Epigastric Hernia: Small Midline Bumps Explained
Published on: 7/Oct/2025
Posted By: Arka Health
Introduction: That Mysterious Bump on Your Upper Belly
You might notice it one day while getting dressed or after a workout—a small, firm lump located somewhere between your breastbone and your belly button. It might be painless, or it could cause a dull ache, especially when you cough or lift something. For many people in bustling Bengaluru, it’s easy to dismiss such a small bump. However, this could be the sign of an epigastric hernia, a common condition that deserves attention.
An epigastric hernia is a type of abdominal hernia that, while often small, will not go away on its own and can sometimes lead to complications if ignored.1 Understanding what this small midline hernia is, what it feels like, and what your options are is the first step toward peace of mind and proper care.
This guide provides a clear, patient-friendly overview of the epigastric hernia, from its causes and symptoms to modern treatment options. For those seeking expert care in Bengaluru, ARKA Anugraha Hospital stands as a premier institution, recognized as a ‘Centre of Excellence in Hernia Surgery’ by both the Asia Pacific Hernia Society and the Hernia Society of India. We are dedicated to providing not just advanced surgical solutions, but a holistic and integrative path to healing.
Where an Epigastric Hernia Forms and Why
What Is an Epigastric Hernia?
An epigastric hernia is a type of ventral hernia, meaning it occurs on the front wall of the abdomen. Specifically, it forms in the epigastrium—the area along the midline of your upper abdomen, anywhere between the bottom of your breastbone (sternum) and your belly button (navel).
This condition occurs when a small amount of fatty tissue, or in some cases a portion of the intestine, pushes through a weak spot or hole in the abdominal muscles. This weak spot is in a band of connective tissue called the linea alba, which runs down the center of your abdomen where the “six-pack” muscles meet. The result is a small midline hernia that often appears as a noticeable bump under the skin. While they are usually small, it is possible to have more than one at a time.
What Causes This Small Midline Hernia?
An epigastric hernia is caused by a combination of weakness in the abdominal wall and increased pressure inside the abdomen.
- Congenital Weakness: Many epigastric hernias are present from birth (congenital). They occur when the abdominal tissues don’t close completely during development in the womb. This weakness can go unnoticed for years.
- Increased Abdominal Pressure: In adults, the hernia often develops when prolonged or intense strain pushes tissue through this weak spot. Common factors that increase this pressure include:
- Obesity or being overweight
- Pregnancy
- Heavy lifting or strenuous physical activity
- A chronic, persistent cough
- Straining during bowel movements due to constipation
While anyone can develop an epigastric hernia, they are most common in males and often become noticeable in adults between the ages of 30 and 50.
What an Epigastric Hernia Feels Like: Typical Symptoms
Many epigastric hernias cause no symptoms at all and are sometimes discovered by chance during an imaging test for another condition. When epigastric hernia symptoms do occur, they can vary from mild to severe.
What Does an Epigastric Hernia Feel and Look Like?
The most common epigastric hernia symptoms are related to the physical bulge itself:
- A Visible Bump: The primary sign is a small lump or swelling located on the midline of the upper abdomen.1 This bulge may be more obvious when you are standing, coughing, laughing, or straining, and it might disappear when you lie down.
- Pain or Discomfort: While many are painless, an epigastric hernia can cause a range of sensations. You might feel a dull ache or a feeling of pressure in the upper belly. Some people experience a sharp pain, especially during activities that increase abdominal pressure, like lifting or exercising. The area may also feel tender to the touch.
It’s important to note that an epigastric hernia does not cause digestive symptoms like heartburn or acid reflux; those are more commonly associated with a hiatal hernia.
When a Small Bump Becomes a Big Problem
Although most epigastric hernias are small and contain only fatty tissue, they can become a medical emergency if a portion of the intestine gets trapped (incarcerated) or has its blood supply cut off (strangulated).
Seek immediate medical attention if you have a hernia and experience any of these serious symptoms:
- Sudden and severe pain that gets worse
- Nausea and vomiting
- Fever
- The hernia bulge becomes firm, tender, or changes color (red, purple, or dark)
- You are unable to pass gas or have a bowel movement
A Simple Repair Overview: Epigastric Hernia Treatment
An epigastric hernia in an adult will not heal on its own and will likely grow larger over time.For this reason, surgery is the only definitive method of repair.
