Synonyms in a broader sense
- Umbilical hernia
- Outer hernia
- Intestinal Hernia
Umbilical hernia causes the following symptoms and complaints
The most conspicuous symptom of an umbilical hernia is a tumor on the navel, which varies greatly from person to person. In some cases, however, this can be so small that it is not even seen. It only becomes apparent when a child screams or the adult increases the pressure in the abdomen by pressing.
If the existing protrusion disappears spontaneously when lying down, it is called a “repositionable” umbilical hernia. This means that the contents of the hernia can be pushed back into the abdominal cavity by applying light pressure from outside. However, if the protrusion remains even when lying down, it is an irreponible umbilical hernia.
An umbilical hernia does not necessarily always cause subjective complaints. Sometimes affected persons complain of pulling pain in the area around the umbilicus, which occurs or increases especially during physical exertion, coughing or pressing. In most cases, the hernia is to be seen as a protrusion, but even this does not necessarily have to be the case.
If there is an incarceration, the consequence is usually a circulatory disorder of the incarcerated organ, i.e. it is cut off from the oxygen supply, which in the worst case can cause it to die. This causes extreme symptoms ranging from severe pain to the so-called “acute abdomen” (acute abdomen) with a rock-hard abdomen. This can develop into a state of shock, which is considered a life-threatening emergency. The symptoms of an incarceration are: If these are present, surgery must be performed urgently.
- Colicky abdominal pain
- Fever
- Nausea and/or
- Vomiting
The umbilical hernia associated with diarrhea
In most cases an occurring umbilical hernia remains symptomless in the affected persons. Should symptoms nevertheless occur, they are usually determined by pain, but also by gastrointestinal complaints. This is related to the fact that in some cases there is an intestinal loop in the hernial sac of the umbilical hernia.
Normally, such a jammed intestinal loop causes constipation rather than diarrhoea in addition to the pain. However, so-called stool irregularities can occur, such as alternating constipation and diarrhoea. Since the intestine is irritated by the jammed intestinal loop, many different intestinal complaints can be caused.
Overall, diarrhea is not considered a typical symptom of an umbilical hernia and does not serve as a leading symptom for the detection of an umbilical hernia or a resulting incarceration. Nevertheless, if an umbilical hernia is suspected due to a clearly protruding hernial sac at the navel in connection with diarrhoea, a physician should be consulted who can make the correct diagnosis and initiate the necessary treatment. The umbilical hernia that occurs in adults is considered much more problematic.
First symptoms affecting adults include the deformation and bulging of the umbilical region. In the further course of the disease, there is a strong increase in volume of the umbilical hernia which is caused by the protrusion of organ sections through the hernia ring. The size of the umbilical hernia is variable.
It can assume the dimensions of a marble or grow to the size of a soccer. In addition, the localization of the typical bulge of an adult umbilical hernia can also vary. Depending on the location of the weak spot in the abdominal wall, it can show the protrusion both above and below the navel.
Other symptoms affecting adults with umbilical hernia are more likely to occur by chance in most cases. This means that they are only triggered by other factors, such as strong coughing, heavy lifting or pressing. Adults rarely complain of pain in the navel when an umbilical hernia is present.
Nevertheless, there are cases in which the affected patients describe pulling and/or burning pain. Symptoms such as: Especially these symptoms indicate that parts of the intestine are trapped in the area of the umbilical hernia and thus their blood supply is restricted. In such a case, a specialist must be consulted as soon as possible and a surgical procedure must be initiated.Furthermore, it must be distinguished whether the symptoms of the adult with umbilical hernia are permanently present or can be influenced by a certain behavior.
A still reponible umbilical hernia (i.e. an umbilical hernia that can still be mechanically repositioned in the abdominal cavity without surgery) is characterized by the fact that the symptoms disappear when the patient lies down. Pain that occurs when adults suffer from an umbilical hernia can radiate into the pubic region or the scrotum. Furthermore, severe reddening of the skin can be observed in severe or long-lasting cases.
- Nausea,
- Vomiting and/or
- Stool retention should be perceived as a warning signal in the presence of an umbilical hernia.
Women are generally more frequently affected by umbilical hernia than men. This can have different reasons for the cause. One of the main reasons for this is probably that umbilical hernia can occur during pregnancy, among other things, and this contributes to the increase in the incidence of umbilical hernia in women compared to men.
Especially after several pregnancies, the risk for women to suffer an umbilical hernia increases. The peak age for the occurrence of umbilical hernia in women is between 40 and 50 years. Since, in addition, a congenital weakness of the connective tissue is more common in women than in men and is a risk factor for the occurrence of an umbilical hernia, this can also be an explanation for the increased incidence of umbilical hernias in women.
Statistically, women suffer from umbilical hernia about 3-5 times more often than men. Other factors that are not specific to women can also be responsible for the occurrence of umbilical hernia. In particular, obesity, physical strain, lifting heavy objects and diseases that result in an accumulation of fluid in the abdominal cavity are known risk factors for the development of an umbilical hernia.
The diagnosis of an umbilical hernia in women is no different from the diagnosis in men or infants. In most cases, a physical examination can provide clarity about the presence of the disease. In rare cases it may be necessary to perform an ultrasound examination.
In order to assess the abdominal muscles and their spacing, such an ultrasound examination can be performed during pregnancy. Especially if pain and a reddish/blue coloration occurs in addition to the protrusion at the navel, a doctor should be consulted immediately to avoid serious complications and to initiate a correct therapy of the umbilical hernia. Although umbilical hernia occurs more frequently in women and infants, men can also be affected by the occurrence of an umbilical hernia.
