Umbilical Hernia Treatment in Delhi, India

An umbilical ring is a small opening in the abdominal wall through which the umbilical cord passes and provides nourishment during our growth in the uterus. This ring closes in the first few days of our life. When the ring does not close (in children) or reopens after closure (in adult life) abdominal contents like fat (omentum) or intestines can protrude out and form a hernia.

An umbilical hernia is most common in newborns, infants, and young children, and in most cases closes up naturally. Repeated straining to increase pressure within the abdomen can force open the obliterated umbilical ring, this happens in adults- common causes are straining to cough or pass urine (prostate hypertrophy), constipation or weakening of the ring in obesity.

While umbilical hernia is often painless, in some cases, it may cause discomfort, particularly if it becomes incarcerated or strangulated. Surgery is the most effective treatment for umbilical hernia.

There are primarily two types of umbilical hernias:

1. Congenital Umbilical Hernia: Present at birth, this type of hernia occurs when the abdominal muscles fail to close around the belly button during foetal development fully.
2. Acquired Umbilical Hernia: This type occurs later in life, often due to increased intra-abdominal pressure, such as from obesity, heavy lifting, pregnancy, or chronic coughing. The likelihood of umbilical hernias is higher in females than in males. 

The symptoms of an umbilical hernia are more or less similar in children and adults.

• Visible bulge: The most noticeable symptom is a soft bulge or lump near the belly button, which may increase in size when coughing, bending, or straining.
• Pain or tenderness: While many cases are painless, some may cause discomfort, especially when lifting or straining.
• Occasional swelling or discomfort: In rare cases, the bulge may be accompanied by pain, particularly if the hernia becomes trapped or pinched.

Differences In Umbilical Hernia Symptoms Between Adults And Children

• In infants: An umbilical hernia often presents as a soft, painless bulge in the belly button. Oftentimes, it may appear only when the baby is crying and disappear when they relax.
• In adults: Adults may experience more pronounced symptoms, such as persistent discomfort or pain, especially with physical activities. The hernia will not resolve without treatment and can lead to complications.

The causes of umbilical hernia are different in children and adults. 

• Congenital defects: Most umbilical hernias in children are congenital and are due to a small opening in the abdominal wall (umbilical cord) that doesn't close properly after birth. Factors such as crying or straining may worsen the bulge, but most congenital hernias in infants close on their own within the first year.

Umbilical Hernia Causes In Adults

• Increased abdominal pressure: Factors such as obesity, pregnancy, chronic coughing, or lifting heavy objects can strain the abdominal wall, leading to an acquired umbilical hernia.
• Weak abdominal muscles: As people age, the muscles in the abdominal wall can weaken, making it easier for a hernia to form.
• Previous abdominal surgery: Surgical scars can weaken the abdominal wall, increasing the risk of developing an umbilical hernia.

Several factors can increase the risk of developing an umbilical hernia. These include:

• Age: Infants and older adults are more likely to develop umbilical hernias. In infants, the condition is often congenital, while in adults over the age of 40, the risk increases due to the weakening of the abdominal muscles over time.
• Premature Birth: Premature infants are more likely to develop an umbilical hernia due to the incomplete development of the abdominal wall at birth.
• Pregnancy: Pregnant women are at higher risk of developing an umbilical hernia due to increased pressure on the abdomen during pregnancy, which can cause the abdominal wall to weaken.
• Obesity: Being overweight or obese can increase the pressure on the abdominal muscles, making it more likely for a hernia to form.
• Chronic Coughing or Sneezing: Conditions that cause frequent coughing or sneezing, such as asthma, can increase abdominal pressure, leading to the formation of a hernia.
• Heavy Lifting: Repeatedly lifting heavy objects can put excessive strain on the abdominal muscles, increasing the risk of an umbilical hernia.
• Previous Surgery: Individuals who have had previous abdominal surgery, especially around the umbilical area, are at a higher risk of developing a hernia in that area due to scar tissue and weakened muscles.
• Increased Abdominal Pressure: Conditions such as constipation, ascites (fluid buildup in the abdomen), or any condition that causes increased pressure in the abdomen may contribute to the formation of an umbilical hernia.

Understanding these risk factors can help individuals take preventive measures, such as maintaining a healthy weight, avoiding heavy lifting, and managing conditions such as chronic coughing.

