I've Got a Lump Near My Belly Button — Is It a Hernia?

What is an umbilical hernia?

Your belly button marks the spot where the umbilical cord connected you to the placenta before birth. After birth, this opening normally closes over and is reinforced by tough fibrous tissue. But this area is never quite as strong as the rest of the abdominal wall — which is why it is one of the most common places for a hernia to develop over time.

An umbilical hernia forms when fatty tissue from inside the abdomen — or in larger hernias, a small piece of bowel — pushes through this weak spot and creates a visible bulge at or just beside the belly button. The gap can be tiny (a few millimetres) or quite large (several centimetres).

Umbilical hernias are very common in adults, particularly in people who have had multiple pregnancies, carry extra weight around the abdomen, have a chronic cough, or do heavy lifting regularly. But they also happen to people with none of these risk factors — the belly button is simply a natural weak point that can give way with time.

Umbilical hernias in children vs adults

It is worth understanding that umbilical hernias in children and in adults are quite different conditions.

In babies, the opening in the belly button often does not close fully at birth, creating a soft bulge. This is very common and usually harmless. About 90% of these close on their own by the time the child is four or five, especially if the gap is small. Paediatricians generally advise watching and waiting unless the hernia is large, causing symptoms, or has not closed by age five.

In adults, the situation is fundamentally different. Once you have an umbilical hernia, it will not heal by itself. The gap tends to enlarge gradually over the years, and the tissue inside it can become trapped. Adult umbilical hernias need surgical repair when they are causing symptoms, growing, or posing a risk of becoming trapped.

What are the symptoms?

The most recognisable sign of an umbilical hernia is a soft bulge at the belly button that:

• Appears when you stand, cough, or strain
• Reduces (softens or goes back in) when you lie flat and relax
• Feels soft and slightly compressible if you press on it gently
• Sometimes produces a mild gurgling or gassy feeling if there is bowel inside the sac

Pain varies a lot from person to person. Some umbilical hernias cause no pain at all and are noticed simply as an unexpected lump. Others produce a persistent ache, a dragging heaviness, or a sharp pain when you cough or exert yourself. Discomfort tends to build through the day and ease with rest.

If the lump suddenly becomes much more painful, feels hard, and you cannot push it back in — those are warning signs of the hernia becoming trapped (incarcerated) or having its blood supply cut off (strangulated). Both need urgent medical attention. See the emergency section below.

What else could it be?

Not every lump near the navel is an umbilical hernia. The comparison below covers the most common alternatives.

Occasionally, a swollen lymph node or a rare growth near the navel (sometimes called a Sister Mary Joseph nodule) can present as a belly button lump. These are uncommon, but they are part of the reason a surgeon will want to examine any new lump near the navel carefully rather than simply assuming it is a straightforward hernia.

Emergency warning signs

It is important to know that even a small hernia can strangulate — in fact, hernias with a tight, narrow opening are sometimes more dangerous than larger ones, because the tighter the gap, the more easily circulation to the trapped tissue can be cut off.

How is an umbilical hernia diagnosed?

Most of the time the diagnosis is made by examination alone — your surgeon will look at and feel the lump while you are standing and lying down, and ask you to cough. In most cases, this is all that is needed to be confident about what you have.

An ultrasound is helpful when the hernia is not clearly pushing back in, when the diagnosis is uncertain, or when other causes need to be ruled out. A CT scan gives more detailed information about the anatomy and is often requested before repairing a larger or more complex hernia, so the operation can be planned carefully.

Treatment options

Adult umbilical hernias do not heal without surgery — the gap in the abdominal wall cannot close on its own. The decision about whether and when to operate depends on your symptoms, the size of the hernia, and your overall health.

Watchful waiting may be appropriate for a very small, entirely symptom-free hernia in someone who is elderly or has other significant health conditions that make surgery more risky. The chance of a small asymptomatic umbilical hernia strangulating is relatively low, and for very frail patients, the risks of surgery can genuinely outweigh the benefit.

Elective surgical repair is the recommendation for most adults with an umbilical hernia — especially if it is causing symptoms, growing, or large enough that bowel could become trapped. Smaller hernias can often be repaired under local or general anaesthetic as a day procedure. Larger defects need a mesh to reinforce the repair and require a general anaesthetic. Keyhole approaches are available for suitable cases.

Recovery after a straightforward umbilical hernia repair is generally quick. Most people can get back to desk work within one to two weeks and resume full physical activity within four to six weeks.

Who is most at risk?

Adult umbilical hernias are more common if you:

• Have had multiple pregnancies — pregnancy stretches the umbilical ring significantly
• Carry significant extra weight around the abdomen — this keeps pressure inside the belly elevated continuously
• Have chronic liver disease causing fluid build-up in the abdomen
• Have had previous surgery near the belly button
• Have had a chronic cough or done heavy manual work over many years

That said, umbilical hernias also develop in slim, otherwise healthy people with none of these risk factors. The belly button is simply a natural weak spot in the abdominal wall, and anyone can develop a hernia there as they age.

Frequently asked questions