UMBILICAL HERNIA

UMBILICAL HERNIA

INTRODUCTION:

Umbilical hernia

  • An umbilical hernia is caused by a weakness of the connective tissue and abdominal muscles around the belly button (also known as the “umbilicus”).
  • This weakness creates an opening, known as a defect, which allows for underlying fat or intestine to protrude through the abdominal wall and form a bulge under the skin in or around your belly button.
  • Umbilical hernias are frequently seen in children, but they are also common in adults. In children, the defects often close with age and may not require surgery. In adults, umbilical hernias do not heal themselves and can only be repaired with surgery.

SIGNS AND SYMPTOMS:

  • A bulge in or near the belly button.
  • Abdominal pain or pressure, which may worsen when coughing or straining.

CAUSES:

  • Two types of umbilical hernia.
  • (1) Congenital umbilical hernia.
  • (2) Acquired umbilical hernia.
  • (1) Congenital umbilical hernia: A congenital umbilical hernia is present at birth. The umbilical cord was attached at the belly button during development in the womb, and a natural opening in the muscles exists at this site because of the blood vessels entering the fetus while in the womb. When this area of muscle does not close completely after birth, a congenital umbilical hernia can form. Typically, children without symptoms of their hernia can be watched until they reach school age before considering repairing them.
  • (2) Acquired umbilical hernia: Acquired umbilical hernias develop over time in adults from age or injury that lead to an opening in the muscle under or adjacent to the belly button . Conditions that increase pressure in the abdomen contribute to the development of the hernia because the pressure stretches this area of natural weakness. Continued exertion or weight gain increases the size of the defect and can push intestines or other organs through the opening. Many of these conditions are listed below.

RISK FACTORS:

  • Chronic cough.
  • Smoking.
  • Obesity.
  • Straining while lifting heavy objects.
  • Straining during bowel movements.
  • Pregnancy.
  • Certain medications, such as steroids.
  • Born prematurely.

CLINICAL FEATURES:

  • Swelling in the umbilical region:- Increase on coughing/straining.
  • Cough impulse- expansile impulse is present.
  • Patient may also have inguinal hernia.
  • Reducibility can be present.
  • Crescent-shaped appearance of the umbilicus.
  • Patient complaint of pain due to tissue tension, and symptom of intermittent bowel obstruction.
  • Dermatitis in case of large hernia (due to thinned & stretched of overlying skin).

TREATMENTS FOR UMBILICAL HERNIA:

PHYSIOTHERAPY TREATMENTS:

Yoga exercises for umbilical hernia

  • Deep breathing exercises.
  • Intermediate exercises.
  • Pelvic tilt exercises.
  • Yoga therapy.
  • Babies and children: In the majority of cases, the hernia closes on its own by the age of 12 months. Sometimes, the doctor may be able to push the lump back into the abdomen (it is important that only the doctor does this).
  • Surgery may be ordered if:
  • The hernia grows after the child is 1-2 years old.
  • The bulge is still there by the age of 4.
  • If the intestines are within the hernial sac, preventing or reducing the movement of the intestines (called peristalsis).
  • If the hernia becomes trapped.
  • Adults: Surgery is usually recommended, to prevent potential complications, especially if the hernia grows or starts to hurt.
  • PRECAUTIONS:
  • Avoid lifting weight and vigorous exercises.
  • Persistent cough, constipation and urinary problem should be treated urgently.
  • Depending on the size of your hernia an abdominal binder a kind of support belt may be advised for about three months to support your tummy.

SURGERY:

  • Umbilical hernia surgery is a small, quick operation to push the bulge back into place and to make the abdominal wall stronger.
  • In most cases, the patient will be able to go home on the same day.
    The surgeon makes an incision at the base of the belly button and pushes either the fatty lump or bowel back into the abdomen.
  • Muscle layers are stitched over the weak area in the abdomen wall, effectively strengthening it.
  • Dissolvable stitches or a special glue are used to close the wound. Sometimes, the surgeon will place a pressure dressing, which remains there for 4-5 days.
  • An umbilical hernia operation usually takes about 20-30 minutes.

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