Most people are familiar with hernias. The most common types are inguinal or umbilical. However, there’s one type that goes unnoticed. This hernia is called the Epigastric Hernia. Epigastric hernia is not as widely discussed. However, the condition is just as important to understand. An epigastric hernia presents as upper abdominal pain. It leaves behind a noticeable lump in your upper stomach area. Hernias are completely treatable. The right knowledge can help you seek help early and get the appropriate treatment.
In this blog, we will look at epigastric hernia in detail, identify its causes & symptoms, and consider the possible treatment options.
What is an Epigastric Hernia?
An epigastric hernia is tissue that pushes through a weak spot in the abdominal wall. Some hernias involve the intestines, but epigastric hernias involve fat tissue bulging out. This will be a noticeable bulge, so it is not one of those “hard to spot” conditions.
Epigastric hernias are typically smaller in size. They can cause a lot of discomfort. They measure less than half an inch. The lump might be more noticeable if you strain, laugh, or lift heavy objects. Some epigastric hernias are painless and mostly go unnoticed; others grow large or cause a significant amount of pain, especially if left untreated. Large hernias can grow up to one and a half inches. Many types of hernias go completely unnoticed until the lump shows up.
An epigastric hernia is most common in men and children, but almost anyone can develop one. Women can develop an epigastric hernia during or after pregnancy, which increases abdominal pressure.
Most cases of epigastric hernias are not life-threatening. However, some larger hernias can increase your risk of complications or long-term issues.
Causes of Epigastric Hernia
The root cause of an epigastric hernia is a weakness in the abdominal muscles. This weakness may be present at birth or develop over time. There are several factors that can cause an epigastric hernia. Let’s take a look at some of the most common causes.
- Congenital Weakness: Congenital epigastric hernia occurs when there’s a natural weak spot in the abdominal wall. The muscles probably didn’t develop completely during fetal development. The fatty tissue or intestine protrudes through this weak spot. This causes a small lump between the belly button and the sternum. Congenital epigastric hernia is often asymptomatic. However, if fat gets trapped, it can get quite painful. The treatment for a congenital epigastric hernia is typically surgery. This surgery is done to prevent complications and for cosmetic reasons.
- Increased Abdominal Pressure: This is one of the primary causes of epigastric hernia. Abdominal tissue pushes through a weak spot in the upper abdominal wall. The risk factors for increased abdominal pressure-related epigastric hernias include pregnancy, obesity, heavy lifting, chronic coughing, and straining during bowel movements. All of these elements cause intra-abdominal pressure. It weakens the abdominal muscles and increases the risk of epigastric hernia formation. An epigastric hernia can have complications like incarceration or strangulation, where the trapped tissue loses its blood supply. Surgical intervention is necessary.
- Obesity: Obesity substantially increases the risk of epigastric hernia. It adds intra-abdominal pressure that is constant. This can weaken the abdominal muscles. A sedentary lifestyle, which is linked to obesity, can also weaken abdominal muscles. When the muscles are weakened, they can’t support the abdominal wall. This makes it easier for the tissue to push through. Treatment includes surgery and extensive weight loss to reduce intra-abdominal pressure.
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- Pregnancy: Carrying a child can add a lot of pressure on your abdominal walls. Hernias are quite common during and after pregnancy. An epigastric hernia during or after pregnancy typically appears near the navel. It causes a lot of pain and discomfort, along with bloating or constipation. Severe cases can lead to complications, so it is always best to consult your doctor if you notice a protruding lump in your abdomen.
- Previous surgeries: Incision sites from previous surgeries are often sites for epigastric hernias. This type of epigastric hernia is also called an incisional hernia. This hernia can be recurrent since hernia treatment involves surgical removal. Treatment for this type of hernia also involves rest and care during the healing process of the surgical site.
Epigastric Hernia Symptoms
Not every hernia will scream for attention. Sometimes, an epigastric hernia may not cause symptoms at all. However, when it does, it is difficult to ignore. Here’s what the epigastric hernia symptoms include:
- You might notice a visible bulge under your skin in the affected area. This area will typically be between your belly button and sternum. This bulge will be noticeable; there is no way to miss it. The bulge may be more apparent when you’re standing, and it might go away when you sit down.
