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Allen KamravaMD · MBA · FACS · FASCRS

Colon and Rectum

Umbilical Hernia

An umbilical hernia is a condition where part of the intestine or fatty tissue bulges through a weak spot in the abdominal muscles near the navel.

Reviewed by Allen Kamrava, MD, MBA, FACS, FASCRS · Last reviewed 2025-10-12

Overview

What is an umbilical hernia?

An umbilical hernia is a type of ventral hernia that occurs when part of the intestine, fat, or fluid protrudes through a weak spot in the abdominal wall at the umbilicus (belly button). The umbilicus is a natural point of weakness in the abdominal wall, as it is where the umbilical cord was attached before birth. These hernias are very common in infants and often close on their own. In adults, umbilical hernias are acquired and will not close spontaneously. They are more common in women and in people with conditions that increase intra-abdominal pressure.

Symptoms

What are the symptoms?

The most common symptom is a soft swelling or bulge near the navel. The bulge can range in size and may become more noticeable when you cough, laugh, or strain. Most adult umbilical hernias are asymptomatic or cause only mild discomfort or an aching sensation. In some cases, the hernia can become tender or cause more significant pain.

Causes & risk factors

What causes an umbilical hernia in adults?

Umbilical hernias in adults are caused by increased pressure on a naturally weak area of the abdominal wall. Factors that can contribute to the development of an umbilical hernia include:

  • Obesity: Excess weight puts continuous pressure on the abdominal muscles.
  • Multiple pregnancies: The stretching of the abdominal wall during pregnancy can weaken the area around the umbilicus.
  • Ascites: The buildup of fluid in the abdominal cavity from conditions like liver disease.
  • Chronic straining: From heavy lifting, a persistent cough, or constipation.
  • Previous abdominal surgery.

When to see a doctor

When should I see a doctor?

You should see a doctor if you notice a bulge near your belly button. A healthcare provider can confirm the diagnosis and determine if treatment is necessary. While small, asymptomatic hernias can sometimes be observed, most symptomatic umbilical hernias in adults are recommended for surgical repair to prevent them from getting larger and to avoid the risk of complications.

Urgent — get care now

When is it an emergency?

Like other hernias, an umbilical hernia can become a surgical emergency if it gets incarcerated (trapped) or strangulated. This is more likely to happen with smaller hernia defects.

You should seek immediate medical help if you have an umbilical hernia and experience:

  • Sudden, severe pain at the site of the bulge.
  • Nausea and vomiting.
  • The bulge becomes firm, painful to the touch, and discolored (red or purple).
  • You are unable to pass gas or have a bowel movement.

Diagnosis & tests

How is an umbilical hernia diagnosed?

The diagnosis is usually made by a physical examination. The doctor will look and feel for a bulge at your navel and may ask you to strain or cough. They will also try to gently push the bulge back in (reduce it). In most cases, no other tests are needed. If the diagnosis is unclear, especially in an obese patient, an ultrasound or CT scan of the abdomen can be used to confirm the presence of the hernia.

Treatment

How is an umbilical hernia treated?

In adults, umbilical hernias require surgical repair as they will not heal on their own and tend to grow larger over time. The surgery is usually performed on an outpatient basis.

  • For small hernias (less than 1-2 cm): The defect may be closed with sutures alone (primary repair). However, even for small hernias, many surgeons prefer to use mesh due to a lower recurrence rate.
  • For larger hernias (greater than 1-2 cm): The standard of care is to repair the defect with a piece of surgical mesh. The mesh reinforces the weak area and significantly reduces the chance of the hernia coming back.

The repair can be done through an open incision (often a small, curved incision at the edge of the umbilicus) or with a minimally invasive (laparoscopic or robotic) approach.

Self-care

What is recovery like after surgery?

Recovery is usually quick. Most people can return to work and light activities within one to two weeks. It is important to avoid heavy lifting and strenuous exercise for 4 to 6 weeks after the surgery to allow the repair to heal fully. You can help prevent recurrence by maintaining a healthy weight and avoiding activities that cause significant abdominal strain.

Frequently asked questions

My baby has an umbilical hernia. Does she need surgery?
Most umbilical hernias in infants close on their own by the time the child is 1 to 2 years old. Surgery is usually only recommended if the hernia is very large, doesn't close by age 4 or 5, or if it becomes incarcerated.

Is it safe to get pregnant if I have an umbilical hernia?
If you have an umbilical hernia and are planning a pregnancy, it is often recommended to have the hernia repaired before you get pregnant. Pregnancy increases abdominal pressure and can cause the hernia to get much larger and potentially become incarcerated.

Do all umbilical hernias need to be repaired with mesh?
While very small hernias can be repaired with sutures alone, the use of mesh is generally associated with a lower recurrence rate. For any hernia larger than about 1 cm, mesh repair is the standard of care to provide a more durable repair.

References

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