Epigastric Hernia Explained: Causes, Symptoms, and Risks

Epigastric hernia is a midline fascial defect above the umbilicus where fat or tissue protrudes, often worsened by increased intra-abdominal pressure, aging/collagen weakness, prior surgery, or trauma. It may present as a reducible bulge with pain or pressure. Risks include incarceration and, rarely, strangulation. Diagnosis is mainly physical exam, sometimes an ultrasound/CT. Definitive treatment is surgical repair—often laparoscopic, using tension-free closure and mesh for larger defects.

An epigastric hernia is a defect in the linea alba (midline abdominal fascia) between the xiphoid and the umbilicus, allowing preperitoneal fat—and less commonly bowel—to protrude through the weakened layer. It often becomes more apparent with maneuvers that raise intra-abdominal pressure (coughing, straining, heavy lifting) and may be linked to obesity, prior abdominal incisions/port sites, age-related collagen loss, trauma, or connective-tissue disorders.

An epigastric hernia occurs when fat or tissue pushes through a weak area in the upper abdominal wall, creating a bulge typically located between the belly button and the lower chest. These hernias may be congenital (present at birth) or acquired over time. While many small epigastric hernias cause minimal symptoms and go undetected, larger or worsening hernias can lead to pain and, in rare cases, dangerous complications that require urgent treatment.

Dr. Moein, a general surgeon serving patients across Los Angeles, Encino, and Glendale, offers advanced evaluation and minimally invasive laparoscopic epigastric hernia repair designed to restore abdominal wall strength and reduce recurrence risk.

What Is an Epigastric Hernia?

Epigastric hernias develop when tissue protrudes through the inner layers of the abdominal wall in the upper midline. Many are reducible, meaning the bulge may appear and disappear—often becoming more noticeable with activities that increase abdominal pressure such as straining, coughing, heavy lifting, or even prolonged standing.

Because symptoms can be subtle, some patients only discover an epigastric hernia during an exam or imaging done for another reason.

Common Causes and Risk Factors

Several factors can weaken the abdominal wall and contribute to hernia formation, including:

Prior abdominal surgery (including midline incisions or port sites)
Chronic increased intra-abdominal pressure (obesity, persistent coughing, heavy lifting, ascites)
Age-related connective tissue weakening
Trauma to the abdominal wall
Rare collagen disorders (such as Marfan or Ehlers-Danlos syndrome)

A careful history and exam help determine risk and guide the most appropriate treatment plan.

Symptoms of an Epigastric Hernia

Symptoms vary widely. Small hernias may cause vague discomfort without an obvious bulge for years. As the defect enlarges, symptoms often become more noticeable:

A visible bulge above or near the navel (not in the groin)
Pain or aching discomfort, often worse with activity or strain
Pressure or tightness in the upper abdomen
Fullness, cramping, or a “pinching” sensation

While true emergencies are less common with fatty-tissue epigastric hernias than with bowel-containing hernias, progression can increase the likelihood of bowel involvement over time.

When to See a Doctor Immediately

An epigastric hernia will not heal on its own. Medical evaluation is important—especially if symptoms increase or the bulge becomes persistent.

Seek urgent care if the hernia becomes:

Stuck “out” and cannot be pushed back in (incarceration)
Increasingly painful or tender
Associated with skin redness, rapid enlargement, fever, or systemic illness

These signs may indicate a higher-risk situation requiring prompt assessment.

Diagnosis: Exam First, Imaging When Needed

Many epigastric hernias can be diagnosed with a focused physical exam, especially while standing and during a cough/strain maneuver. When confirmation or sizing is needed, imaging may be recommended:

Ultrasound to measure the defect dynamically
CT scan for complex anatomy or unclear cases

Why Laparoscopic Epigastric Hernia Repair Is Often Recommended

When repair is appropriate, laparoscopic surgery is commonly favored due to its minimally invasive approach. Using small incisions and a camera-guided technique, the protruding tissue is returned to its proper position and the abdominal wall defect is repaired. For larger defects, mesh reinforcement may be used to support a tension-free repair, helping strengthen the area and reduce recurrence.

Benefits of laparoscopic hernia repair may include:

Smaller incisions and reduced scarring
Shorter recovery time and faster return to daily activities
Less postoperative discomfort for many patients
Strong reinforcement for larger or progressive defects

Recovery Timeline: What Many Patients Can Expect

Most patients return to routine activities within about six weeks, with progressive improvement over the following months. Early recovery typically focuses on walking, protecting the repair while coughing or sneezing, and avoiding heavy lifting until cleared.

Schedule an Epigastric Hernia Consultation in Los Angeles

For patients with a suspected or diagnosed epigastric hernia, early evaluation can help prevent progression and reduce the risk of complications. Dr. Moein provides personalized assessment and modern surgical options—including minimally invasive laparoscopic repair—for patients in Los Angeles, Encino, and Glendale, CA.

Media Contact
Company Name: Healthy Life Bariatrics
Contact Person: Bariatric Surgeon Dr.Moeinolmolki
Email: Send Email
Phone: +1(310)861-4093
Address:2080 Century Park East, Suite 501
City: Los Angeles
State: CA
Country: United States
Website: https://healthylifebariatrics.com/