Hernia (umbilical)

Overview - Umbilical hernia repair

A hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall.

Your muscles are usually strong and tight enough to keep your organs and intestines in place, but a hernia can develop if there are any weak spots.

What is an umbilical hernia?

Umbilical hernias are very common in infants and young children, particularly in babies born prematurely.

An umbilical hernia appears as a painless lump in or near the navel (belly button). 

It may get bigger when laughing, coughing, crying or going to the toilet and may shrink when relaxing or lying down.

Picture of a baby with an umbilical hernia
Credit:

RUTH JENKINSON/SCIENCE PHOTO LIBRARY

In many cases, the umbilical hernia goes back in and the muscles reseal before the child's first birthday.

Umbilical hernias can also develop in adults. Without treatment, the hernia will probably get worse over time.

For information on other types of hernia, see:

What causes an umbilical hernia?

During pregnancy, the umbilical cord passes through an opening in the baby's abdomen (tummy). This opening should close shortly after birth, but in some cases the muscles don't seal completely.

This leaves a weak spot in the surrounding muscle wall (abdominal wall). An umbilical hernia can develop when fatty tissue or a part of the bowel pokes through into an area near the navel.

In adults, factors that can contribute to developing an umbilical hernia include:

  • being overweight or obese
  • straining while moving or lifting heavy objects
  • having a persistent heavy cough
  • having a multiple pregnancy (such as twins or triplets)

When is surgery needed?

If necessary, umbilical hernias can be treated with surgery to push the bulge back into place and strengthen the weakness in the abdominal wall.

This operation may be recommended for your child if the hernia is large or hasn't disappeared by the time they reach 3 or 4 years old.

You'll usually be advised to wait for your child to reach this age because the operation isn't essential unless there are complications. The risk of your child developing complications is very low.

Surgery is recommended for most adults with an umbilical hernia because the hernia is unlikely to get better by itself when you're older and the risk of complications is higher.

Complications that can develop as a result of an umbilical hernia include:

  • obstruction – where a section of the bowel becomes stuck outside the abdomen, causing nausea, vomiting and pain
  • strangulation – where a section of bowel becomes trapped and its blood supply is cut off; this requires emergency surgery within hours to release the trapped tissue and restore its blood supply so it doesn't die

Surgery will get rid of the hernia and prevent any serious complications, although there's a chance of it returning after the operation.

Repairing an umbilical hernia

An umbilical hernia repair is a relatively simple procedure that normally takes about 20 to 30 minutes. General anaesthetic is usually used so there's no pain while the operation is carried out.

In children, the weak spot in the abdominal wall is usually closed with stitches. If the hernia is large or in adults, a special mesh may be used to strengthen the area instead.

You or your child should be able to go home on the same day as the operation. You may feel a bit sore and uncomfortable while you recover. 

You'll need to limit strenuous activities for a few weeks after the operation, and 1 or 2 weeks off school or work is often recommended. Most people are able to return to all their normal activities within a month of surgery.

Read more about:

Are there any risks from surgery?

Complications from an umbilical hernia repair are uncommon, but can include:

  • infection of the wound – it may appear red, have a yellow discharge and be painful or swollen
  • bleeding
  • rupture of the wound
  • the hernia may return
  • the belly button may look different

These complications occur in less than 1 in 10 people (less than 10%).

Page last reviewed: 7 August 2018
Next review due: 7 August 2021

How it's performed - Umbilical hernia repair

Umbilical hernia repair is a fairly quick and simple operation. It takes about 20 to 30 minutes and it's usually possible to go home on the same day.

However, some people stay in hospital overnight if they have other medical problems or if they live alone.

Before the operation

The hospital will send you instructions about when to stop eating and drinking before the operation.

At the hospital, you'll meet the nurse, anaesthetist (specialist who puts you or your child to sleep), and surgeon. This is a good opportunity to ask questions if there's anything you're not sure about.

In most cases, the operation is carried out under general anaesthetic. This means you're unconscious during the procedure and won't feel any pain as it's carried out.

If general anaesthetic is used, it's usually inhaled as a gas or injected into the back of the hand. You can stay with your child until they're taken into the operating theatre.

Local anaesthetic, where the area being operated on is numbed but you remain awake, is occasionally used instead of general anaesthetic. It's usually only used in adults with a small hernia who aren't in good enough health to have a general anaesthetic.

