The area of the front abdominal wall between the belly button and the breastbone is called the epigastrium, which means “above the stomach.” Epigastric hernias are defects in the fascia of the abdominal wall. Luckily, there are some noticeable epigastric hernia symptoms to tell whether you are dealing with one.
What Can Be Mistaken for Epigastric Hernia?
Epigastric hernias can be mistaken for other conditions because of similar symptoms. Following are some common conditions that might be confused with an epigastric hernia:
- Umbilical Hernia: This occurs near the belly button and can affect both infants and adults. It looks like a bulge in the abdominal wall, similar to an epigastric hernia, but is lower, near the belly button.
- Incisional Hernia: It happens at the site of a previous surgery where the abdominal wall is weak. It can look like a bulge or cause discomfort, similar to an epigastric hernia, but a history of surgery helps to tell them apart.
- Spigelian Hernia: These hernias occur through the Spigelian fascia, to the side of the rectus muscle. They may not show a clear bulge, making them easy to confuse with epigastric hernias, especially if there’s localized pain.
- Diastasis Recti: This is when the rectus muscles separate along the midline, often in pregnant women or after weight changes. It can create a bulging appearance like an epigastric hernia but doesn’t involve any abdominal contents pushing out.
- Gastroesophageal Reflux Disease (GERD): It can cause upper abdominal discomfort, which might feel like an epigastric hernia. Symptoms like pain or burning in the upper abdomen can be similar.
- Fatty Tumors (Lipomas): They are non-cancerous lumps of fat in the abdominal wall. They may look like a soft bulge under the skin, similar to an epigastric hernia, especially if in the same area.
Major Epigastric Hernia Symptoms
An epigastric hernia usually causes a bump to form between the breastbone and the belly button. This bump happens because a piece of fat pushes through the hernia.
The raised area might always be visible, or it may only show up when you cough, sneeze, or laugh. In some cases, the bump can get bigger, and it’s possible to have more than one epigastric hernia at the same time. It can also cause tenderness and pain in that area, but it is also possible to feel no symptoms at all.
Causes of Epigastric Hernia
An epigastric hernia happens when the tissues in the abdominal wall don’t fully close during development. Researchers are still studying the exact causes, but these hernias are often not reported because they usually don’t cause noticeable symptoms. One common theory is that they might be caused by tension in the area where the abdominal wall connects to the diaphragm.
Treatment for Epigastric Hernia
Similar to inguinal hernia treatment, epigastric hernia repair can involve methods with or without mesh, using either open or laparoscopic techniques. The choice to use a mesh depends on the size of the hernia, the patient’s weight, and other risk factors. For small hernia openings (less than 1.5 cm) with no additional risks, a simple suturing technique is effective. In this case, the edges of the fascia are stitched together using non-absorbable sutures. For larger hernias (greater than 1.5 cm) or patients with higher risk, mesh reinforcement is recommended.
Wrapping Up
Most of the time, there are absolutely no epigastric hernia symptoms. Therefore, if you notice something unusual or feel uneasy, contact your healthcare professional for a diagnosis. A delayed treatment carries the risk of strangulation.
Visit Dr. Rick Ngo at Texas Hernia & Surgical Specialists. Our doctor has achieved distinction in the field of hernia surgery and is a Fellow of the American College of Surgeons. Call us at (888) 365-1544 to book an appointment.