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An umbilical hernia occurs when part of the intestine or fatty tissue pushes through a weak spot near the belly button (umbilicus), resulting in a visible bulge.
This condition is more common in infants but can also affect adults, particularly those with weakened abdominal muscles. While often harmless, it can sometimes cause discomfort or complications if left untreated.
Several symptoms can occur as tissue pushes through the weakened area near the belly button. Common symptoms include:
Visible Bulge: The protrusion occurs because part of the intestine or fatty tissue pushes through the weakened area. This bulge becomes more noticeable during activities that increase abdominal pressure, such as coughing, crying, or straining.
Pain or Discomfort: In adults, the hernia may cause discomfort because the tissue pressing through the muscle creates tension. Bending, lifting, or physical exertion can increase this pressure, leading to pain.
Swelling or Tenderness: The area around the hernia may become swollen or tender due to inflammation. This occurs as the body responds to the continuous pressure and irritation caused by the hernia.
Digestive Issues: When a hernia traps a portion of the intestine, it can result in symptoms like nausea, vomiting, and discomfort in the digestive system. This occurs because the trapped section of the intestine can obstruct normal bowel movements, resulting in a blockage.
An umbilical hernia can result from conditions or activities that strain or weaken the abdominal muscles. Common causes include:
Activities like heavy lifting, chronic coughing, or frequent straining during bowel movements can put excess pressure on the abdomen, pushing tissue through weak spots in the muscles, and leading to hernia formation.
In newborns, the abdominal muscles may not fully close after the umbilical cord is cut, leaving a small opening. If this opening does not close properly as the baby grows, an umbilical hernia can develop.
Excess body weight places additional strain on the abdominal wall, increasing the risk of tissue pushing through weak muscle areas, which can lead to a hernia.
During pregnancy, the abdominal muscles stretch and thin to accommodate the growing baby. This stretching can weaken the muscles, making hernia formation more likely, particularly if the woman gains significant weight or has multiple pregnancies.
Diagnosing an umbilical hernia involves several steps to confirm the condition and plan for treatment.
The doctor visually examines the bulge near the belly button and may ask the patient to cough or strain. This increases abdominal pressure, making the hernia more visible and helping assess its size and impact.
Gentle pressure is applied to check if the hernia can be pushed back into the abdomen (reducible). This assessment helps determine the urgency of treatment and whether the hernia is at risk of complications, such as becoming trapped (incarcerated).
If the hernia is not clearly visible or there are concerns about complications, the doctor may recommend an ultrasound or CT scan. These imaging tests provide a detailed view of the hernia, including its size, location, and whether any intestine or tissue is trapped, which aids in treatment planning.
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Treatment for an umbilical hernia depends on the size, symptoms, and the patient’s overall health. Non-surgical approaches may be suitable for mild cases, while surgery is advised if there is a risk of complications.
In infants, umbilical hernias often close on their own by age 1 or 2, so regular monitoring is recommended. Adults with small, symptom-free hernias may also be observed over time without immediate surgery, as long as the hernia does not worsen or cause discomfort.
Hernia repair surgery involves carefully pushing the herniated tissue back into its proper position and reinforcing the abdominal wall with sutures or a mesh implant. The procedure is generally considered low-risk and often performed on an outpatient basis, allowing patients to return home the same day. Surgery is recommended to prevent complications, particularly for adults who experience pain, have a growing hernia, or are at higher risk of tissue strangulation.
Prevention focuses on minimising abdominal strain and maintaining muscle strength. Avoiding heavy lifting and activities that require intense straining can lower the risk, particularly for those with a history of hernias.
Maintaining a healthy weight is also necessary, as excess body weight adds pressure to the abdominal wall, increasing the likelihood of hernia formation. Strengthening core muscles can help support the abdomen, but exercises should be guided to avoid strain or injury.
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MbChB (Sheffield)
M.Med (Surgery)
FRCSEd (General Surgery)
蘇萊曼·尤索夫博士
Dr. Sulaiman Yusof is a distinguished Senior Consultant in colorectal and general surgery, boasting over 15 years of expertise. His passion lies in minimally invasive techniques, particularly robotic surgery, where he has achieved remarkable success using the Da Vinci Xi system. Dr. Sulaiman is dedicated to delivering high-quality, personalized, and empathetic care, always striving for the best outcomes for his patients.
Dr. Sulaiman’s journey began at the University of Sheffield, where he graduated in 2002. He honed his skills during his house officer and basic surgical training in the UK before returning to Singapore. There, he completed his Advanced Surgical Training at Changi General Hospital and earned the Joint Speciality Fellowship in General Surgery in 2013.
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In infants, umbilical hernias often close on their own by the age of 1 or 2 as the abdominal muscles strengthen naturally. In contrast, umbilical hernias in adults do not resolve on their own and typically require surgical repair if they cause symptoms or increase in size, as the muscle weakness is unlikely to improve without intervention.
If an umbilical hernia is not treated, complications may develop, such as incarceration, where the herniated tissue becomes trapped and cannot be pushed back into the abdomen. This can restrict blood flow, leading to strangulation, a severe condition where the blood supply to the tissue is cut off. Strangulation can cause tissue death and requires emergency surgery.
Yes, although hernia repair surgery is generally effective, there is a possibility of recurrence. Factors that increase the risk of a hernia returning include obesity, heavy physical activity, pregnancy, or chronic conditions that cause abdominal pressure, such as persistent coughing or constipation. Following post-surgical care instructions can help reduce the risk.
Recovery from umbilical hernia surgery typically involves rest and limited physical activity for a few weeks. Patients may experience mild discomfort or swelling near the incision site, which usually resolves with time. It is necessary to avoid heavy lifting and follow instructions on when to resume normal activities. Full recovery usually takes 4-6 weeks.