Umbilical Hernia

Dr Calvin Ong

MBBS M.MED (SURGERY) MRCS FRCS

An umbilical hernia occurs when part of the intestine or abdominal tissue pushes through a weakened area of the abdominal wall near the belly button (umbilicus), causing a noticeable bulge.

It is more common in infants but can also affect adults, especially those with weakened abdominal muscles or increased abdominal pressure.

Causes and Risk Factors

Various factors can increase the likelihood of developing an umbilical hernia. Common causes include:

Increased Abdominal Pressure

Activities like heavy lifting, straining during bowel movements, or chronic coughing can increase abdominal pressure, pushing tissue through weakened areas around the navel.

Infant Development

After birth, incomplete closure of the abdominal muscles around the site of the umbilical cord can allow tissue to protrude, leading to a hernia.

Obesity

Excess body weight puts continuous pressure on the abdominal muscles, weakening the abdominal wall over time and increasing the likelihood of a hernia.

Pregnancy

During pregnancy, the abdominal muscles stretch to accommodate the growing baby, resulting in weak points that can lead to hernia. Women who have had multiple pregnancies are at a higher risk because of cumulative muscle weakness.

Diagnosis of Umbilical Hernia

Diagnosing an umbilical hernia involves a comprehensive evaluation through the following key steps:

Physical Examination

A thorough physical examination is performed to identify any visible bulge or swelling near the navel. The patient may be asked to cough, strain, or stand to increase abdominal pressure to make the hernia more prominent.

Imaging Tests

If the hernia is not clearly visible or complications are suspected, imaging tests such as ultrasound or a CT scan may be recommended. These tests provide detailed views of the hernia and reveal if any tissue is trapped (incarcerated).

Physical Palpation

The doctor gently presses on the bulge to confirm the presence of the hernia and assess its characteristics. This helps determine whether the hernia is reducible (able to be pushed back into the abdomen) or non-reducible.

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Treatment Options for Umbilical Hernia

Treatment for an umbilical hernia depends on its size, severity of symptoms, and the patient’s overall health.

Non-Surgical Management

In infants, umbilical hernias often resolve on their own by the age of 1-2 years. Monitoring without intervention is typically recommended during this period. For adults, non-surgical management may be considered if the hernia is small, painless, and presents no immediate risk of complications. Regular check-ups ensure the hernia remains stable.

Surgical Treatment

Surgery is recommended if the hernia causes pain, grows in size, or risks complications like incarceration (trapped tissue) or strangulation (cut-off blood supply). The procedure involves repositioning the tissue and reinforcing the abdominal wall with stitches. In larger or recurrent cases, a mesh implant may be used to prevent recurrence. It is usually done on an outpatient basis, with most patients returning home the same day.

Preventing Umbilical Hernias

Prevention focuses on reducing abdominal strain and maintaining muscle strength. Managing body weight can lower the pressure on the abdominal wall, while avoiding heavy lifting and excessive straining during activities helps reduce the risk. Core-strengthening exercises, performed under proper guidance, can improve muscle support around the abdomen, further preventing hernia formation.

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Dr Calvin Ong Jianming

MBBS (S’pore)|

M.Med (Surgery)|

MRCS (Ireland)|

FRCS (Edin)|

王健名医生

Dr. Calvin Ong is a Senior Consultant with more than 15 years of surgical experience. He specializes in colorectal and general surgery, performing minimally invasive as well as advanced robotic surgeries for benign and malignant colorectal conditions, including inflammatory bowel disease, pelvic floor disorders, colorectal cancer, and hernia repair. He is dedicated to providing high-quality, personalised care for his patients.

Dr. Ong graduated with a Bachelor’s degree in medicine and surgery from the National University of Singapore in 2008 and completed his Masters of Medicine (Surgery) at the same institute. He finished his advanced specialist training in 2016 and became a fellow of the Royal College of Surgeons of Edinburgh.

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    Frequently Asked Questions

    Can an umbilical hernia return after surgery?

    Yes, there is a small chance of recurrence, especially if the abdominal wall remains weak or if there is ongoing pressure, such as from obesity or frequent straining. Proper post-surgery care and addressing these risk factors can help reduce the likelihood of recurrence.

    How long does recovery take after umbilical hernia surgery?

    Recovery typically takes 1-2 weeks. During this time, patients are advised to avoid strenuous activities and heavy lifting to ensure proper healing and prevent complications.

    What happens if an umbilical hernia is left untreated?

    While many umbilical hernias cause no immediate harm, leaving them untreated can lead to serious complications such as incarceration (trapped tissue) or strangulation (restricted blood supply), which may require emergency medical attention.

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