Due to the male anatomy, as well as the statistically greater stress in everyday life, men more often suffer a perforation of the abdominal viscera. However, these hernias usually occur in other places, such as the groin. In addition to increased physical strain, there are other risk factors that can contribute to men suffering from umbilical hernia.
In particular, obesity and diseases that lead to an increased amount of fluids in the abdominal cavity are factors that favor the occurrence of an umbilical hernia in adults. Other diseases and activities that lead to increased pressure in the abdomen, such as continuous heavy coughing or “pressing” on the toilet, can also trigger an umbilical hernia. The fact that men are generally less frequently affected by an umbilical hernia than women can be explained by the fact that pregnancy as well as an existing weakness of the connective tissue, which occurs more frequently in women, also favor the development of an umbilical hernia.
The diagnosis of an umbilical hernia in men does not differ from the diagnosis performed in case of suspected umbilical hernia in infants or in women. An umbilical hernia is conspicuous by the protruding curvature at the navel, in which, depending on the size, intestinal loops may be located. Especially if the area is painful and/or reddened or bluish, a doctor should be consulted as soon as possible to examine the affected person.
In most cases, a physical examination as well as palpation of the so-called hernia sac is sufficient for the diagnosis of an umbilical hernia. In contrast to the newborn, an umbilical hernia in adults must always be operated on, as there is too great a risk of intestinal loops becoming trapped. There are different methods of surgical repair of an umbilical hernia in adults.The prophylaxis to prevent an umbilical hernia in adulthood is mainly the prevention of risk factors that can lead to an umbilical hernia.
Classical abdominal muscle training cannot prevent an umbilical hernia or make its occurrence less likely. This is due to the fact that the affected area is located between two abdominal muscles, at a site surrounded only by connective tissue. For the diagnosis of an umbilical hernia, palpation of the umbilical region is usually sufficient, since the hernia is usually well palpable.
With the help of a stethoscope the doctor can listen to the hernia sac. If he can detect gargling noises, this indicates that parts of the small intestine are inside. If it is unclear or it should be ruled out that parts of the intestine have already shifted into the hernial sac, the doctor can help himself with imaging procedures such as ultrasound, X-ray, MRI or CT.
However, this is rarely necessary. An important differential diagnosis of the umbilical hernia is the so-called rectus diastasis (from Musculus rectus abdominis = straight abdominal muscle). This is a thinning of the fascia of the abdominal muscles without a defect in the abdominal wall.
There is therefore no risk of incarceration, which is why there is no indication for surgery. If the rectus fascia is widely spread in the midline, this is referred to as a “burst abdomen”. This is a serious finding, in which the small intestine is only covered by skin.
With an ultrasound, however, these similar clinical pictures can be clearly distinguished from each other. In this case, the ultrasound should be performed by a specialist, since many factors are decisive for a useful result, for example, in which position the examination takes place or what type of transducer is used. Umbilical hernia can occur in women during pregnancy.
It is one of the reasons why women as a whole are more often affected by an umbilical hernia than men. This can be explained by the fact that the pressure in the abdominal cavity increases during pregnancy and thus presses the internal organs more strongly against the abdominal wall. Due to the increase in pressure and the stretching of the abdominal wall by the growing child, the distance between the abdominal muscles is also increased.
Between the abdominal muscles, only connective tissue separates the abdominal cavity with the skin. As a result of pregnancy and the resulting divergence of the abdominal muscles, both the surface area and the pressure on them increase, thus increasing the risk of suffering an umbilical hernia during pregnancy. An umbilical hernia during pregnancy should not be confused with the normal “passing” of the umbilicus.
The spreading of the umbilicus opposite the skin on the abdomen of the pregnant woman occurs in many cases and is medically normal and harmless. If, however, instead of a spreading of the navel, a visible significant protrusion in the umbilical region occurs, in most cases an umbilical hernia can be assumed. In general, an umbilical hernia is usually harmless to the pregnant woman and the child.
Although the occurred protrusion should be examined by a physician, who confirms the harmlessness of its occurrence under certain circumstances, it is in most cases no reason for concern. An umbilical hernia during pregnancy becomes critical if an intestinal loop is located in the hernial sac, i.e. the protrusion, and causes problems there. In the worst case, a so-called acute abdomen can occur, a situation that can be potentially dangerous for the mother as well as for the child.
An acute abdomen can occur if there is an incarceration. If an intestinal loop lies in the protrusion of the umbilical hernia, it can become jammed and cause problems due to an insufficient blood supply to this part of the intestine. In most cases, the symptoms of an umbilical hernia during pregnancy are absent, apart from the visible protrusion at the navel.
However, if pain in the affected region around the navel, as well as reddish or bluish changes in the protrusion, a doctor must be consulted as soon as possible. If these symptoms occur, an incarceration and thus the indication for surgery is likely. The diagnosis of an umbilical hernia is relatively simple for the doctor, especially during pregnancy.In most cases, the correct diagnosis can be made by a physical examination and palpation of the bulge by a doctor.
Under certain circumstances, an ultrasound examination can be carried out to establish a reliable diagnosis and to determine whether an incarceration is present. The treatment of an umbilical hernia during pregnancy can be done in different ways and depends on the individual severity of the disease. For example, women who are asymptomatic and suffer no pain despite the presence of an umbilical hernia can be spared treatment.
After the birth of the child and the associated drop in abdominal pressure, the umbilical hernia should usually regress on its own. If there is pain and possibly even an incarceration, surgery should be performed in any case to protect mother and child from the complications of the disease. Current surgical techniques can minimize the risk for both mother and child. If an umbilical hernia occurs after birth or does not disappear on its own, surgery on the hernia is recommended. The recurrence of an umbilical hernia after a successful surgery is almost impossible.
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