Epigastric Hernia


What is an
Epigastric Hernia?

An epigastric hernia (say “eh-pih-GAS-trik HER-nee-uh”) occurs when fat pushes through a weak part of the belly wall. It occurs in the middle of the belly between the breastbone and the belly button, or navel. Most of the time, these hernias are small. You can have more than one at a time.

Epigastric hernias often have no symptoms. But they can cause pain in the upper belly. You may need surgery to repair an epigastric hernia. Talk with your doctor about your treatment choices.

Epigastric Hernia Repair

The best epigastric hernia repair for you will depend on the exact nature of your hernia. Epigastric hernias may be simple, such as just a small hole in the abdominal fascia. In this case, our surgeons recommend repairing the hernia by returning the bowel to its proper location, and then closing the hole in the abdominal wall. In many cases, an underlay mesh is used, which is placed to remove tension from the abdominal wall during closure. This gives the abdominal wall a chance to heal well in a tension-free environment, which is the key to a successful outcome.

Sometimes, patients with an epigastric hernia have an underlying condition called “rectus diastasis” or abdominal muscle separation. This can occur in both men and women, but is especially common after pregnancy. The muscles on either side of your abdomen, the ones that make up your “six pack,” are called the rectus muscles. They normally join at your midline, adjacent to your navel. These muscles can separate or stretch apart, called a diastasis. You can tell you have a rectus diastasis because you will notice your abdomen bulges easily after meals, it is difficult to “suck it in”, and your abdominal strength is reduced.

If your epigastric hernia includes rectus diastasis, your abdominal muscles need to be repaired. The separation of the muscles creates a natural weakness of the abdominal wall, so repair of the muscles at the same time as the hernia will decrease the recurrence rate, be a stronger repair, and will increase the strength of your entire core.

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