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Umbilical Hernia - Magdi Alexander MD - General Surgeon in Pasadena California

An umbilical hernia occurs when intestine, fat, or fluid pushes through a weak spot of the umbilical opening in abdominal muscles of the belly, causing a bulge near the bellybutton, or navel. Fortunately, even though umbilical hernias are most common in infants, they are usually harmless.

In Adults

Umbilical hernias can still occur in adults. Being overweight or having multiple pregnancies may increase the risk of developing an umbilical hernia. More commonly found in women, the umbilical hernia will grow bigger over time. Leaving the hernia untreated can lead to it becoming a strangulated hernia, which is when the intestine or fat is trapped and the blood supply to the tissue is cut off. Strangulated hernias are very painful and require emergency surgery.

Most umbilical hernias are common and typically harmless, though you should seek medical advice if you find a bulge near your navel as immediate diagnosis and treatment will help prevent any avoidable complications. Emergency care is highly recommended as soon as the bulge becomes painful or tender.

Umbilical Hernia Repair

The best umbilical hernia repair will depend on the exact nature of the hernia. Umbilical hernias may be simple, such as a small hole in the abdominal fascia. In this case, Dr. Alexander recommends repairing the hernia by returning the bowel to its proper location and then closing the hole in the abdominal wall.

In most cases, instead of sewing the opening closed, an underlay mesh is used to remove tension from the abdominal wall during closure. The abdominal wall then has a chance to heal well in a tension-free environment, which is the key to a successful outcome.

Few patients with an umbilical hernia may suffer from an underlying condition called “rectus diastasis” or abdominal muscle separation. The muscles along either side of the abdomen, known as the “six pack,” are called the rectus muscles. They normally join at the midline, adjacent to the navel. However, when these muscles separate or stretch apart, it is called a diastasis. If the abdomen bulges easily after meals, is difficult to “suck in,” or strength is reduced, then chances are you suffer from rectus diastasis. Though occurring in both men and women, it is especially common in women after pregnancy.

If a patient suffers from rectus diastasis and an umbilical hernia, the abdominal muscles need to be repaired first. When the muscles separate it causes a natural weakness of the abdominal wall. Therefore by repairing the muscles at the same time as the hernia, it will decrease the chances of a hernia recurrence, increase the strength of the core muscles, and overall be a stronger repair.

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