What Is an Umbilical Hernia?

An umbilical hernia occurs when tissue — usually a small amount of fat or part of the intestine — pushes through a weakness in the abdominal wall near the belly button. They’re one of the more common types of hernia, and while they often look alarming, they’re usually very manageable.

What Causes an Umbilical Hernia?

The belly button is a natural weak point in the abdominal wall — it’s where the umbilical cord was attached before birth. In infants, this opening doesn’t always close completely after birth, which is why umbilical hernias are common in babies. Most childhood umbilical hernias close on their own by age 4 or 5.

In adults, umbilical hernias develop when increased pressure in the abdomen pushes tissue through this same weak spot. Common contributing factors include:

• Pregnancy (especially multiple pregnancies)
• Significant weight gain
• Ascites (fluid buildup in the abdomen)
• Heavy or repetitive lifting
• Chronic coughing

What Does It Look Like and Feel Like?

The most obvious sign is a soft bulge at or near the belly button. It may be barely noticeable or quite prominent, depending on its size. The bulge typically:

• Becomes more visible when standing, coughing, or straining
• May reduce or disappear when lying flat
• Is usually soft and easily pushed back in (reducible)

Many umbilical hernias are painless, especially when small. Others cause discomfort, a pulling sensation, or occasional sharp pain — particularly with physical activity.

When Does an Umbilical Hernia Need Surgery?

Not all umbilical hernias require immediate repair. Small, asymptomatic hernias can sometimes be monitored over time. However, surgery is generally recommended when the hernia:

• Is causing pain or discomfort
• Is enlarging
• Cannot be pushed back in (irreducible)
• Poses a risk of becoming incarcerated or strangulated

Incarceration — when the hernia becomes trapped and cannot be reduced — needs urgent evaluation, because it can progress to strangulation, where the trapped tissue loses its blood supply. Strangulation is a surgical emergency. If a bulge suddenly becomes firm, painful, or discolored, or you develop nausea or vomiting, seek emergency care right away.

What Does Repair Involve?

Umbilical hernia repair is a straightforward procedure. Dr. Ash performs repairs using laparoscopic, robotic, or open techniques depending on the size of the hernia and the patient’s situation. The goal is to return the protruding tissue to the abdomen and close the defect, often reinforcing it with a small mesh patch.

Recovery is typically faster with laparoscopic repair — most patients return to light activities within one to two weeks. Open repair may have a slightly longer recovery, particularly for larger hernias.