An umbilical hernia, known in technical terms as an umbilical hernia, refers to a tear or opening in the abdominal wall through which the intestines can visibly protrude forward. Babies are often affected, but middle-aged women are also affected. Experts advise that umbilical hernias in adults should always be operated on.
What is an umbilical hernia?
Physicians do not understand an umbilical hernia as such. Rather, it is a tear or hole in the abdominal wall that causes the intestines to protrude. See psyknowhow for Hemophilia Explained.
This often happens through heavy pressing or pressure that causes the abdominal wall to give way. The intestines are then only held inside by the skin. An umbilical hernia is visually recognizable by a clearly visible bulge in the area of the navel, the so-called hernia sac.
Umbilical hernias are particularly common in infants. Adults, especially women between the ages of 50 and 70, can also be affected.
Causes
An umbilical hernia can occur for a variety of reasons. Basically, a weakness in the abdominal wall in the area of the former umbilical cord is the trigger for the intestines to leak out.
This weakness is genetic. It can either be congenital or develop slowly over the course of life. The abdominal wall often does not heal properly after birth, which is the reason for frequent umbilical hernias in infants.
If an adult suffers from an umbilical hernia, the weakness of the abdominal wall has developed over the years. Then a strong strain on the abdominal muscles or heavy pressing during pregnancy or constipation is sufficient to cause a tear in the abdominal wall.
Symptoms, Ailments & Signs
An umbilical hernia is first noticed by a swelling or protrusion in the area of the navel. The swelling usually does not cause any symptoms at the beginning. Depending on whether parts of the intestine are trapped, a pulling or burning sensation can occur. Signs of inflammation such as hard or reddened areas are also characteristic.
The pain occurs mainly when bending over, pressing, coughing or lifting heavy loads. Rarely, the bowel can become lodged in the hernial sac, resulting in severe pain. The affected intestinal region is also no longer adequately supplied with blood and oxygen, which can lead to necrosis. Such a severe course is also manifested by blood in the stool and other problems with bowel movements.
In some cases, colic, fever, nausea and vomiting also occur. Intestinal entrapment occurs in four out of every hundred patients. In the remaining cases, the umbilical hernia is symptom-free and is only detected during a routine examination. If the umbilical hernia is not treated, the symptoms increase.
Eventually, perforation can occur, which can lead to internal bleeding, infection, and other life-threatening complications. With early diagnosis and treatment, the umbilical hernia symptoms go away completely within a few weeks.
Diagnosis & History
The attending doctor can determine whether there is an umbilical hernia, primarily by carrying out an ultrasound examination.
This way he can see if the intestines have changed position. He can also try to push them back into the abdominal cavity with slight pressure. If this is not possible or if pain occurs, the intestines may be trapped.
Then a quick operation is necessary. In principle, an umbilical hernia does not necessarily have to be treated, because it does not pose an immediate health risk unless the organs are jammed. However, those affected must be aware that it will not heal on its own – this only happens in small children up to three years of age.
Complications
An umbilical hernia usually heals by itself during the first two years of life. In old age, serious and sometimes even life-threatening complications can be expected from an umbilical hernia, especially if it is not treated promptly. Parts of the intestine can become trapped in the hernial sac, which is accompanied by very severe, colicky pain. The abdomen becomes very sensitive to pressure, and even light touching during the examination can cause extreme pain in the patient.
Larger umbilical hernias with parts of the large or small intestine in the hernial sac can cause diarrhea or constipation, and patients sometimes notice blood in the stool. In addition, there is a risk that the trapped parts of the intestine will no longer be supplied with sufficient blood and will push away. If the protective abdominal wall is missing, dangerous injuries to the intestines can occur, which often necessitate emergency surgery.
Other possible complications are high fever combined with nausea and vomiting. In the event of entrapment, there are often outbreaks of sweating, excruciating thirst, tachycardia and a severe drop in blood pressure.
If treatment is delayed, there is also a risk that the contents of the fracture will become inflamed or stick to the surrounding area, making it impossible to reduce the fracture. If emergency surgery is required due to delayed treatment, the risk of pulmonary embolism also increases.
When should you go to the doctor?
Irregularities and disorders in the area of the navel should be presented to a doctor. If there is swelling, discoloration of the skin or deformities, action is required. A doctor’s visit is necessary if there is a bulging or lump formation at the navel. If the swelling increases in size, consult a doctor as soon as possible.
If pain occurs, the person concerned needs help. Painkillers should not be taken and should only be taken in consultation with a doctor. There are risks and side effects about which the person concerned must be informed and educated. Bleeding or loss of other bodily fluids from the navel is a concern. You must be presented to a doctor so that the cause can be clarified and a treatment plan can be drawn up. If there is blood in the stool or urine, these symptoms should be discussed with a doctor.
