Umbilical hernia - not sure what to do now

[LangClegsInSpace]

I was diagnosed with an umbilical hernia in Urgent Care on 28 March. It was infected and I was given 7 days of antibiotics. Hernia was small but didn't go back in when lying on my back.

The doctor in urgent care said it was not strangulated but was infected. She said it probably would need an operation but outcomes are better if surgery is planned, not done as an emergency. She therefore referred it back to my GP and requested an urgent ultrasound. She said there was a chance that it would go back in on its own following antibiotics and that if it did this it might be better not to operate as surgery scars are themselves a risk for future hernias, but she recommended an urgent ultrasound to make sure in any case.

I took the antibiotics and it felt a lot better but was still there, even when lying down.

I had a phone appointment with the GP on 4 April. She said it was nonsense to just refer for an ultrasound and it needed a referral to the surgical team because it was they who made the decision whether to operate. She said she would refer me for an urgent ultrasound and an urgent surgical outpatients appointment.

I have now received an appointment for surgical outpatients for the end of March 2024 - i.e. almost a year away, so they can't possibly have treated this referral as urgent. I have received no ultrasound appointment.

I am feeling a lot better, I'm not in pain any more, but the hernia is still there. It's a lump about the size of a marble just above my navel. If I lie on my back, sometimes it disappears back into my abdomen and sometimes it doesn't - probably about 50/50.

I'm keen to avoid surgery if I can and if it's safe but all the info I can find says that if it's left untreated then strangulation is a constant risk and if that happens it's a medical emergency.

I'm worried that nobody's looked at it since 28 March and that was just a quick external examination while it was infected and inflamed.

Should I go back to the GP? I'm not actually in pain any more so it doesn't feel so urgent but is this something that can be safely ignored?

Also I've been given no advice on any exercises that might help or activities to avoid that might make it worse. I just don't know what to do.

I've had ops for 3 hernias - 2 inguinal and 1 umbilical.

Another umbilical hernia popped up in early 2020 (it's like whack-a-mole!) I was given a date for surgery but chose not to have it as the lockdown had just been announced and they warned me against non-urgent surgery during a pandemic.

I can still push it back in and sometimes have to after a big meal, but I think if it was strangulated and urgent you'd know pretty quickly, you'd be in constant pain (this is how it was with my first 3). If there was ever a time I couldn't push it back in and it started hurting I'd be straight to A&E. At the moment the cons of operating outweigh the pros.

Thank you for your response. Have you been given any advice for living with hernias in terms of exercises that could help or activities to avoid?

No, and a quick Google tells me I should avoid a lot of the core strength that I do - eg squats, planks, heavy lifting, sit ups... All of which I do to keep trim and fit. Ditto running. So obviously not a one size fits all as I don't think it's made it worse over the years.

To me it would seem counterproductive to tell someone not to strengthen their core if they are prone to hernias, but I wouldn't want to advise against NHS advice either!

Yes, I don't want my muscles to get any weaker but I don't want to make things worse either.

I think I'll just see how I go for now, I can push it back in sometimes so there's nothing permanently trapped. I don't want to hassle to be seen sooner if it's the sort of thing people are just expected to live with for years anyway.

At the moment the cons of operating outweigh the pros.

Would you mind saying what the pros and cons are for you?