Epigastric Hernia

What is an Epigastric Hernia?

An epigastric hernia occurs in the upper abdomen, between the breastbone (sternum) and the belly button (navel). It happens when fatty tissue or a small portion of the intestine pushes through a weakness in the abdominal wall (linea alba).

How big are they ?

These hernias are usually small (about 1 cm) but can sometimes grow up to 4 cm in size. In some cases, multiple hernias can occur in this region.

Why does an Epigastric Hernia occur?

An epigastric hernia develops when a weak spot forms in the linea alba, the connective tissue that runs vertically along the front of your abdomen. Through this weak area, fatty tissue or intestine can protrude outward.

You can be born with this condition (congenital), or it may develop over time (acquired) due to increased abdominal pressure or muscle weakening.

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What are the common causes of Epigastric Hernia?

  • Aging and thinning of the abdominal wall
  • Chronic cough
  • Constipation with repeated straining
  • Obesity
  • Lifting heavy objects
  • Pregnancy
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Which age group gets Epigastric Hernia?

Epigastric hernias most often affect adults between 30 and 50 years of age.

What are the symptoms of an Epigastric Hernia?

  • A visible or palpable bulge in the upper abdomen (between the belly button and breastbone) that becomes noticeable while standing or straining and may disappear when lying down.

  • A dull ache or discomfort in the middle of the abdomen, worsening as the day progresses.

  • Sharp pain when coughing, lifting heavy objects, or straining to pass stool.

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What are the possible complications of Epigastric Hernia?

Untreated or neglected epigastric hernias can lead to serious complications such as:

  1. Incarcerated hernia – The herniated fat or intestine becomes trapped and cannot be pushed back inside, leading to pain, vomiting, and abdominal distension.
  2. Strangulated hernia – The trapped intestine loses blood supply, resulting in tissue death, infection, or sepsis, a life-threatening condition requiring emergency surgery.
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How is an Epigastric Hernia diagnosed?

Your doctor may recommend:

  1. Clinical examination – To feel the bulge and assess reducibility.
  2. Ultrasound abdomen – To determine the size and contents of the hernia.
  3. CT abdomen – For complex, recurrent, or complicated cases (to check for obstruction or strangulation).
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Does every Epigastric Hernia need treatment?

  • Small and asymptomatic hernias may not require immediate surgery and can be observed.
  • Large, painful, or symptomatic hernias definitely require surgical repair to prevent complications.

How are Epigastric Hernias treated?

Surgery is the only definitive treatment. Since this is a mechanical defect, medications cannot close the opening in the abdominal wall.
Both open and laparoscopic mesh repair techniques are available and highly effective.

Treatment of Epigastric hernia

What are the advantages of laparoscopic mesh repair?

  • Performed through tiny (≤1 cm) incisions
  • Minimal pain and scarring
  • Short hospital stay (usually 1–2 days)
  • Faster recovery and early return to work
  • Low recurrence rate
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When is open mesh repair recommended?

Open repair is preferred in:

  1. Medically high-risk patients – Those with severe lung, heart, or liver conditions where general anaesthesia is unsafe.
  2. Complicated hernias – Cases involving strangulated or gangrenous bowel, or when multiple previous repairs have been done.

What is postoperative recovery like?

Recovery after epigastric hernia repair is usually quick and smooth:

  • Most patients can eat, walk, and perform light activities from the first day after surgery.
  • Desk job workers can resume work within a few days.
  • To ensure proper healing, avoid heavy lifting, treat cough or constipation early, and maintain a healthy body weight.

Frequently Asked Questions (FAQs)

Can an Epigastric Hernia recur after surgery?

Recurrence is rare when the repair is done properly and postoperative precautions are followed.

How to avoid recurrence of Epigastric Hernia?
  • Ensure cough, constipation, and urinary problems are managed before and after surgery.
  • Avoid strenuous physical activity for the recommended period.
  • Prevent wound infection.
  • Maintain a healthy weight to reduce strain on abdominal muscles.
  • Choose an experienced surgeon for a well-planned and well-executed repair.
Can an epigastric hernia go away on its own?

No. An epigastric hernia does not heal or close on its own because it involves a defect in the abdominal wall. The only definitive treatment is surgical repair. Small, asymptomatic hernias can be monitored but may enlarge or become painful over time.

Are there risks to treatment?

No. The modern-day laparoscopic surgery for epigastric hernia is very safe and carries minimal risk.

What kind of doctor treats an epigastric hernia?

Gastrointestinal (GI) surgeon is the specialist who diagnoses and treats hernias, including epigastric hernias.

The Best Gastro care center is the right place for treating epigastric hernia

Can I prevent an epigastric hernia?

While congenital (birth-related) hernias cannot be prevented, you can lower your risk of developing an acquired epigastric hernia by:

  • Maintaining a healthy weight
  • Treating chronic cough or constipation early
  • Using proper technique when lifting heavy objects
  • Avoiding smoking (reduces chronic cough and improves tissue healing)
At The Best Gastro Care Centre

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Our expert team provides world-class treatment for Epigastric Hernia and other gastrointestinal diseases using advanced techniques and compassionate care.

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