What causes umbilical hernia in adults

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Last updated: April 4, 2026

Quick Answer: Umbilical hernias in adults typically occur when increased abdominal pressure causes a portion of the intestine or other abdominal tissue to bulge through a weakness in the abdominal wall near the navel. This weakness can be congenital or develop over time due to factors like obesity, pregnancy, or chronic straining.

Key Facts

Umbilical hernias are more common in women, with up to 80% of adult cases occurring in females.
Pregnancy is a significant risk factor, with multiple pregnancies increasing the likelihood.
Obesity is a primary cause, increasing intra-abdominal pressure.
Heavy lifting and chronic straining (e.g., from constipation or chronic cough) can contribute to hernia development.
Most adult umbilical hernias do not resolve on their own and often require surgical repair.

Overview

An umbilical hernia in adults occurs when there is a protrusion of abdominal contents, such as the intestine or fatty tissue, through a weak spot or opening in the abdominal wall near the umbilicus (navel). Unlike in infants, where these hernias often close spontaneously, adult umbilical hernias are generally persistent and may require surgical intervention. The primary mechanism involves increased intra-abdominal pressure pushing tissues through a weakened area, forming a bulge that can be visible or palpable.

Causes and Risk Factors

The development of an umbilical hernia in adults is multifactorial, stemming from a combination of inherent weaknesses in the abdominal wall and external factors that increase pressure within the abdomen. These factors can be broadly categorized:

Increased Intra-abdominal Pressure

This is the most common underlying cause. Anything that consistently raises the pressure inside the abdominal cavity can force abdominal contents through a weak spot near the navel. Significant contributors include:

Obesity: Excess abdominal fat increases intra-abdominal pressure. Individuals with a higher Body Mass Index (BMI) are at a greater risk of developing umbilical hernias.
Pregnancy: The growing uterus puts considerable pressure on the abdominal wall. Multiple pregnancies or pregnancies with larger fetuses can further exacerbate this pressure.
Ascites: The accumulation of fluid in the abdominal cavity, often associated with liver disease (like cirrhosis), significantly increases internal pressure.
Chronic Straining: Persistent straining during bowel movements (due to chronic constipation), chronic coughing (common in smokers or those with lung conditions like COPD), or difficulty urinating (due to prostate enlargement) can all contribute to hernia formation.
Heavy Lifting: Regularly engaging in activities that involve heavy lifting, especially with improper technique, can place immense strain on the abdominal muscles and wall.

Weaknesses in the Abdominal Wall

While some individuals may have a congenital predisposition to a weaker abdominal wall at the umbilicus, this weakness can also develop over time:

Congenital Weakness: The umbilical ring, an opening through which the umbilical cord passes during fetal development, normally closes after birth. In some adults, this closure may be incomplete, leaving a potential weak spot.
Previous Abdominal Surgery: Incisions made during prior abdominal surgeries can weaken the abdominal wall, and if an umbilical hernia develops, it may occur through or near a previous surgical site.
Age: As people age, the abdominal muscles can naturally weaken, potentially making the development of hernias more likely.

Who is at Risk?

Certain demographic groups and individuals with specific conditions face a higher risk:

Women: Adult umbilical hernias are significantly more common in women than in men, largely due to the higher incidence of pregnancy and childbirth. Estimates suggest women account for up to 80% of adult umbilical hernia cases.
Individuals with Obesity: As mentioned, excess weight is a major risk factor.
People with Chronic Respiratory Conditions: Persistent coughing associated with conditions like asthma, bronchitis, or COPD increases abdominal pressure.
Those with Chronic Constipation: Frequent straining during bowel movements is a common contributing factor.
Individuals with Liver Disease: Conditions leading to ascites significantly elevate intra-abdominal pressure.

Symptoms

The most common symptom is a soft bulge or swelling near the navel, which may become more noticeable when standing, coughing, or straining, and may disappear when lying down. Other symptoms can include:

A dull ache or discomfort in the abdominal area.
A feeling of fullness.
Pain, especially during exertion.

In rare cases, the protruding tissue can become trapped (incarcerated) or have its blood supply cut off (strangulated). This is a medical emergency and requires immediate attention. Symptoms of strangulation include sudden, severe pain, redness or discoloration of the bulge, nausea, vomiting, and fever.

Diagnosis and Treatment

Diagnosis is typically made through a physical examination, where a doctor can often feel the hernia bulge. Imaging tests like an ultrasound or CT scan may be used to confirm the diagnosis or assess the extent of the hernia. Treatment for adult umbilical hernias usually involves surgical repair, as they rarely close on their own and carry a risk of complications like strangulation. The surgery involves pushing the protruding tissue back into the abdomen and strengthening the abdominal wall, often using sutures or a surgical mesh.