomiting, marked abdominal swelling, or inability to pass stool or gas.

Tests & Procedure

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Symptoms

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