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When Are Hard Abdominal Lumps Serious?

A hard lump can be caused by gas, a cyst, or even a hernia, so getting the right diagnosis is key.
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Last updated September 17, 2020

Hard abdominal lump quiz

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Hard abdominal lump quiz

Take a quiz to find out what's causing your lump.

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Hard lump in stomach explained

The abdomen contains many important structures responsible for digestion and the filtration of toxins. When everything is in working order, you probably don't give it much thought. If you notice a lump in this area, it may be concerning; however, it does not guarantee a medical emergency.

Common accompanying symptoms and causes of a hard abdominal lump

An abdominal lump is often associated with the following:

  • Pain or discomfort: Especially when changing positions
  • Tenderness to the touch
  • Abdominal Redness
  • Fever
  • Changes in appearance: The lump may look different during activities such as standing, coughing, or straining.
  • A burning or aching sensation

Less-concerning characteristics

New lumps and bumps in the abdomen can be a sign of a cancerous process. However, there are symptoms that can be less worrisome. For example, a lump in the abdomen, even if it is hard, is less concerning if it possesses the following characteristics:

  • Easily mobile
  • Reducible: This means it can be pushed back into the abdomen with manual pressure.

Concerning characteristics

Prompt follow-up is required if the lump has the following characteristics:

  • Hardness
  • Significant pain
  • Rigidity/feeling of being stuck in place
  • Grows in size over time

Make an appointment with your physician if you experience these symptoms in order to get an appropriate diagnosis and the best course for treatment.

What causes a hard lump on the abdomen?

Abdominal structures

A hard lump in the abdomen is usually the result of one or more of the structures behaving abnormally. There are various structures within the abdominal region, including:

  • Muscles: The muscles of the groin are called the adductor muscles. These muscles allow you to bring your thighs together and work with other muscles in movements such as bringing the knees to the chest. Furthermore, the muscles of the abdomen also connect in this area.
  • Fat: There is a layer of fatty tissue under the skin that stores energy, insulates/regulates the body’s temperature and serves as a protective cushion.
  • Lymphatics: Underneath the skin, there are three to five lymph nodes — structures throughout the body that play an important role in allowing the body to fight off infections

Other conditions in the following sections can also lead to the development of a hard abdominal lump.


A hernia occurs when part of an organ pushes through an opening or weakness in the muscles or tissues that surround it. The protrusion can result in a noticeable lump or bulge in the area. Hernias can result due to the following:

  • Surgical: A surgical incision can create a weak point in the abdominal wall. After surgery, the abdominal wall is closed; however, weight gain, pregnancy, or excessive activity too soon after the procedure can result in an increase in abdominal pressure and stretching of the incision. This makes it easy for contents to protrude through the incision, resulting in a hernia.
  • Developmental: A developmental hernia, also called an umbilical hernia, occurs when intestinal contents protrude through the hole the umbilical cord passed through at birth. This hard lump is located in the area of the belly button and is easily identifiable in newborns and small children. Epigastric or Spigelian hernias can also result from improper development of the abdominal structures.

Other causes

Other causes that can lead to hard abdominal lumps include:

  • Lymphatic: The lymph nodes are structures that contain immune cells that fight infection and filter harmful substances from the body. When these structures become infected, they can swell and result in palpable lumps. The abdomen contains some lymph nodes that are susceptible to infection and swelling. If swollen lymph nodes are causing the lump in your abdomen you may also experience tenderness and fever.
  • Cancerous: A hard lump in the abdomen, especially in the abdomen of a child, can be a sign of a cancerous condition called neuroblastoma. It is very important to follow up with your physician if you notice a hard lump in that area accompanied by symptoms such as pain, weight loss or an enlarged belly.

This list does not constitute medical advice and may not accurately represent what you have.

Uterine fibroids

Uterine fibroids are benign growths in the wall of the uterus and most often appear during childbearing years. Fibroids are almost never associated with cancer.

Those at higher risk include black women and women who started their periods at a young age. Other risk factors are vitamin D deficiency, poor diet, obesity, drinking alcohol, and family history of fibroids.

Fibroids can cause pelvic pressure and pain, severe menstrual cramping, and heavy menstrual bleeding that leads to anemia. Quality of life is diminished due to the chronic pain and discomfort. Though fibroids don't always make it impossible to become pregnant, infertility and pregnancy loss may occur as well as pre-term delivery.

Fibroids can be diagnosed through a routine pelvic exam or ultrasound in a doctor's office.