Although many umbilical hernias, particularly in babies, are benign, there is a higher risk of complications in adults if left untreated:

• Incarceration: This occurs when the tissue or part of the intestine gets stuck in the hernia sac and cannot be pushed back into the abdomen. This can lead to severe pain and bowel obstruction.
• Strangulation: A more severe form of incarceration where the blood supply to the herniated tissue is cut off, leading to tissue death. This requires immediate medical attention and surgery.

At Max Hospitals, we follow a systematic approach to diagnose umbilical hernias. This process ensures an accurate diagnosis, allowing us to offer the best treatment options tailored to each patient’s needs. Here’s how we diagnose an umbilical hernia:

1. Physical Examination:
• Initial Assessment: A doctor will perform a thorough physical exam, carefully examining the area around the belly button for any visible bulges or swelling.
• Increased pressure observation: The doctor may ask the patient to cough, bend, or strain to observe how the bulge changes with increased abdominal pressure, which helps confirm the presence of a hernia.
• Pain and discomfort analysis: If the hernia is causing severe pain, redness, or tenderness, this may indicate a strangulated hernia, which requires immediate attention. Imaging tests like ultrasound or CT scans are essential for ruling out strangulation or other life-threatening complications.
2. Ultrasound:
• Non-invasive imaging: An ultrasound is often the first imaging test used to diagnose an umbilical hernia. This safe, non-invasive procedure uses sound waves to create an image of the soft tissues and assess the size of the hernia.
• Confirming hernia presence: The ultrasound can confirm the presence of the hernia, identify its size, and check for any fluid build-up within the sac.
3. CT Scan:
• Detailed imaging: If more detailed images are needed, especially in complex cases, a CT scan may be recommended. This can provide a clearer view of the hernia’s size, location, and potential complications.
• Assessing other conditions: A CT scan helps rule out other potential causes of swelling and discomfort, ensuring a more accurate diagnosis.
4. Examine Other Areas:
• Identify related issues: Sometimes, the hernia may be associated with other conditions, such as a hernia in another part of the body. The doctor will examine the entire abdominal region to ensure an accurate diagnosis and holistic treatment approach.

At Max Hospitals, we offer a comprehensive, patient-centred approach to treating umbilical hernias through a combination of conservative and advanced surgical techniques. We ensure that every patient, whether child or adult, receives the most appropriate treatment based on their unique condition. Here’s an overview of the umbilical hernia treatment options we provide:

Conservative Treatment for Umbilical Hernia

Doctors recommend conservative umbilical hernia treatments for small, uncomplicated hernias. These approaches aim to manage symptoms and reduce the need for surgery, especially when the hernia is not causing significant complications.

• Watchful Waiting: If the hernia is small, painless, and not causing any severe symptoms, our doctors may recommend a "watchful waiting" approach. This involves monitoring the hernia over time to see if it resolves on its own or becomes symptomatic. Watchful waiting is also recommended for infants below the age of three, as the hernia usually resolves on its own. Regular check-ups are scheduled to ensure the hernia is not causing any serious complications, and intervention is only recommended if the condition worsens.
• Manually Pushing Back the Lump: In paediatric patients, doctors may attempt to push the hernia back into place gently. 

In some cases, doctors may recommend a hernia belt to provide support to the area and alleviate discomfort, particularly for individuals experiencing mild symptoms. This is especially beneficial for women or those who are pregnant, as it can help relieve pressure on the abdomen. A hernia belt may not cure the hernia but can assist in managing discomfort while awaiting a more permanent solution.

Surgical Treatment for Umbilical Hernias

Surgery is often recommended for more significant hernias, especially when they cause pain or discomfort, or if they have become incarcerated (unable to be pushed back into place). It is recommended for children in whom the hernia has not resolved by the age of three. Adult patients eventually do require surgery, as umbilical hernia progressively worsens and may cause complications. At Max Hospitals, we offer traditional and latest surgical techniques to provide the best outcomes for our patients.

• Open surgery: The procedure involves a large incision near the belly button, from where the doctors access and push the hernia back into its proper position and repair the abdominal wall with stitches. For adults, additional reinforcement with surgical mesh may be required. This surgery is typically performed under general anaesthesia, and our skilled surgeons ensure the highest standards of precision, safety, and care.
• Minimally Invasive Surgery: At Max Hospitals, we also offer minimally invasive techniques, such as laparoscopic surgery, as umbilical hernia treatment. This involves a laparoscope, specialised surgical tools, and making smaller incisions, which leads to quicker recovery times, reduced scarring, and minimal pain during recovery. This technique is especially effective for those with larger hernias or those who have had previous abdominal surgery. Laparoscopic surgery offers a less traumatic approach with the same level of success as traditional methods.
• Robotic Surgery: Another option for a minimal access procedure is Robotic surgery offering various benefits over conventional open surgery. It ensures smaller incisions, minimal scarring and faster recovery.

