man suffering abdominal pain with magnified image of epigastric hernia

Epigastric Hernia: Causes Symptoms and Treatment

October 23, 2019

Do you have any idea on what a hernia is? If your answer to that question is yes, then you would most likely know this. Most hernias are located in the abdomen. And that includes an epigastric hernia which we will be looking at today. Hernias generally are as a result of a weak abdominal wall. And this leads to some tissue or organ going out of place to cause a bulge. Epigastric hernias actually occur in the upper portion of the abdominal wall. The reason it’s called epigastric hernia is that it’s located in the epigastrium.

An interesting fact about this type of hernias is that they can be present at birth. They come in different sizes. And also, there’s a possibility that a person would have more than one hernia at a time. One thing with this type is that they are mostly small in size. So a person may not even know it’s there. It only becomes quite obvious when the person applies so much pressure to the abdominal wall. Either when laughing, coughing or even carrying heavy objects.

 

Causes and Risk Factors

This hernia type is one that’s actually present from birth. And it’s as a result of the wall of the abdomen not closing completely during development. Researchers have tried time and time again to come up with the causes of this hernia type. But it seems quite difficult. Probably because there aren’t so many cases. And also because the symptoms are not so pronounced.

One theory though has been able to come up with one reason. They say it is caused as a result of tension. Tension in the area where the abdominal wall is attached to the diaphragm. The diaphragm is the upper demarcation of the abdomen. And it helps support the abdomen.

There are some factors though that tend to increase the tendency of having an epigastric hernia. One thing though that you must bear in mind is that most hernia types have common causes. And also risk factors. So the risk factors listed below can be applicable to almost all hernia types out there.

  • Physical labor
  • Obesity
  • Pregnancy
  • Chronic cough
  • Heavy lifting
  • Intensive sports or training

Symptoms of Epigastric Hernia

The symptoms associated with epigastric hernia are not so pronounced. This is why it has not been easy identifying its cause. But here are some symptoms that you would find in patients having this type of hernia. Especially when it’s related to a complication.

Pain

As mentioned earlier this type of hernia could be really small. And hard to notice. When this is the case it might not be associated with pain. But when it gets bigger it could become painful. Also, if the hernia gets entrapped somewhere in the abdominal wall then it could cause severe pain. Tenderness at that site may also occur. If you experience pain and tenderness then you have to see a doctor. That’s because it could lead to a complication.

Abdominal bulge

This type of hernia may cause an abdominal bulge. Especially when you’re applying so much pressure to the wall of the abdomen. Or when you’re exerting yourself too much. For instance when to strain your abdominal muscles during a bowel movement the bulge because very prominent.

Fever

This is another symptom that would tell you there’s a complication. Normally, most patients with this type of hernia wouldn’t have a fever. If you have a fever then you should see a doctor. It could be as a result of a problem with the blood flow. Or it could even be as a result of an infection. The earlier you see a doctor the better.

Nausea and Vomiting

Associated with the fever could also be nausea and vomiting. Note that these symptoms are not regular symptoms for an epigastric hernia. So any sign of them would mean there could be a complication. This is why you have to go see a doctor if you’re experiencing any of these symptoms.

Skin Discoloration

This is one of the symptoms you will notice when the case is serious. When there’s skin discoloration it’s known as a strangulated hernia. It’s as a result of part of an organ getting trapped in the muscle. And that part isn’t able to receive blood supply. When there’s lack of oxygen then you would expect that part of the abdomen to turn black or blue. This symptom indicates an emergency. You must seek medical attention immediately.

Treatment and Recovery

Unlike some other types of hernias, this hernia does not heal on its own. The only way to fix it is by having surgery. In infants, it’s advised that they get a little older before the surgery is done. That’s because when they are a little older they would be able to handle the surgery a lot better. Repairing the hernia as soon as possible is important. That way the chances of complications and further damage is reduced.

Normally general anesthesia would be given to the patient. But some patients prefer local anesthesia. It all depends on what you want. The point here is that you have nothing to worry about when it comes to pain during the surgery.

After the surgery, your doctor would recommend that you take pain relief for about 2 days. Because the site of incision would still be very painful. And there could also be pain, swelling, discomfort and even bruising of the abdomen.

Also, after the surgery, you have to start taking fluids. Take a lot of water. If you can take fluids already then you can start with a light diet. The reason is that a patient can have constipation after the surgery. That’s why a light diet is advised for the first few days after the surgery.

Another advise the doctor gives is to engage in light activities. Heavy activities would apply too much pressure on the abdomen. And with that, your wound might open up while doing all that work. So you have to be very careful.

After two to four weeks you should be able to return back to work. By that time all the wound should have completely healed up. Once you’ve undergone the surgery then you’re most likely completely free from an epigastric hernia.