Epigastric hernia

The main symptoms associated with an epigastric hernia are:

• a bulge or lump between your belly button and the breastbone (epigastrium area)
• pain caused by the tissue being pinched by the abdominal wall
• more intense pain when lifting heavy objects or coughing

In rare cases, the hernia can cause extreme abdominal pain and vomiting. This is caused by parts of the bowel getting caught in the hernia, causing a blockage that requires an emergency operation.

The hernia can be left untreated, but it is likely to get bigger and it won’t go away without surgery.

Your GP or consultant will examine the lump and affected area, which is often enough to identify a hernia. They may also refer you for an ultrasound scan. This is a painless and non-invasive test, but it will help to confirm the diagnosis and assess how severe it is.

Your consultant is likely to consider the following factors before recommending surgery:

• The risk of strangulation, which may occur if the hernia contains parts of your bowel
• If your symptoms are changing or getting worse
• The effect it is having on you and your ability to perform everyday tasks

Before recommending any treatment, your consultant will discuss the risks involved to determine the best approach for you.

If epigastric hernia repair surgery is recommended, the procedure is relatively straightforward. It will usually be performed under a general aesthetic, and most patients go home on the day of the operation.

It can be performed by open or laparoscopic (keyhole) surgery and involves returning the contents of the hernia back into the abdomen and then strengthening the abdominal wall. This is done by either using a special mesh or by stitching the muscle layers together to help prevent the hernia returning.