A general malaise, nausea, indigestion, irregular heartbeat or inner weakness are signs of a health problem. If the symptoms persist or show increasing intensity, a doctor is needed. If you have fever, cramps or colic, you should see a doctor immediately. Since life-threatening developments can occur with an umbilical hernia, a check-up visit to a doctor should take place at the first sign.
Treatment & Therapy
If the attending physician has clearly diagnosed an umbilical hernia, it must be considered whether and how it should be treated. In small children, the fracture is usually not treated because it usually heals by itself without any complications up to the age of about three years.
Under certain circumstances, the abdomen can be bandaged to support this process. If an adult suffers from an umbilical hernia, there is no chance of self-healing. Experts advise having the fracture treated surgically to minimize the risk of life-threatening organ jamming.
Such an operation can even be performed on an outpatient basis; the patient can usually leave the clinic after just a few hours.
There are basically two surgical methods to choose from, which differ in how large the umbilical hernia is in each individual case. In the case of tears of up to about 2 cm, the abdominal wall is sewn up with a firm suture. Only a very small surgical scar remains here.
In the case of larger tears or holes, the abdominal wall is additionally reinforced with a plastic mesh so that further or repeated umbilical hernias cannot occur. If the procedure proceeds without complications, the patient can already be physically active again after about 14 days without hesitation.
Outlook & Forecast
In infants, the prognosis of healing is very good. Umbilical hernias in infants heal without complications in 90 percent of all cases in the first year of life. Sometimes the parents need a little more patience, since the abdominal wall can take up to the 3rd year to close completely. If the umbilical hernia is painless and an ultrasound shows no abnormalities, the children have good conditions for self-healing.
Adults, on the other hand, will have to have an umbilical hernia operated on sooner or later to avoid complications. The adult body no longer closes the holes and cracks on its own. Self-healing is almost impossible. In an operation, the hole is covered with a plastic mesh and healing is accelerated. Complications rarely occur after such an operation. Severe scarring occurs in some patients. At the treated site, there remains an increased risk of fracture from heavy loads (heavy coughing, intense exercise or heavy lifting). Physical activity should be limited as much as possible until the tear is treated. There is a high risk that the umbilical hernia will become larger and the operation more difficult.
Prevention
Since an umbilical hernia is caused by a weakness in the abdominal wall, it cannot be directly prevented. If there is a suspicion of an umbilical hernia, a doctor should be consulted to rule out organ jamming. Even if no treatment is usually necessary for small children, they should always be presented to the doctor if there is an umbilical hernia. In this way, possible complications can be avoided and healing can be supported.
Aftercare
One of the aims of aftercare is to prevent the recurrence of new symptoms. Doctors therefore rely on close follow-up controls. In the case of an umbilical hernia, external circumstances lead to the disease. The patient can only try to circumvent them. Preventive measures include not lifting heavy loads and reducing excess weight.
Strengthening the abdominal muscles has also been shown to prevent another umbilical hernia. The implementation of these precautionary measures is the responsibility of the patient. The doctor will provide information about suitable preventive measures as part of the initial therapy. An umbilical hernia always heals completely.
In fact, no treatment is required for infants and expectant mothers. They usually heal spontaneously after a short time. Due to the absence of symptoms, there is no relevance for follow-up care at the end of the therapy. Neither long-term treatment nor everyday support are necessary.
The patient can leave the hospital after just a few days. In the case of an outpatient procedure, recovery takes place at home. As part of a final examination, the doctor feels the affected area with his hands. An ultrasound examination may indicate that everything is healing as expected.
You can do that yourself
Since the umbilical hernia is often due to a weakness in the connective tissue in the abdomen, the affected patient can do little about it. Umbilical hernias are relatively common in children and are usually harmless. Since an umbilical hernia in children very often recedes on its own, no therapeutic measures are usually taken. Bandaging the middle of the body can promote the healing process, but is rarely mandatory. However, the fracture point, which can be seen as a bulge under the skin, should be observed by the child’s caregivers. If the area changes, the child is in pain or the skin turns bluish, a doctor must be consulted immediately.
Umbilical hernias also occasionally occur during pregnancy, but they also very often recede on their own after the birth. Prenatal exercises and avoiding excessive weight gain can reduce the risk of umbilical hernia in pregnant women.
Umbilical hernias in adults who are not expecting a child are often due to incorrect physical exertion or severe obesity. They are usually not dangerous, but should be treated surgically to prevent life-threatening organ jamming, which occurs much more frequently in adults than in children. Above all, anyone suffering from an acute umbilical hernia should refrain from lifting heavy objects in order not to enlarge the hernia. Even after a successful operation, heavy lifting should be avoided to avoid another umbilical hernia. If you are overweight, weight reduction reduces the risk of an umbilical hernia.
