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There are many different types of hernia, including a hiatal hernia, an umbilical hernia, or inguinal hernias.
An epigastric hernia occurs when a lump develops in the midline between your umbilicus (belly button) and sternum (breastbone) which can cause pain. An epigastric hernia in adults can sometimes be caused by smoking or diabetes.
Your abdominal cavity contains your intestines and other structures.
These are protected by your abdominal wall, which is made up of four layers, including your abdominal muscle. In an epigastric hernia (a form of abdominal hernia), fat pushes out through a weak spot in the wall of your abdomen between your umbilicus and sternum and forms a lump.
The most common symptom of a hernia is pain caused by the fat being pinched by your abdominal wall. A hernia might cause painful swelling in your tummy or groin area.
Hernia pain can be a burning or aching sensation, which may progressively get more painful as time goes on and the hernia remains untreated. This pain is caused by the muscles being forced apart abnormally, hence the burning and aching sensation.
Developing an epigastric hernia is common in both adults and children. However, there is a quick procedure to remove it, alleviating hernia pain in turn.
Epigastric hernias present several symptoms. Most significantly, the hernia will cause a swelling or bump in the middle of your chest area (sternum). This bump may or may not be painful, but it can cause nausea and general abdominal pain, particularly around the hernia itself. This nausea is caused by the hernia disturbing the intestine’s function.
The pain and hernia itself can be exacerbated by chronic conditions such as coughing and straining on the toilet. This is because your muscles contract when these actions take place. This puts pressure on the gut and strains the muscles further.
Specialist epigastric hernia exercises can help strengthen your core and prevent a hernia from reappearing after surgery.
These exercises include specialist pelvic floor exercises, which your Consultant or physiotherapist will work with you to develop. They will guide you through the process of carrying these out.
If you do not treat an epigastric hernia, the weakness in your muscle wall could enlarge and rarely may contain loops of the bowel. If you are unable to push the hernia back, a blockage of your bowel may occur, which causes vomiting and abdominal pain. This is known as strangulation.
Symptoms of this include a fever, vomiting and sickness. If you experience these symptoms and you have a hernia, you should contact your Consultant immediately as you may require an emergency operation.
An epigastric hernia can be generally treated by having a hernia operation, either in open surgery or with key-hole surgery (laparoscopic epigastric hernia repair).
Generally, surgeons prefer key-hole surgery as it is quicker, minimally invasive and means you can recover quicker, as well. The time between diagnosis and private hernia surgery is often less than a month, ensuring you receive rapid surgical repair treatment.
Our laparoscopic surgery requires a few small surgical incisions around the sternum by experienced and highly skilled clinicians. You will be placed under general anaesthetic for the procedure.
Using a lightweight, synthetic mesh, the Consultant will push the fatty tissue back into its normal place. Then, they will push the piece of intestine back into the abdominal cavity and cover it in a lightweight synthetic mesh. This strengthens the abdominal wall, preventing the hernia from popping out again.
This technique is referred to as an umbrella hernia repair. Previous patients who have received this treatment through mesh repair have recommended it rather than a manual pulling of the muscles together to heal the weakness, which can be more intrusive.
This less invasive surgery takes 45 minutes from start to finish, and is a day case, meaning you can arrive and leave on the day of the surgery.
A hernia operation can help to relieve pain that is caused by the hernia by reversing it entirely.
It should prevent the hernia from appearing again.
The hernia can be left alone, but pain caused by the hernia will usually continue and complications can happen if it is left untreated.
Unfortunately, this type of hernia will not get better without surgery.
Like all surgical procedures, some complications or risk factors can be serious and even cause death. However, you can discuss the following general and specific complications with your doctor:
General complications of any operation
- Pain;
- Bleeding;
- Infection of the surgical site (wound);
- Unsightly scarring of your skin;
- Blood clot in your leg, and
- Blood clot in your lung.
Specific risk factors of this operation
- Developing a collection of blood (haematoma) or fluid (seroma) under your wound, and
- Injury to structures within your abdomen.
You should be able to go home the same day after your epigastric hernia surgery procedure.
However, you won’t be able to go back to work for one to two weeks.
Returning to work will depend on how much surgery you need and the type of work you do. Your Consultant will remind you that you cannot carry out any heavy lifting for at least six weeks.
Regular exercise should help you to return to normal physical activities as soon as possible. Before you start exercising, ask your healthcare team or GP for medical advice or any queries you might have.
After six weeks, most people make a full recovery and can return to normal activities.
Overall, an epigastric hernia is a common condition caused by a weakness in your abdominal wall between your umbilicus and sternum.
If left untreated, an epigastric hernia can cause serious complications.
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