Although, safe and effective, like any other surgery, umbilical hernia surgery carries certain risks:

• Infection: The surgical site may become red, swollen, painful, or discharge yellow fluid, indicating an infection.
• Bleeding: Excessive bleeding can occur during or after surgery, requiring prompt attention.
• Rupture of the Wound: In some cases, the surgical wound may rupture, causing further complications.
• Hernia Recurrence: There is a possibility that the hernia may return even after surgery, requiring additional treatment.

At Max Hospitals, we provide comprehensive care and immediate attention to manage any complications that may arise, ensuring a smooth and safe recovery process.

Recovery from umbilical hernia surgery typically involves:

• Postoperative care: After surgery, rest and avoiding strenuous activities are essential for proper healing.
• Pain management: Mild pain or discomfort may be managed with prescribed medication.
• Full recovery: Most people can resume normal activities within a few weeks, although heavy lifting and strenuous exercise should be avoided for about 4-6 weeks.

While it may not always be possible to prevent an umbilical hernia, certain measures can help reduce the risk:

• Maintain a healthy weight: Avoiding obesity can decrease the pressure on the abdominal wall.
• Exercise: Strengthening the abdominal muscles through exercises that target the core muscles can provide additional support to the abdominal wall.
• Avoid heavy lifting: If possible, avoid heavy lifting, or use proper lifting techniques to prevent strain on the abdomen.

It is important to consult a doctor upon observing any symptoms of umbilical hernia, however, the following are some signs that indicate complications, requiring immediate medical attention:

• Sudden and Sharp Pain or Increasing Size: If the bulge or hernia becomes painful or starts to increase in size, it may indicate that the hernia is becoming more complicated, and prompt medical evaluation is necessary.
• Nausea, Vomiting, or Bowel Obstruction Symptoms: Symptoms such as nausea and vomiting or any signs of bowel obstruction (such as blood in the poop, difficulty passing stool, or gas) could signal that the hernia is affecting the intestines, which is a serious complication that requires urgent care.
• Redness, Tenderness, or Colour Changes: If the hernia becomes red, dark, tender, or changes colour, it may indicate that blood flow to the hernia is restricted, a condition called strangulation. It can lead to tissue death and may require emergency surgery.

Max Hospitals offers comprehensive care and advanced treatments for umbilical hernias. With experienced surgeons and a holistic treatment approach, we ensure the best patient outcomes. Consult our specialists for advice on umbilical hernia treatment options, we are here to help you every step of the way.

Are umbilical hernias genetic?

Yes, there is a genetic component, and family history can increase the likelihood of developing an umbilical hernia. (rare, small fraction of all hernias)

Can an umbilical hernia heal on its own?

Yes, congenital umbilical hernias generally heal on their own without surgery before the child turns three or four, however, they do not heal on their own in adults and often require surgical intervention.

Why did my baby get an umbilical hernia?

Babies may develop umbilical hernias due to incomplete closure of the abdominal wall after birth.

Do umbilical hernias go away after pregnancy?

In some cases, umbilical hernias may improve or resolve after childbirth, but surgery is often needed if the hernia persists.

Is umbilical hernia dangerous in adults?

While not typically dangerous, untreated umbilical hernias can lead to complications, including strangulation or bowel obstruction.

What size hernia needs surgery?

Surgery is needed for any hernia causing symptoms, large hernias (greater than 2 centimetres), or those that cause pain, discomfort, or complications like incarceration.

How can I reduce the size of my hernia?

Hernia size cannot be reduced through natural means; surgery is required for permanent resolution.

What foods or medicines shrink a hernia?

No specific foods or medicines can shrink a hernia, surgery is the only way to repair the hernia. 

Can a hernia grow back?

Yes, hernias can recur after surgery, though this is rare with proper surgical techniques and care.

What should you avoid with an umbilical hernia?

Avoid heavy lifting, straining, or activities that increase intra-abdominal pressure, which could worsen the hernia.

Reviewed by Dr. K R Vasudevan, Director - Liver Transplant & Surgical Gastroenterology, Liver Transplant and Biliary Sciences, Gastrointestinal Surgery, on 30 May 2025.

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