Epigastric hernia occurs when the muscles of the abdominal wall become weak. As a result the tissues of the abdomen push out through these muscles. Hernia can occur in any part of the body, but they are common in abdomen. The site of epigastric hernia is between the breast bone (sternum) and the belly button also called umbilicus.
Unlike many other abdominal hernias, epigastric hernia is smaller in size and involves only protrusion of peritoneum. Peritoneum is the lining of the abdominal cavity. In its severe form, a part of intestine or fatty tissue may make its way through the weakened muscle wall.
Epigastric hernia occurs in the mid line of the abdomen. People between 20 to 50 years are vulnerable to develop epigastirc hernia. Most of the time, patient remains asymptomatic and the mass is discovered while examining the patient.
Causes Of Epigastric Hernia
Epigastric hernia may be present since birth in some cases. This is due to the inborn weakness of the abdominal muscles. However, when the child becomes adult and with the growing strength of abdominal muscle, epgastric hernia may go into a state of remission.
At later age, epigastric hernia may protrude again due to some triggering factors.In most cases the hernia is not apparent while lying down but with the pressure such as coughing, straining during bowel movement, crying, etc where the intra abdominal pressure increases epigastric hernia becomes visible.
What Are The Symptoms Of Epigastric Hernia?
Most of the time, epigastric hernia is reducible. This means it protrudes out and goes in different postures and circumstances. Some of the signs and symptoms of epigastric hernia are;
- A prominent bulge in mid line of the abdomen between the belly button and lower end of breast bone is visible. It increases in size on slightest intra abdominal pressure.
- Normally a reducible epigastric hernia is does not cause pain. However, in circumstances where the fatty tissue or the intestine of the abdomen gets trapped between the weak muscle of abdomen, patient may complain of pain and tenderness.
- Nausea and vomiting are associated with strangulation of epigastric hernia. It is an emergency and patient should contact his doctor as fast as possible.
- Fever is another complication of strangulated epigastric hernia.
- In rare cases the skin may become discolored above the hernia site. It is the result of strangulated hernia becoming gangrenous. Here the blood supply of the trapped intestine is completely blocked and the portion of intestine becomes dead. If the condition is not treated on time, chances of fatality increase.
Non-Surgical Treatment For Epigastric Hernia
Protrusion of any hernia till they are not symptomatic can be well tolerated by the patient. But at the same time, it is necessary to remember that after a period of time, when the hernia increases in its size and when it starts producing discomforting symptoms it may need to be treated. The same is the case with epigastric hernia.
To an extent the symptoms of hernia can be controlled with precautionary measures at home. They are as follows:
- Avoid too much of abdominal pressure. If you are constipated, prevent it by taking more fiber containing food. This will reduce more exertion with each bowel movement.
- Applying warm compresses may temporarily alleviate the pain.
- Avoid doing too much of physical activities which produces abdominal pressure. Avoid lifting weight.
- Stop smoking as that will cause cough and increased intra abdominal pressure.
- Patient should reduce weight.
After a period of time when all the conservative methods fail patient may need surgical repair of the epigastric hernia. In most cases it is a permanent solution and recurrence is rare.