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Epigastric Hernia Symptoms

An epigastric hernia develops in the upper abdomen (epigastrium) between the breastbone and belly navel. In some cases, a visible lump forms on the surface of the stomach. The lump is caused when fat or organs bulge through a hole in the abdominal muscle. The protrusion is among the most reported symptoms of a hernia. Sometimes the patient can press the hernia back inside, to make it regress or disappear, but often the bulge remains.

There are two types of epigastric hernias.

  • Reducible epigastric hernia – is when the tissue pushes out of an abdominal weakness then loops back in.
  • Incarcerated epigastric hernia – is when the tissue becomes lodged outside a hole in the abdomen, and does not recede.

In the early stages, symptoms are often mild, sometimes unnoticeable. However, if any major abdominal organs become lodged in the lining of the abdominal cavity (the peritoneum), then serious complications could occur. Epigastric hernia symptoms may include:

Noticeable protrusion

The first symptom most patients notice is a protrusion between their navel and breastplate. At times, this is only noticeable when stooping, bending, or other activities that make the stomach muscles tighten.

Discoloration

The skin around the herniated area can become discolored. Normally the skin turns purplish, or black and blue much like a bruise. When the skin becomes discolored, this is a sign the hernia has become strangulated and cut off from blood flow.

Chronic Pain

Pain may not occur right away. As the hernia grows, it can lead to muscle and nerve tension. The slow process often results in aching, burning, throbbing, and discomfort around the location. Chronic pain is somewhat different from acute pain because it is not as intense; rather it is more like a dull ache.

Referred Pain

When the nerves become stretched, the full length of the nerve can be painful. The nerve irritation causes pain to travel outside of the herniated area. Even if a hernia is pushed back inside, the irritation may lead to long term discomfort. Many symptoms can be felt in several parts of the abdomen, even though the hernia may be located somewhere else.

Nausea and Vomiting

Nausea and vomiting can be mild and sporadic or severe. If a small part of the intestine gets stuck inside the abdominal tear, it may cause discomfort. Nausea may come and go, as the hernia protrudes and retracts.

Constipation

In rare cases, when the intestine becomes trapped, food and fecal matter can also become trapped causing constipation.

Many symptoms of an epigastric hernia do not become present unless a hernia becomes strangulated. A strangulated hernia can lead to severe pain, nausea, vomiting, and diarrhea.

Epigastric hernia causes

There are natural areas of weakness within the abdominal wall. Hernias often occur in weak areas when a person strains under heavy pressure. Age, injury or prior surgical scarring may also cause epigastric hernias. The following are common causes.

  • Obesity
  • Pregnancy
  • Abdominal fluids
  • Heavy lifting
  • Bowel movement strain
  • Coughing, sneezing, laughing or crying

Diagnosing epigastric hernia

Your doctor will first review your medical history, then complete a physical examination. During the exam, the doctor may ask you to do a series of movements. These movements should make the hernia more visible. Next, the doctor may order an ultrasound or computerized tomography (CT) scan. 

Abdominal ultrasound

The ultrasound machine scans the abdomen by using an electronic sensor. The gel used acts as a conductor allowing the sensor to transmit information to the computer.

CAT or CT scan

A CT scan is a doughnut-shaped machine that x-rays the inside of the body and sends images to the attached computer. A CT Scan can determine the size and shape of a hernia.

Treating epigastric hernia

It is crucial to have an epigastric hernia fixed before serious complications arise. Often anti-inflammatory medications are given to relieve pain due to swelling.

If surgery is necessary, the surgeon will remove the herniated tissue and close the abdominal opening. If necessary, the surgeon may use a nylon mesh to strengthen the abdominal muscles.

Rarely Epigastric hernias are found in children. Surgery is not usually performed until the child is old enough to recover well. However, if the child experiences complications, the doctor will suggest moving forward with the surgery.

Many times, this is an outpatient surgery. However, some patients may require aftercare monitoring in the hospital.

Recovery

Most patients recover quickly after an outpatient surgery. Once you are awake and can walk on your own, you will be released to go home. Expect to be sore for a couple days, as the surgery does involve your muscles. The day after surgery, you should be as mobile as possible so your muscles do not become restricted. You should be able to return to your normal daily routine within days after surgery. Your doctor should make a follow up appointment for two weeks post surgery. With proper diet and exercise, some patients are even able to return to work after a couple of weeks.

Alternative to surgery

Some patients may find temporary relief by wearing fitted girdles or corsets. However, the only proven and permanent remedy is surgical repair.

Epigastric hernia complications

Untreated hernias lead to many complications. The most serious is fecal matter trapped within a herniated intestine. Such difficulties may become severe and require immediate medical treatment.

With treatment, the prognosis of an epigastric hernia is good. This article describes what to expect when you have an epigastric hernia; however, not every person experiences the same symptoms and treatment. Ask an Expert for more information regarding your medical problem.  

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