An umbilical hernia is a condition that occurs when part of the intestines protrudes through the abdominal muscles near the belly button creating a bulge. The prevalence of umbilical hernias during pregnancy is estimated to be around 1-2% of all pregnancies adn their prevalence varied based on different factors such as geographical location, population demographics, and other health-related factors.Pregnancy can sometimes contribute to the development or worsening of umbilical hernias due to the increased pressure on the abdominal wall.
Many a times umbilical hernia is accompanied with Diastasis Recti, which is a separation of rectus abdominis muscle, but not always. People that have an umbilical hernia may experience symptoms such as abdominal pain & tenderness, constipation, fever and vomiting and their abdomens may appear full and round and may be accompanied by a red, purple or dark or discolored bulge. Most of the patients that I have seen in clinic for umbilical hernia have either had pain on touch or pressure but many patients have no symptoms and for most it is cosmetically inconvinient.
Most of the hernia need to surgery to repair, but if you do not have any symptoms, many surgeons will ask you to leave it as it. It is important to understand that the hernia was most likely causes by a weakening in the abdominal wall, and so surgery is repairing the hernia but the cause if still present if you do not strengthen the abdominal wall. So the next questions is, what exercises are appropriate and which ones can aggravate the symptoms?
The answer is it depends on couple of factors.
Considerations for umbilical hernia repair surgery
A study done by Oma E et al in 2015 looked at 225 women who underwent hernia repair surgery. They found the recurrence rate to be 16.3% for mesh repair and 10.9 after suture repair. Another study done by same author in 2018 looked at 9 studies and found lack of consistent management strategy for umbilical hernia and also proposed that:" candidates for elective primary ventral or incisional hernia repair of childbearing age should be counselled on the increased risk of recurrence associated with subsequent pregnancy, and if possible, the procedure should be postponed until after last planned pregnancy. If a pre-pregnancy repair is performed for an umbilical or epigastric hernia, a non-mesh repair seems appropriate for smaller defects. If the hernia recurs, a mesh repair might be performed after last"
How do we manage umbilical hernia:
It is important to understand the mechanism of hernia, or why hernia happens. Think about a water pipe burst. There are two factors that play a part. One is either weakness of the wall of the pipe or second is the pressure in that area exceeded the strength capacity. Same thing happens for hernia. The weakness of the surrounding muscle or connective tissue due to may be aging, or strain in the area, or injury can lead to organs protruding through that weakened area.
What we target in treatment are exactly the two factors that lead to hernia. Strengthening the weakened ( cannot strengthen connective tissue or ligaments or fascia) and teaching you to manage the intraabdominal pressure through various techniques.
Is it possible to reverse the hernia 100%?
No, we can reduce the appearance of it and prevent it from worsening, manage the symptoms related to it, identify the factors leading to it, and work on those.
Will I still need surgery after therapy?
There are two factors that can lead one to opt for surgery.
One is aesthetic and other is form and function. We can 100% help you with the function part which anyways you will need to work on whether you opt for surgery or not.
Second is aesthetic part, and we might not be able to 100% help you with that. But we can point you to the right resources.