- There might be a dull ache in the middle of the upper part of your belly. The ache may also feel worse during the day.
- A hernia can also feel like a sharp pain, which usually surfaces when you cough, lift something heavy, or strain on the toilet.
- You may feel some tenderness when you press on the bulge. Similarly, you may also feel an internal pulling sensation or a burning sensation, which will be hard to pin down.
A sure sign of an epigastric hernia is the bulge. If left untreated, the bulge may continue to cause pain and potentially become more noticeable. These symptoms don’t look the same in every person with an epigastric hernia. For some, the pain is very manageable, even going unnoticed. For others, this might not be the case; the pain might be a downright hindrance to their day-to-day life.
If the bulge becomes very noticeable and painful, please consult a doctor immediately. Surgical intervention is almost always necessary in cases of hernia, so it is best to get it checked early.
Epigastric Hernia Symptoms in Females
Hernia in women is more common than one might think. While epigastric hernia is studied primarily with men and children in mind, it does affect women. Women often experience the symptoms a little differently than their male counterparts. For instance, pregnancy is a significant risk factor for epigastric hernia. The question is: If symptoms in female patients look different, how do we identify them? Here’s what you can look out for:
Epigastric hernia symptoms in females often masquerade as something else. A woman feels the discomfort of a hernia, but chalks it up to bloating or indigestion. If the hernia pain is mild, it can even be confused with menstrual cramps, especially if it occurs closer to the belly button. The hernia might not be completely obvious.
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During pregnancy, as the belly expands to accommodate the baby, so does the pressure on the abdominal walls. Hernias during pregnancy are quite common, especially during childbirth. Epigastric hernia in females, particularly pregnant females, may feel like an uncomfortable sensation, even if it is not painful.
If you’re a woman who is noticing a suspicious protruding lump on your torso, or you are having concerns about a potential hernia, please consult a doctor as soon as possible. While hernias need not be life-threatening, women should still stop by for a quick check-up.
Small Epigastric Hernia – What You Need to Know
Don’t let the name fool you; a small epigastric hernia is just as important as a large one. It happens often that a person discovers a small hernia and dismisses it as “no big deal.” However, the size doesn’t always mean it is not harmful.
Some hernias stay small and quiet for years before they surface aggressively. Others grow slowly and steadily. Most of the time, the hernia might not hurt. You might not even notice it’s there. Suddenly, there’s a flare-up after a heavy meal or a workout. This shows us that regardless of size and symptoms, a hernia has the potential to worsen if left untreated. Even a small hernia can trap tissue.
If the hernia is really small, the doctor may take an approach of “let’s wait and see.” That can leave you feeling impatient and without an answer. They will ask you to keep an eye on the hernia, ensuring you seek medical help if you notice any changes. Avoid ignoring it entirely; this is a problem that may seem small, but it can lead to serious complications. It will come back to cause you more trouble.
Epigastric Hernia Treatment Options
Once you know you’ve got a hernia, you’ve got two paths: surgical repair or watchful waiting.
- Surgical repair: Surgical repairs are the only true fix for epigastric hernias. The surgeon pushes the tissue back in place and then reinforces the abdominal wall. Sometimes this reinforcement looks like mesh. Surgery is the best option, as it stops the growth of the hernia, leading to other complications.
- Watchful waiting:This simply refers to the “wait and observe” method. Doctors usually ask you to wait and observe if the hernia is too small.
As part of your treatment plan, you may also receive instructions to maintain a healthy weight, avoid lifting heavy things, or treat a chronic cough. This is because all of these things can lead to an epigastric hernia. Obesity, strain, and chronic conditions can increase your risk of developing an epigastric hernia. These management methods may not fix the whole problem, but they provide great support for recovery.
Epigastric Hernia Treatment Without Surgery
One of the first things people worry about when it comes to epigastric hernia treatment is, “is there a way to avoid the surgery altogether?” The answer to that question is: Surgery might be the only permanent way to fix an epigastric hernia. Non-surgical options are ideal for the management of the symptoms, but not for a permanent resolution of the problem.
