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Umbilical Hernia

Definition:
Does your baby's bellybutton protrude when he or she cries? Don't be alarmed. This is a classic sign of an umbilical hernia — a common and typically harmless condition.

An umbilical hernia occurs when part of the intestine protrudes through a weak spot in the abdominal muscles. Umbilical hernias are most common in infants, but they can affect adults as well.

Most umbilical hernias close on their own by age 2. To prevent complications, umbilical hernias that don't disappear by age 4 or 5 or those that appear during adulthood may need to be repaired surgically.

Causes:
During pregnancy, the umbilical cord passes through a small opening in the baby's abdominal muscles. The opening normally closes before birth. If the muscles don't grow together completely, this weakness in the abdominal wall may cause an umbilical hernia at birth or later in life.

In adults, too much abdominal pressure can cause an umbilical hernia. Possible culprits include:
  • Obesity
  • Heavy lifting
  • Coughing
  • Multiple pregnancies
  • Fluid in the abdominal cavity
Risk Factor:
Umbilical hernias are most common in infants — especially premature babies and those with low birth weights. The condition affects boys and girls equally.

For adults, being overweight or having multiple pregnancies may increase the risk of developing an umbilical hernia.

When to seek medical advice:
If you suspect that your baby has an umbilical hernia, consult his or her doctor. Seek emergency care if:
  • Your baby appears to be in pain
  • Your baby begins to vomit
  • The bulge becomes tender, swollen or discolored
Similar guidelines apply to adults. Consult your doctor if you have a bulge near your navel. Seek emergency care if the bulge becomes painful or tender. Prompt diagnosis and treatment can help prevent complications.

Symptoms:
An umbilical hernia creates a soft swelling or bulge near the navel (umbilicus). The bulge may range from 1 to 5 centimeters in diameter.

If your baby has an umbilical hernia, you may notice the bulge only when he or she cries, coughs or strains. The
bulge may disappear when your baby is calm or lies on his or her back.

Umbilical hernias in children are usually painless. Umbilical hernias that appear during adulthood may cause abdominal discomfort.

Dignosis:
An umbilical hernia is diagnosed during a physical exam. Sometimes blood tests or imaging studies — such as an abdominal ultrasound or X-ray — are used to screen for complications.

Complication:
For children, complications of an umbilical hernia are rare. In less than 1 percent of cases, the protruding abdominal tissue becomes trapped (incarcerated) and can no longer be pushed back into the abdominal cavity. This reduces the blood supply to the section of trapped intestine and can lead to umbilical pain and tissue damage.

Adults are somewhat more likely to experience incarceration or obstruction of the intestines. Emergency surgery is typically required to treat these complications.

Treatment:
Most umbilical hernias close on their own by age 2. The doctor may even be able to push the bulge back into the abdomen during a physical exam.

For children, surgery is typically reserved for large or painful umbilical hernias or those that:
  • Get bigger after age 1 or 2
  • Don't disappear by age 4 or 5
  • Become trapped or block the intestines
For adults, surgery is typically recommended to avoid possible complications — especially if the umbilical hernia gets bigger or becomes painful.

During surgery, a small incision is made at the base of the bellybutton. The herniated tissue is returned to the abdominal cavity, and the opening in the abdominal wall is stitched closed. Most people are able to go home within a few hours after surgery and resume typical activities within two to four weeks. Recurrences are unlikely.
 
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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