Key takeaways:
- A lump between the ribcage above the stomach may indicate many underlying health problems.
- A lump in the center of the abdomen may be due to epigastric hernia, certain types of cancer, or other issues.
- Consult with your healthcare practitioner when you observe a lump on your abdomen.
- Routine health check-ups may help you to catch health issues early and increase your chances of a better prognosis.
Unusual activities within the body may manifest as a sign or a symptom. A sign that is easily visible is an overgrowth on the abdomen, observed as an abdominal mass or lump between the ribcage above the stomach.
In the majority of cases, an abdominal lump can be an innocuous growth that can either go away on its own or through mild treatment. However, sometimes, it can signal a serious underlying condition. If you see a lump on your belly, it is best to see your medical practitioner to identify the cause and further course of treatment.*
The Most Common Cause of a Lump Between the Rib Cage Above the Stomach
The most common underlying problem that can cause an abdominal mass to appear is a hernia1.
All organs inside the abdominal cavity are surrounded by connective tissue and muscle to form the abdominal wall. If there is a weak spot in this wall (caused by a lack of stiffness in the fascia2), the part of the organ closest to it may squeeze through this newly formed opening to enter the adjoining cavity, resulting in a hernia.
A weak spot may occur in the connective tissue or the muscle as a result of increased abdominal pressure. This can be caused by constipation, diarrhea, persistent coughing, sneezing, or lifting a heavy object. Weakness in abdominal muscles further contributes to an increased risk of a hernia; causes of weakness include poor nutrition, obesity, smoking, and old age3.
Your abdominal cavity is home to a number of organs. The location of the abdominal mass on your belly may help your healthcare practitioner begin to identify which organ (or associated structure) it is coming from. Lumps can be classified as either epigastric (if it is located in the center of the belly, just below the rib cage) or periumbilical (if it is located around the navel or belly button).
Epigastric hernias
A lump between the rib cage above the stomach is often due to a condition called an epigastric hernia4. The epigastrium is the part of your abdominal cavity that is just below the rib cage. In this condition, a lump may be visible just below the sternum or breastbone or above the belly button. This can often be noticed as a lump in the stomach when lying down.
When the abdominal wall in this area weakens, fatty tissue pushes through the weak spot and forms a lump. This condition is often asymptomatic5. The only symptoms are tenderness and a slight pain in the lump as the fatty tissue is pinched by the muscles in the abdominal wall. A development in the pain or levels of discomfort may be a cause for concern.
Epigastric hernias won’t go away on their own. They may worsen over time, and, for this reason, surgery is often recommended, even if pain and discomfort are not extreme6. Serious complications can arise from hernias. These may include bowel obstruction, which can be life-threatening, or the strangulation or incarceration of the hernia, which occurs when the tissue becomes trapped, and the blood supply is cut off, leading to tissue death5.
Other Reasons for an Abdominal Mass
There can be many possible causes for lumps on the abdomen:
1. Cysts
Cysts are small sac-like structures usually filled with a semi-solid material7. They can form anywhere in the body, including as a painful lump on the rib cage or on the abdomen. Cysts that may cause a lump on the abdomen include ovarian cysts8, pancreatic pseudocysts9, and peritoneal inclusions10. In rare cases, cysts may become cancerous11.
Cysts, especially those that are easily visible, can be cleaned by draining the fluid and helping it to heal. However, cysts are usually a manifestation of an underlying cause, so the focus should be on treating the condition.
Most cysts form inside the body and may cause complications if they go undiagnosed and untreated. An imaging test like a full-body MRI can help detect such abnormalities inside the body.
Recommended reading: What’s the Difference Between a Cyst vs. Tumor?
2. Lipoma
Lipomas are soft tissue tumors that form due to the slow growth of fatty tissue12. They aren’t cancerous. They cause soft, rubbery lumps that move when you touch them. They can be found all over the body, often manifesting as painless lumps under the ribcage.
They are very common, with approximately 1 person in every 1,000 having them. Most lipomas will not cause any problems and can often go unnoticed. If a lipoma is bothering you, it may be removed through a minor surgery.
3. Bacterial Infection
A bacterial infection can cause an abscess or a furuncle (boil), each of which may cause a lump on the surface of the skin13,14.
An abscess is a pus-filled pocket where bacteria enter the skin through a cut or a scratch, localize, and start multiplying. An infection involving a hair follicle may also result in a boil or a furuncle.
The body’s immune system reacts to these foreign bodies, leaving many dead cells – both bacterial and tissue – in addition to liquid that has been released from the surrounding blood vessels. As the tissue dies, it creates a cavity. Pus fills the cavity and causes a lump-like structure.
The lumps are usually tender to the touch and very painful. Treatment is through antibiotics.
4. Hematoma
When a blood vessel ruptures due to a trauma injury, blood leaks out into the tissues, where it accumulates, causing what is known as a hematoma15. The formation of a lump is often a result of an associated inflammatory response.