During the operation

During umbilical hernia repair, the surgeon makes a small cut of about 2 to 3cm at the base of the belly button and pushes the fatty lump or loop of bowel back into the tummy.

The muscle layers at the weak spot in the abdominal wall where the hernia came through are stitched together to strengthen them. For large or adult umbilical hernias, a special mesh patch may be placed in the abdominal wall to strengthen the area instead.

The wound on the surface of the skin is closed with dissolvable stitches or special surgical glue. Sometimes, a pressure dressing is applied, which usually stays on for 4 to 5 days.

After the operation

Although the operation only takes up to 30 minutes, you or your child will be away from the ward for around 2 hours.

If your child has had surgery, you'll be taken to the recovery room as soon as they wake up so you can be with them on their way back to the ward.

Read more about recovering from an umbilical hernia repair.

NHS waiting times

If your GP refers you to a consultant for specialist treatment, such as surgery, you have the right to start treatment within 18 weeks.

You may be able to book your hospital appointment through the NHS e-Referral Service while you're still in the GP surgery.

Read more about NHS waiting times for treatment.

Page last reviewed: 7 August 2018
Next review due: 7 August 2021

Recovery - Umbilical hernia repair

It's usually possible to go home the same day as having an umbilical hernia repair.

It's normal to feel sore and uncomfortable immediately after surgery. Local anaesthetic, which numbs the area, will be injected before the end of the operation to reduce the pain. Painkillers will also be provided.

Your child may be sleepy or cry a lot and demand extra attention after the operation. This is normal and will pass.

Most adults and children can go home a few hours after surgery when they've had something to eat and drink.

An overnight stay in hospital is usually only recommended for people with other medical problems, or people who are vomiting regularly and are unable to keep food and drink down.

Follow-up appointment

Before being discharged from hospital, you'll be told whether you or your child needs to have a follow-up appointment.

If an appointment is needed, you'll receive a letter in the post confirming the details of the date and time.

At home

You may have bruising and tenderness around the wound during your recovery at home. This is normal and usually settles within about a week. However, the swelling may not go down for several weeks.

Hospital staff will advise you about taking painkillers to relieve any discomfort. You can give your child painkillers such as paracetamol and ibuprofen. Children under 16 must not be given aspirin.

Wearing loose clothing may help reduce any discomfort your child has, but they should be able to wear trousers or a skirt as normal.

Make sure you follow the instructions you were given before leaving hospital about hygiene, caring for the wound and bathing.

Straining on the toilet because of constipation can cause pain around the wound. Drinking lots of fluids and eating plenty of vegetables, fruit and high-fibre foods such as brown rice, wholemeal bread and pasta can help reduce the chances of this occurring.

Activities

Your surgical team will be able to give you a good idea about how long it takes to recover from surgery.

If the operation was carried out under a general anaesthetic, your co-ordination and reasoning may be affected for a short time. Adults should therefore avoid drinking alcohol, operating machinery or signing legal documents for at least 48 hours after the procedure.

Normal activities can gradually be resumed over time until they can be carried out without feeling any pain. Most people are able to do light activities after 1 or 2 weeks.

Gentle exercise, such as walking, can help the healing process. Heavy lifting and strenuous activities should be avoided for about 4 to 6 weeks.

Work and school

It's best to keep your child off school for about a week to give them time to recover from the anaesthetic and the operation. They should be excused from sports and games for at least 2 weeks when they return to school. Contact sports should be avoided for 6 to 8 weeks.

Adults who have surgery should be able to return to work after a week or two, although you may need more time off if your job involves manual labour.

Driving

It's usually advisable to avoid driving until you can do an emergency stop without feeling any pain or discomfort – you can practise this without starting your car.

It will usually be at least 1 or 2 weeks after surgery before you reach this point.

Contacting your car insurance company before you start to drive again is normally recommended.

When to get medical advice

Call your surgeon or GP if any of the following symptoms develop after surgery for an umbilical hernia:

  • persistent fever over 38C
  • bleeding
  • increased swelling or pain in the abdomen
  • pain that isn't relieved by painkillers
  • persistent nausea or vomiting
  • chills
  • persistent coughing or shortness of breath
  • increasing redness around your incisions
  • difficulty passing urine

Page last reviewed: 7 August 2018
Next review due: 7 August 2021