What is an Umbilical Hernia

An umbilical hernia is where a portion of the abdominal lining. or even one of the internal organs, protrudes through the area around the belly button. They are caused by a hole or weakness in the abdominal wall. It turns out that umbilical hernias are most common for infants, but they can also affect adults, such as in my case. Perhaps as many as 1 in 6 infants have umbilical hernias. In infants the bulge from the hernia may be visible all the time, or it may only show during times of strain, such as when crying or straining to make a bowel movement. The strain pushes the contents of the abdomen through the hole in the abdominal wall, causing the bulge to enlarge.

In adults, the same would be true where it might be visible all the time, or it might only show during times of strain. In my case, it was always visible, but during strenuous activity, the bulge would enlarge. Finally, it got to a point where it ripped open wider, and I felt the need to see a doctor about it. In some cases, the hernia can expand to the point where the intestines or internal organs can actually protrude through the abdominal wall, and circulation to these vital organs can be cut off. I didn’t want to take the chance that this could happen to me, since it was clear that the hernia was most definitely in the process of expanding.

The hernia contents are contained in a lining known as the hernia sac. This occurs at the site of the umbilicus, which we usually refer to as a belly button or navel. This is because the belly button is a place where there is a natural weakness of the abdominal wall, therefore it is common for umbilical hernias to occur. In children they are known to resolve themselves without requiring any abdominal hernia repair.

Most umbilical hernias don’t show any symptoms. Usually they will close by age 2. Doctors determine the size of the hernia by feeling the size of the abdominal muscle wall opening, not by looking at how much protrudes through the hole. Umbilical hernias are also much more common in premature infants, and African-Americans. They are more common in women than in men.Umbilical hernias also tend to run in families. I know my brother and my dad both had one, and they each underwent umbilical hernia operations as well.

Risk Factors and Causes of Abdominal Umbilical Hernia

The most common risk factors and causes of Umbilical hernia include:

A failure of the umbilical ring to close completely. This is the muscle that the umbilical blood vessels passed through while the baby was still in the womb.

Having an extensive period of time in labor during childbirth.

Fluid in the abdominal cavity.

Family history increases the likelihood of developing umbilical hernias.

In adults, obesity and/or multiple pregnancies increase the risk of developing an umbilical hernia.

Any abnormality of the urethra.

Symptoms of Umbilical Hernia

Symptoms of Umbilical hernia include:

A soft protrusion over the navel.

Nausea and/or vomiting.

Any new lump in the groin or other abdominal wall area.

Dizziness/weakness.

Redness or discoloration.

Fever.

Pain

Swelling or distension of the abdomen.

Umbilical Hernia Repair Surgery

Although with children, often no treatment is required to correct an umbilical surgery, hernia surgery might be required if the hernia does not self correct after the age of about 4 years. The best way to do surgical hernia repairs is to use a hernia patch or mesh. This hernia repair mesh is placed over the hole in the abdominal wall. This is exactly what I had done. Dr. George Trajtenberg M.D.,F.A.C.S. of Surgical Specialists P.C. performed my operation. Although, that information probably isn’t useful to anyone not in or near Southeastern Pennsylvania, I did want to give credit where it is due. And if you do live in the area, he’s one of the best, and as a patient myself, I recommend him.

The hernia surgery itself is an outpatient procedure. You show up and they prepare you for surgery. This included being given an IV cocktail of many different things, including pepcid to reduce nausea, benedryl, anesthesia, saline to prevent dehydration, and a few other things that I can’t recall. They shaved my belly and sterilized the area. Finally, I was ready for the hernia repair operation. They wheeled me into the operating room, and I was out a few seconds later.

When I woke up I was really feeling dehydrated, but the operation was over. It only took an hour or two for the actual surgery, and about half a day for the whole ordeal. It was tough, because as usual with surgery, I was not allowed to eat or drink for 12 hours before surgery. This is because most surgery related complication are a result of the anesthesia. The idea is to have as little in the system that might cause complications as possible.

Hernia Repair Recovery

The first few days I was in a lot of pain. There was really no way to ever be comfortable, but the closest I could get was to lie flat on my back. Even sitting upright was not possible. I had to eat standing up. It was also not possible to lay on my side, which is how I like to sleep. After about a week, I could sit for an hour or two at a time, and I would pace around for an hour at a time just to keep a level of activity, and to not go insane from being in bed all the time. I was given percoset 5mg for the pain. During this week I was restricted from working or driving at all.

I had a follow up appointment after one week, and was given antibiotics because the incision was getting infected. It was difficult to drive, and very uncomfortable, especially when making sudden stops, hard turns, or when riding over bumps. I returned to work doing paperwork for half days, and would come home exhausted, and go back to sleep until dinner. At the two week mark I had another follow up appointment, and things were looking normal, so I was told to come back in 3 weeks.

The third week, I returned to work full time, still just doing paperwork. I didn’t accomplish much beyond not needing to use more vacation time, and I would return home absolutely wiped out. I was pretty useless that week. But I slowly started to feel closer to normal.

Week 4 I was starting to be more mobile. I could handle a full day at work (still no lifting) a little better, and was getting better with driving and sitting up. I could finally roll on my side for short periods of time, but it hurt a little to do that, so my success in side sleeping was pretty limited.

Week 5 I started feeling mostly normal. There is still a little pain during any sort of strain. The umbilical area is healed pretty nicely, but there is definite scarring in the area, so my belly button and the surrounding area feels hard. I was able to lift 25-30 pounds, but I think I compensated by lifting with my back muscles instead of my abdominal muscles, so my back got very sore. I go back to Dr. Trajtenberg tomorrow, and I think at this point it’s just a matter of continuing to ease into a normal routine, and restrengthen my muscles all over again.

That’s my observations on hernia repair surgery. I would love to have your comments on it as well.