How serious is an umbilical hernia? Understanding the risks and treatment options

October 2, 2025 •

5 min read

Did you know that while an umbilical hernia often resolves naturally in children, it rarely does in adults? An umbilical hernia is the protrusion of tissue through a weak spot near the navel. Understanding how serious is an umbilical hernia is critical for timely intervention, especially given the differing risks across age groups.

Quick Summary

The seriousness of an umbilical hernia depends on the patient's age, with most infantile cases resolving spontaneously while adult hernias carry a higher risk of serious complications like incarceration or strangulation.

Key Points

Age Matters: While most umbilical hernias in infants close spontaneously, adult hernias will not heal on their own and typically require intervention.
Risk of Strangulation: In adults, the main risk is strangulation, a medical emergency where the hernia's blood supply is cut off, potentially causing tissue death.
Incarceration Warning: An incarcerated hernia is a trapped hernia that can lead to bowel obstruction and requires urgent medical evaluation.
Symptoms to Watch: Severe pain, redness, discoloration, nausea, vomiting, or an inability to pass gas or stool are emergency signs of a serious complication.
Surgery is Curative: For adults, surgery is the definitive treatment to prevent future complications, with options including open or minimally invasive procedures.
Watchful Waiting for Infants: In children, a 'watch and wait' approach is common, as most hernias resolve without surgical intervention by school age.
Mesh vs. Suture: Surgical repair methods often involve using a mesh for reinforcement, which significantly reduces the risk of recurrence compared to suture-only repairs.

What is an Umbilical Hernia?

An umbilical hernia occurs when part of the intestine, fat, or fluid bulges through a weakness in the abdominal wall, near the belly button (umbilicus). This condition is common and creates a soft swelling or bulge that is often more noticeable when a person coughs, strains, or cries. The hernia develops at the site where the umbilical cord once passed through the abdominal muscles, which should have closed completely after birth.

Umbilical Hernia: A Tale of Two Age Groups

The prognosis for an umbilical hernia is heavily dependent on the patient's age. This difference is key to understanding the potential seriousness of the condition.

In Infants: In most cases, umbilical hernias in children and babies are harmless and typically close on their own. Over 90% of pediatric umbilical hernias resolve naturally by the age of 5. For this reason, doctors often recommend a "watch and wait" approach, monitoring the hernia's size and reducibility (ability to be pushed back in). Surgery is only considered if the hernia is large, painful, doesn't close on its own, or becomes complicated.
In Adults: Unlike children, an umbilical hernia in an adult will not go away on its own. Adults with umbilical hernias are at a higher risk of complications, and surgical repair is often recommended. Increased abdominal pressure from factors like obesity, multiple pregnancies, or chronic coughing can cause a weak spot to develop or worsen, leading to the condition. Even if a hernia is currently asymptomatic, it may become symptomatic over time.

The Serious Risks: Incarceration and Strangulation

The primary concern that elevates the seriousness of an umbilical hernia is the risk of complications, especially in adults. The two most severe potential outcomes are incarceration and strangulation.

Incarceration

Incarceration occurs when the tissue that is bulging through the abdominal wall becomes trapped and cannot be pushed back into place. While painful, an incarcerated hernia does not always have its blood supply cut off. It can, however, lead to a bowel obstruction, causing symptoms like nausea, vomiting, and constipation. This is a serious condition that requires immediate medical attention and, in some cases, urgent surgical intervention.

Strangulation

This is the most dangerous complication. A strangulated hernia happens when the trapped tissue becomes twisted, and its blood supply is cut off. The lack of blood flow can cause the tissue to die (necrosis), leading to life-threatening issues such as gangrene, infection, or sepsis. A strangulated hernia is a surgical emergency and requires immediate repair.

Comparison: Infant vs. Adult Umbilical Hernias


Feature	Infants and Children	Adults
Likelihood of Closure	Very high, often by age 5.	Will not close spontaneously.
Symptom Profile	Usually painless; may be more prominent when crying or straining.	More likely to experience discomfort, pain, or pressure, especially with activity.
Risk of Complications	Very low; incarceration and strangulation are rare.	Significantly higher risk of incarceration and strangulation.
Treatment Approach	Often "watch and wait" unless large or complicated.	Surgical repair is frequently recommended to prevent future complications.