Other conditions, including diseases, pregnancy, menstruation, labor, and taking certain medications, may also cause hematomas.
Most hematomas naturally resolve with time. If the trauma is severe, there may be widespread internal bleeding and damage that may require medical intervention.
5. Splenomegaly
Splenomegaly is a condition in which your spleen becomes enlarged due to an underlying condition like liver disease, infections, or blood cancers16. The enlarged spleen bulges out and can be felt as a lump on the upper quadrant of the abdomen.
The first step is to assess why the spleen is enlarged through a spleen MRI and then to coordinate an appropriate treatment.
6. Abdominal Aortic Aneurysm
An aortic aneurysm is a condition in which the aorta undergoes balloon-like bulging17. The aorta is a major blood vessel that carries blood from your heart to the rest of your body. The bulge on the aorta may burst and cause extreme complications, even death.
If the bulging occurs further down the aorta, it is called an abdominal aortic aneurysm18. This results in a lump in the abdomen below the chest. While the lump itself may not be as painful, it may relate to throbbing, pulsating pain in the back or the left side.
Treatment of this condition is by a combination of medicines and surgery.
7. Xiphoid Syndrome (Xiphodynia)
The xiphoid process, also referred to as the metasternum, is a small, bony extension of the sternum at its lower end19. When this part is damaged, it gets inflamed. The resultant swelling may form a lump in the middle of the chest, between the ribs.
The sternum, or breastbone, is in the center of the chest; chest trauma is, therefore, the major cause of inflammation in the xiphoid process.
Treatment depends upon the extent of the injury. Before deciding on the course of treatment, the healthcare practitioner will first need to confirm the diagnosis. This is usually done using imaging tests such as MRI or CT scans.
If the xiphoid process isn’t fractured and is only inflamed, medication may help treat the condition. If, however, the damage is extensive, surgery may be needed.
8. Crohn’s Disease
Crohn’s disease is a severe condition affecting the digestive system20. The digestive tract is inflamed, resulting in abdominal pain and severe diarrhea that results in malnutrition, fatigue, and weight loss.
This condition may cause the formation of a mass in the right lower quadrant.
9. Cancer
In rare cases, the abdominal mass observed on your belly may be a tumor of the underlying organ.
Not all tumors are cancerous. To verify, you need a proper diagnosis from a medical professional.
If the abdominal mass is seen as a lump between the ribcage above the stomach, it may be a cancer of the stomach or the pancreas.
Note: ezra does not examine the stomach, as MRI technology is not the preferred way to scan this part of the body.
If the lump is in the right upper quadrant, it may be due to cancer of the liver or gallbladder. However, liver enlargement may also be due to other conditions. Similarly, if the lump is due to a problem with the gallbladder, it might either be cancer or cholecystitis (inflammation of the gallbladder21).
If the abdominal mass is in the left upper quadrant, it may indicate the involvement of the spleen, gut, or kidney.
What To Do About Abdominal Lumps
If you think you have a lump in the upper abdomen, visit your healthcare practitioner. However, a lump might not be apparent to you and will only be found during a routine physical exam.
Your healthcare practitioner will ask you to get a few tests. These may include blood tests, urinalysis, biopsy, and imaging tests like a CT (computed tomography) scan or MRI (magnetic resonance imaging) scan22,23.
A lump between the ribcage above the stomach may indicate many things, from minor issues like abscesses, cysts, and lipomas to more serious causes like hernia or cancer.
Routine visits to your healthcare practitioner may reveal a lump unnoticed by yourself, as many lumps are asymptomatic.
When to Seek Emergency Care
All lumps should be assessed by a healthcare professional. However, this can generally be done via a non-emergency route. Emergency care should be obtained in the following situations:
- A sudden and severe pain in the abdomen.
- Vomiting, nausea, or a fever alongside the lump.
- An inability to pass stool.
- A pulsating lump in the abdomen accompanied by severe pain.
These symptoms could be indicative of serious conditions, such as bowel obstruction, a strangulated hernia, or a ruptured aneurysm – all of which are considered medical emergencies and require medical attention as soon as possible24,25.
Stay Ahead of Health Issues With Proactive Screenings
At Ezra, we believe routine, annual screenings help you gain a look inside your body, so you have more information about what might be happening with your body. That way, you can take proactive control of your health.
Early screening may give you a better chance of a good prognosis. The Ezra Full Body is a full-body screening service that scans up to 13 organs for potential cancer.
As part of this service, you will get a 45-minute follow-up consultation with a medical provider to walk you through your easy-to-interpret Ezra report, and a personal care advisor to answer questions you may have throughout your Ezra experience.
Our scans are fast, reliable, and accurate and put you in an advantageous position with regard to your health.
Book your Ezra scan today or take our five-minute quiz to better understand your risk of cancer.
*Disclaimer: The information provided in this article is not intended to diagnose or recommend a specific medical treatment and should not be relied on for any medical purposes. It is intended to provide information that can help you manage your well-being. If you have any concerns about your health, please talk to a healthcare provider.