Nevertheless, let’s take a look at some non-surgical responses to epigastric hernia:
- Wearing a hernia belt or binder for temporary support
- Adjusting diet to avoid constipation and bloating
- Losing weight to reduce abdominal pressure
- Avoid lifting heavy weights and doing high-impact exercises
These steps are great when combined with a surgical treatment. The non-surgical techniques make life easier, but they won’t close the gap in the abdominal wall or strengthen it enough to repair it. Your doctor will recommend surgery at some point, even if you start with conservative care.
Epigastric Hernia Surgery – When is it Required?
Surgery becomes necessary when the hernia grows. It causes pain and increases the risk of complications. The aim of the surgery is to repair the weak spot and prevent the hernia from recurring. That being said, not every hernia requires surgery right away. Doctors only recommend surgery when it’s the right time to do so. They will recommend surgery if:
- The hernia grows or becomes painful
- It starts interfering with your daily life (it’s apparent even when you do small activities like bending, eating, or exercising)
- It won’t go back in
- There is sudden severe pain, accompanied by fever, nausea, or swelling. In this case, emergency surgery is performed
The surgery itself is very straightforward. You can either get an open surgery or a laparoscopic surgery. Open surgery is where the surgeon makes an incision big enough to push the hernia back in, and then strengthens the abdominal wall with mesh. Laparoscopic surgery is where the surgeon makes small incisions and uses a camera to navigate their tools, pushing back the protruding tissue slowly.
Open surgery can leave behind significant scarring, while laparoscopic surgery is minimally invasive, causes less pain, and has a quicker recovery time.
Conclusion
Epigastric hernias are relatively common, and nothing to feel embarrassed about. Epigastric hernias are not discriminatory when it comes to the demographic most affected. They show up in men, women, and even kids. However, knowledge of the condition can make it seem less scary. Get any suspicious lumps checked out, even if they appear harmless or painless. Listen to your body: the sooner you notice the signs of an epigastric hernia, the sooner you can treat and manage it, and live a stress-free life.
FAQs:
What is an Epigastric Hernia?
An epigastric hernia is a small or large lump that develops on your torso, somewhere between the sternum and the belly button. The exact location depends on what is causing the hernia. If the lump is small or otherwise asymptomatic, it might only appear when you're straining or coughing, and then disappear again when you relax. For some people, there's no pain at all. They are completely asymptomatic. For others, it is anything but comfortable. They might feel pain, discomfort, and pressure at the hernia site. An epigastric hernia is not particularly dangerous, but it's also something you should pay close attention to.
What are the common symptoms of an Epigastric Hernia?
The most obvious sign is a lump in your upper belly. It will be protruding and most noticeable when you strain or cough. Some have said they felt a burning sensation or tenderness in that area. For others, there's no pain, so there is just an intruding bulge that comes and goes. If the lump suddenly becomes painful, red, and firm, and you begin feeling sick, seek medical help right away.
What causes an Epigastric Hernia?
The main cause is abdominal wall weakness. Sometimes it’s a genetic factor, and sometimes it develops as you grow. Things that make abdominal wall strength worse include straining on the toilet, heavy lifting, obesity, pregnancy, and chronic coughing. If there is a family history of epigastric hernias, your likelihood of developing one increases. Generally, anything that puts pressure on your belly can nudge that weak spot until it gives way.
Can an Epigastric Hernia be treated without surgery?
You can only manage epigastric hernia symptoms without surgery. There are plenty of management techniques, such as maintaining a healthy weight, dietary changes, using hernia belts, and avoiding heavy lifting. However, surgery is the only thing that can permanently fix this problem. If your hernia is too small, your doctor might suggest waiting and watching for now.
Is an Epigastric Hernia common in females?
An epigastric hernia in women is more common than you think. While it is most commonly noted in men and children, women do develop one. In women, the symptoms often mask themselves as symptoms of a different problem. For instance, hernia pain is often mistaken for digestive problems or menstrual cramps. Since the symptoms in women appear so differently, there can be a delay in diagnosis. Pregnancy and hormonal changes can add a lot of pressure to their abdominal walls, stretching and weakening the tissue. Hernias become more likely that way.
