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A hernia is an obvious swelling underneath the skin. An umbilical hernia is a hernia near, usually just above, the belly button. The hernia is caused by obesity, pregnancy, or ascites, which is the accumulation of fluid in the abdominal cavity, usually as a result of liver disease. Umbilical hernias can also occur in infants without any clear cause.

In children who have not yet reached the age of 5, about 90 percent of umbilical hernias just go away on their own.In older children, teens, and adults, umbilical hernias don't go away without surgery. It's possible to go for years without any troublesome symptoms from an umbilical hernia. It may not even be noticeable when you lie down. On the other hand, the hernia can cause the stangulation of the small intestine, which is a medical emergency.

An umbilical hernia can cause a distended belly and pain or discomfort when you bend over, say, to tie your shoes or to pick something off the floor. Your doctor may not recommend treatment on the basis of this symptom alone. If your hernia is causing skin problems, or it is larger than 1 cm (a little less than half an inch), or you have unusual problems with alternating constipation and diarrhea, then you will probably be told that you need to schedule elective surgery.

How can you tell your umbilical hernia needs urgent treatment?

  • You are extremely constipated, or,
  • You can't pass gas, or
  • You have intense abdominal pain. 

The surgery for an umbilical hernia is usually done under general anesthesia. It can be done with an open incision, up to 12 inches (30 cm) long, or it more often is done laparoscopically, with an instrument inserted through an incision only about 3 to 5 mm (one-quarter of an inch) long. It's important to understand that the surgeon won't always be able to do the procedure through a laparoscope, and the longer you wait to get the hernia repaired, the more likely you are to need a longer incision. The hernia may be repaired with sutures or with mesh. Generally, mesh results in fewer complications. If the hernia is small than about 3 cm (a little more than an inch), then mesh reduces the risk of complications such as blood accumulation, fluid accumulation, and pain by about 90 percent. However, mesh isn't as useful for patients who have diabetes or who are morbidly obese. In them, it actually can increase the probability of complications.

How seriously you take your recovery makes a big difference in how well your surgery works out. You will probably need pain medication, especially if the surgeon could not do a laparoscopic procedure. In the US, you will probably be offered pain medication on demand. In some countries, you will probably have to ask for it. Don't be afraid to ask for help when you sit up or get out of bed. It's critically important that you do not fall.

You also need to be careful about infection prevention. About 20 percent of old-style hernia repair incision surgery develop infections. Take all of your antibiotics. Change dressings precisely as directed.

What if you aren't having surgery right away? 

It's possible to be in great shape but still have an umbilical hernia, but if you do, it's not a great idea to do "abs exercises." Crunches are a no-no. In fact, anything that causes periumbilical (around the belly button) pain is something you need to avoid. It's important to remember to breathe when you are doing resistance exercises.

Even if you don't work out, paying attention to your abdominal muscles as you lift objects, holding them in just a little, and breathing out and holding your breath, slightly, just before you push objects away from your body is a good idea. 


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