Epigastric Hernia

An epigastric hernia develops when fatty tissue or part of the stomach pushes through a weak spot in the abdominal wall between the belly button and breastbone. While sometimes painless and small, these hernias can cause discomfort and require medical attention.

On this page, we’ll cover what an epigastric hernia is, its causes, symptoms, diagnosis, and treatment options, as well as what patients can expect during recovery.

What Is an Epigastric Hernia?

The epigastric region refers to the upper part of the abdomen, located just below the sternum and above the navel. When the abdominal wall in this area develops a small gap, pre-peritoneal fatty tissue—or in rare cases, part of the stomach—can protrude through, forming an epigastric hernia.

Key facts about epigastric hernias:

• They may be present at birth (congenital) or develop later in life.
• Multiple small hernias can occur at once.
• They are more common in men than women.
• Some remain painless and unnoticed until discovered during a physical exam.

Compare with Umbilical Hernia

Causes and Risk Factors

The exact cause is not always clear, but epigastric hernias often develop when pressure in the abdominal wall meets a weak spot in the muscle.

Common risk factors include:

• Obesity – added abdominal pressure weakens the wall.
• Pregnancy – stretching of the abdominal muscles can increase risk.
• Heavy lifting or straining – sudden increases in abdominal pressure.
• Chronic coughing – ongoing stress on the abdominal wall.

Symptoms of Epigastric Hernia

Many patients with epigastric hernias experience no symptoms at all, particularly if the hernia is small.

When symptoms are present, they may include:

• A small lump or bulge in the upper abdomen (more visible when standing or straining).
• Pain or tenderness between the belly button and breastbone.
• Discomfort during activity, lifting, or bending.
• A burning or aching sensation at the site.

If the bulge becomes painful, firm, or cannot be pushed back in, seek medical help right away, as this may indicate a strangulated hernia.

Diagnosis

Doctors usually diagnose epigastric hernias through a physical exam. Your provider may:

• Ask about your medical and family history.
• Examine your abdomen while you sit, stand, or lie down.
• Press gently on the affected area to assess the bulge.

Imaging tests such as ultrasound or CT scan may be ordered to confirm the diagnosis and rule out complications.

Treatment Options

Unlike some hernias in children that may heal naturally, epigastric hernias do not close on their own. Surgery is the only definitive treatment.

Surgical Approaches

• Open Hernia Repair – The surgeon makes an incision over the hernia, pushes tissue back into place, and reinforces the abdominal wall with stitches or mesh.
• Laparoscopic Repair – A minimally invasive option using small incisions, a camera, and surgical instruments to repair the defect. Benefits include less pain, smaller scars, and faster recovery.

Both procedures typically take around 30–60 minutes and are performed under general anesthesia.

Recovery and Aftercare

• Most patients go home the same day as surgery.
• Expect mild discomfort, swelling, or bruising near the incision.
• Light activity (walking, daily movement) is encouraged to reduce risk of blood clots.
• Avoid heavy lifting or strenuous activity for 6–8 weeks.
• Children and adults may resume normal activity in about 4–6 weeks, depending on healing.

When to See a Doctor

Seek immediate medical attention if you experience:

• Severe abdominal pain
• A firm, tender bulge that doesn’t go away
• Nausea, vomiting, or fever

These may be signs of a strangulated hernia, which is a surgical emergency.

Expert Care at Hernia Innovations

At Hernia Innovations, our board-certified surgeons specialize in treating all types of hernias, including complex epigastric hernias. With expertise in open, laparoscopic, and robotic-assisted surgery, our team provides personalized care and faster recovery times.

Call us today at (925) 940-1025 or schedule a consultation online.