Epigastric hernias are a type of abdominal wall hernia. This article clarifies their location, physical characteristics, and contributing factors.
Understanding Epigastric Hernias
An epigastric hernia involves internal tissue, often fatty tissue, pushing through a weakened area in the muscles of the abdominal wall. This protrusion creates a bulge that can be seen or felt.
These hernias develop in the upper, central part of the abdomen. The nature of the hernia is a defect, or small hole, in the connective tissue that normally keeps abdominal contents contained. This allows a portion of the internal structures to protrude, forming the characteristic bulge.
Precise Location and Physical Characteristics
Epigastric hernias are found in the midline of the upper abdomen. This region spans from the bottom of the breastbone, the sternum, down to the navel. The protrusion occurs through a defect in the linea alba, a strong, fibrous band of connective tissue that runs vertically down the center of the abdominal wall, connecting the rectus abdominis muscles.
Physically, an epigastric hernia often presents as a soft lump or bulge. This bulge may become more noticeable when abdominal pressure increases, such as during coughing, straining, or standing. It can sometimes be pushed back into the abdomen.
The size of these hernias can vary, typically measuring less than 1 centimeter, though larger ones up to 4 centimeters can occur. While many epigastric hernias cause no symptoms and are discovered incidentally, some individuals may experience a dull ache or sharp pain in the upper belly. This discomfort can worsen with physical activity or straining.
Common Causes and When to Seek Medical Advice
Epigastric hernias can stem from an inherent weakness in the abdominal wall, which may be present from birth or develop over time. Increased pressure within the abdominal cavity also plays a significant role.
Activities that raise abdominal pressure include heavy lifting, chronic coughing, straining during bowel movements, obesity, and pregnancy. While some hernias are congenital, most acquire over time, particularly in adults between 30 and 50 years old.
It is advisable to consult a healthcare provider if a bulge appears in the upper abdomen, even if it is not painful. Medical attention should be sought immediately if the bulge becomes larger, more painful, or changes color, or if new symptoms like nausea, vomiting, or difficulty passing gas or stool develop.