An umbilical hernia is a defect in the abdominal wall at or near the navel through which tissue can bulge. In adults, the opening generally persists, unlike many umbilical hernias in infants. Not every visible bulge is immediately dangerous, but it should be examined. The need for treatment and the technique depend on symptoms, size, individual risks and whether tissue could become trapped.
Sudden severe navel pain, discoloration, a firm bulge that does not recede or vomiting may indicate trapped tissue: seek emergency medical assessment immediately.
Causes and risk factors
The navel is a natural weak point in the abdominal wall. Connective-tissue structure, pregnancy, excess weight or persistently increased abdominal pressure may contribute. A small hernia may only become visible after years. A defect can occur alongside widening of the abdominal midline, called rectus diastasis, but these are not the same. Distinguishing them helps avoid unnecessary surgery and missed hernias.
Typical symptoms
A bulge at the navel is the most common sign. It may become more noticeable on coughing or straining. Some people feel pulling or pressure; others only see the bulge. Symptoms sometimes increase with size but can also occur with small openings. Severe persistent pain, discoloration and swelling that no longer recedes may indicate trapped tissue. Vomiting makes immediate assessment particularly important.
Diagnosis
We examine the navel and abdominal wall, assessing the opening, bulge and tenderness. Ultrasound may define size and contents or clarify uncertain findings. Larger, recurrent or complex hernias occasionally need further imaging. Weight, other medical conditions, medicines and previous operations are discussed before planned surgery. The safety of outpatient treatment is assessed individually, as is the appropriate technique.
Non-surgical treatment
For very small hernias causing little trouble, observation may be discussed according to risk. It does not close an adult abdominal-wall defect. Weight loss if overweight or treatment of chronic cough may reduce abdominal-wall loading. An abdominal support does not replace definitive treatment. Clear advice on when to seek review is important. Increasing pain or a changing bulge needs reassessment.
Surgical options
Surgery closes the defect with stitches and, depending on size and circumstances, mesh reinforcement. Open and minimally invasive options are weighed according to the findings. Umbilical hernia repair is among our selected procedures at the external surgical centre. A true hernia is treated differently from isolated rectus diastasis. Wound-healing problems, infection, persistent pain and recurrence are explained beforehand. A permanently recurrence-free result cannot be guaranteed.
Aftercare and rehabilitation
After surgery, wound checks and gradual return to normal activities follow. Early movement is usually possible; heavier loading increases according to technique, healing and the medical plan. Time off work also depends on the job. Pain should be manageable and improve over time. Increasing swelling, redness, fever or vomiting needs prompt assessment. Long-term advice includes modifiable factors that place strain on the abdominal wall.
Common questions
Is rectus diastasis an umbilical hernia?
No. A widened abdominal midline does not automatically mean a hernia defect. Both can occur together, however.
Can I exercise with an umbilical hernia?
That depends on symptoms and findings. New pain during activity should be assessed; exercise does not close the hernia.
Can surgery be performed as an outpatient?
Often, when the hernia and your general health are suitable. Larger or complex hernias may need a different setting.
Arrange a consultation
We discuss which treatment is suitable for your findings and which procedures are available within our outpatient service during a personal consultation. Outpatient operations take place at an external surgical centre.
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Further reading
Selected external resources about this condition. Some linked publications are in German.
Medical background
Sources & further information
These professional and patient resources provide further information about this condition. The text on this page is independently written.
NHS: Umbilical herniaNHS: Hernia