Recognizing Emergency Symptoms

It is crucial to know the signs that an umbilical hernia may have progressed into a medical emergency. Seek immediate medical care if you or your child experience any of the following:

A sudden onset of severe abdominal pain.
Nausea and vomiting.
A fever or rapid heart rate.
The hernia bulge becomes firm, tender to the touch, and can no longer be pushed back in.
The skin over the hernia turns red, purple, or dark in color.
Inability to pass gas or have a bowel movement.

Diagnosis and Treatment Options

Diagnosis

A doctor can typically diagnose an umbilical hernia with a physical examination. They will check for the bulge and may try to gently push it back into the abdomen. In some cases, imaging tests like an ultrasound, CT scan, or MRI may be used, particularly if complications are suspected.

Treatment Options

Watchful Waiting: As mentioned, this is the standard approach for most infants and young children. It may also be an option for adults with a very small, painless hernia, although it is not considered a permanent solution.
Surgery: For adults and children with complicated or symptomatic hernias, surgery is the only definitive cure. The procedure, called a herniorrhaphy, involves pushing the protruding tissue back into the abdomen and repairing the weak spot in the abdominal wall. Sometimes, a synthetic mesh is used to reinforce the area, especially for larger hernias, to prevent recurrence.

Surgical Repair: Open vs. Minimally Invasive

There are several surgical methods available for umbilical hernia repair, and the best approach is determined by the surgeon based on the hernia's characteristics and the patient's overall health.

Open Repair

Procedure: A single incision is made near the belly button. The hernia sac is reduced, and the abdominal wall defect is closed with sutures. For larger defects, a mesh is often used to provide reinforcement.
Recovery: A full recovery can take several weeks, with restrictions on heavy lifting and strenuous activities during this time.

Minimally Invasive Repair (Laparoscopic or Robotic)

Procedure: Several small incisions are made away from the hernia site. The surgeon uses a camera and specialized instruments to repair the hernia from the inside. A mesh is typically used to cover and reinforce the defect.
Recovery: Offers potential benefits such as less postoperative pain, faster recovery, and a quicker return to normal activities. For more details on the procedure and recovery, consider reviewing the information from MedlinePlus.

The Final Verdict on Seriousness

Ultimately, the seriousness of an umbilical hernia is not universal. It varies significantly between infants and adults and is defined by the risk of complications. While an uncomplicated hernia in an infant is typically not serious, the potential for incarceration or strangulation in an adult makes it a condition that requires careful monitoring and often surgical repair. Early consultation with a healthcare provider is the best course of action to accurately assess the risk and determine the appropriate management strategy for your specific situation. Never ignore a painful or discolored bulge, as it could signal a life-threatening emergency.

Frequently Asked Questions

No, an umbilical hernia is not always serious. The level of seriousness depends heavily on the person's age. While common and usually harmless in infants, it poses a higher risk of complications in adults, making it a more serious condition for them.

No, an umbilical hernia in an adult will not go away on its own. Unlike pediatric cases where the abdominal wall often strengthens, adults typically require surgery to repair the weak spot and prevent complications.

Emergency signs include sudden and severe pain, nausea and vomiting, fever, a bulge that becomes hard or discolored (red, purple, or dark), and an inability to have a bowel movement or pass gas. These symptoms can indicate a strangulated hernia and require immediate medical attention.

Treatment varies by age. For infants, a "watch and wait" approach is often used. For adults, surgery is the standard treatment and can be performed using an open incision or minimally invasive (laparoscopic or robotic) techniques. A surgical mesh may be used to reinforce the repair.

In children, umbilical hernias are usually painless. In adults, they can cause discomfort, a dull ache, or pressure, especially when straining or lifting. The presence of sharp, increasing pain can signal a more serious complication.

If left untreated in an adult, an umbilical hernia can grow larger and lead to complications such as incarceration or strangulation. These can become medical emergencies, necessitating urgent surgical intervention to prevent serious health issues.

Risk factors in adults include obesity, multiple pregnancies, increased abdominal fluid (ascites), previous abdominal surgery, and activities that cause chronic straining, such as heavy lifting or chronic coughing.

Recovery depends on the surgical method. Minimally invasive surgery may allow for a quicker return to light activities (within a week or two), while open repair may require a few weeks of rest. Strenuous activities are typically restricted for several weeks, regardless of the procedure.