Dear Dr. Donohue: I am 65 and in good health. Recently during a physical, my doctor pointed to my belly button and said, “You have a hernia.” I had noticed a year ago that my belly button went from an innie to an outie, but didn’t give the matter much thought. The doctor said that unless it causes problems, I don’t need to do anything about it. Now I am very aware of the whole area and feel some tightness in the abdomen there. I am trying to figure out if the hernia is causing actual physical problems or if it’s psychosomatic. Does a person definitely know when the time comes for surgery? Are there any dire consequences from doing nothing? – R.F.
Dear R.F.: All hernias are protrusions of an internal organ or tissues through a weak spot in the muscular wall that keeps those structures in place. Many umbilical hernias develop early in life – at birth or shortly after – because of imperfect closure of the umbilical cord attachment. They usually heal on their own. If they don’t by age 5, surgery is done.
In adults, such a hernia comes about from a weakening of the scar tissue that closed over the umbilical cord defect. A small umbilical hernia that causes no symptoms can be ignored. Yours is in that category. There are no dire consequences from doing nothing.
How do you know when the time for surgery arrives? Believe me, it’s hard not to know. The hernia becomes progressively larger, the bulge cannot be pushed back into the abdominal cavity or you have pain severe enough to alert you that prompt attention is needed.
Stop thinking about this hernia. You’re not sitting on a time bomb. It’s not going to explode or kill you.
Write to Paul Donohue, M.D., P.O. Box 536475, Orlando, FL 32853-6475.