Getting an Accurate Diagnosis
The diagnosis for an epigastric hernia is usually straightforward.
- Physical Exam: A doctor can typically diagnose the hernia by performing a physical exam. They will look for and feel the bulge in your upper abdomen and may ask you to stand or cough to make it more prominent.
- Imaging Tests: If the diagnosis is uncertain, your doctor might order an imaging test like an ultrasound or a CT scan to get a clearer view of the abdominal wall and confirm the hernia’s contents.
Basic Repair Options
Surgery is the recommended epigastric hernia treatment for adults, even if symptoms are mild, to prevent the hernia from enlarging and to avoid the risk of future complications.
- Open Surgery: This traditional approach involves making a small incision directly over the hernia. The surgeon gently pushes the protruding tissue back into the abdomen and closes the weak spot in the muscle wall with strong stitches. For larger defects (typically over 2 cm), a piece of sterile surgical mesh may be used to reinforce the area and reduce the chance of the hernia returning.
- Laparoscopic (Minimally Invasive) Surgery: For larger or more complex hernias, a surgeon may recommend a laparoscopic or “keyhole” repair. This modern technique uses several very small incisions, a camera, and specialized instruments to repair the hernia from the inside. This approach often results in less pain, smaller scars, and a faster recovery. Robotic surgery is an even more advanced form of this minimally invasive technique, offering enhanced precision.
Expert Epigastric Hernia Treatment in Bangalore: The ARKA Anugraha Advantage
When it comes to surgery, choosing a hospital with proven expertise is essential. In Bengaluru, ARKA Anugraha Hospital is a premier institution for hernia care, formally recognized as a ‘Centre of Excellence in Hernia Surgery’.
Our surgical center is led by Dr. M. Ramesh, a trailblazer with over 40 years of experience in laparoscopic surgery, supported by a world-class team specializing in the most advanced minimally invasive techniques. This focus on laparoscopic and robotic repair means our patients benefit from smaller incisions, less post-operative pain, and a significantly faster return to their daily lives, often with a hospital stay of less than 24 hours.
What truly sets ARKA Anugraha Hospital apart is our unique integrative and functional medicine approach. We believe that surgery is just one part of the healing journey. Our philosophy is to treat the whole person, not just the hernia. We support our surgical patients with:
- Holistic Pain Management: We go beyond standard pain medication, integrating evidence-based therapies like acupuncture and guided meditation to minimize post-surgical discomfort.
- Nutritional Optimization: Our team provides personalized nutritional guidance to support your body’s natural healing processes and prevent issues like constipation that can strain the surgical repair.
- Personalized, Compassionate Care: From your first consultation to your final follow-up, our dedicated team provides care that is tailored to your individual needs, ensuring you feel supported every step of the way.
Frequently Asked Questions (FAQ)
Q1: Can an epigastric hernia go away on its own?
A: In adults, an epigastric hernia will not heal by itself and tends to get larger over time. Surgery is the only way to permanently repair the defect and is usually recommended to prevent complications.
Q2: Is surgery for a small midline hernia painful?
A: You will be under anesthesia during the surgery and will not feel pain. Post-operative discomfort is normal but is well-managed with medication. Patients who undergo minimally invasive laparoscopic surgery typically experience significantly less pain and have a faster recovery.
Q3: What is the recovery time for an epigastric hernia repair?
A: Recovery time varies, but it is generally quick. Most people can return to light activities and desk work within one to two weeks. However, you should avoid heavy lifting and strenuous exercise for four to six weeks to allow the repair to heal fully.
Q4: What happens if I don’t get my epigastric hernia treated?
A: An untreated epigastric hernia can grow larger and become painful. While rare, there is a risk of serious complications like bowel blockage (obstruction) or strangulation, where the trapped tissue loses its blood supply, which is a medical emergency.
Q5: Why should I choose ARKA Anugraha for my epigastric hernia treatment in Bangalore?
A: ARKA Anugraha Hospital is an accredited ‘Centre of Excellence in Hernia Surgery’. We offer world-class expertise in minimally invasive laparoscopic and robotic surgery, which leads to faster recovery and less pain. Our unique integrative medicine approach supports your entire healing journey with holistic pain management and personalized care plans, ensuring the best possible outcome.
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