A gynecologist can prescribe various medications to ease the symptoms and regulate the menstrual cycle. There are also a number of surgical techniques, some minimally invasive, to shrink or remove the fibroids while leaving the uterus in place. Hysterectomy, or removal of the uterus, is an option in some cases.

Rarity: Common

Top Symptoms: vaginal bleeding, pelvis pain, abdominal cramps (stomach cramps), painful periods, irregular period

Urgency: Primary care doctor

Hard abdominal lump quiz

Take a quiz to find out what's causing your lump.

Take hard abdominal lump quiz

Stomach neoplasm

The word "neoplasm" means "new formation" and describes a tumor that may be either benign or malignant. Stomach neoplasm means some form of cancer of the lining of the stomach.

Risk factors include gastroesophageal reflux disease (GERD;) obesity; smoking; infection with H. pylori, which causes ulcers; and a diet low in fiber and high in smoked and heavily salted foods.

Symptoms include fatigue, unexplained weight loss, persistent nausea and vomiting, feeling full or bloated after small amounts of food (early satiety,) severe heartburn, and stomach pain.

As with all tumors, the earlier they are caught the easier they are to treat. Ongoing symptoms should be assessed by a medical provider.

Diagnosis is made with upper endoscopy, CT scan, x-ray with barium swallow, and sometimes with exploratory surgery.

Early-stage tumors will be surgically removed. Later treatment may involve removal of part or all of the stomach (gastrectomy.) Radiation therapy and/or chemotherapy may be done along with surgery, and there are new and promising anti-cancer drugs now available.

Skin cyst

A cyst is a small sac or lump, filled with fluid, air, fat, or other material, that begins to grow somewhere in the body for no apparent reason. A skin cyst is one that forms just beneath the skin.

It's believed that skin cysts form around trapped keratin cells – the cells that form the relatively tough outer layer of the skin.

These cysts are not contagious.

Anyone can get a skin cyst, but they are most common in those who are over age 18, have acne, or have injured the skin.

Symptoms include the appearance of a small, rounded lump under the skin. Cysts are normally painless unless infected, when they will be reddened and sore and contain pus.

Diagnosis is made through physical examination. A small cyst can be left alone, though if it is unsightly or large enough to interfere with movement it can be removed in a simple procedure done in a doctor's office. An infected cyst must be treated so that the infection does not spread.

Rarity: Common

Top Symptoms: skin-colored armpit bump, marble sized armpit lump, small armpit lump

Symptoms that always occur with skin cyst: skin-colored armpit bump

Urgency: Wait and watch

Skin abscess

A skin abscess is a large pocket of pus that has formed just beneath the skin. It is caused by bacteria getting under the skin, usually through a small cut or scratch, and beginning to multiply. The body fights the invasion with white blood cells, which kill some of the infected tissue but form pus within the cavity that remains.

Symptoms include a large, red, swollen, painful lump of pus anywhere on the body beneath the skin. There may be fever, chills, and body aches from the infection.

If not treated, there is the risk of an abscess enlarging, spreading, and causing serious illness.

Diagnosis is made through physical examination.

A small abscess may heal on its own, through the body's immune system. But some will need to be drained or lanced in a medical provider's office so that the pus can be cleaned out. Antibiotics are usually prescribed.

Keeping the skin clean, and using only clean clothes and towels, will help to make sure that the abscess does not recur.

Rarity: Common

Top Symptoms: rash with bumps or blisters, red rash, red skin bump larger than 1/2 cm in diameter, pus-filled rash, rash

Symptoms that always occur with skin abscess: rash with bumps or blisters

Urgency: Primary care doctor

Ovarian cyst

During her reproductive years, a woman's ovaries release a single egg cell each month. But sometimes the egg remains on the surface of the ovary, where the follicle that enclosed it continues to grow. It then becomes a fluid-filled ovarian cyst.

Ovarian cysts may be caused by hormonal imbalances; by endometriosis tissue, if it attaches to the ovary; and by severe pelvic infections that spread to the ovaries. Cysts may also form during pregnancy.

Small ovarian cysts often cause no symptoms. Larger cysts may cause pelvic pain, backache, unexplained weight gain, abnormal vaginal bleeding, and/or pain during sex. Ovarian cysts are almost never a form of cancer.

Sudden, severe abdominal pain could indicate a ruptured cyst. This is a medical emergency and the patient should go to an emergency room or call 9-1-1.

Diagnosis is made through ultrasound.

Hormonal birth control, such as the pill, injection, or patch, prevents ovulation and therefore prevents the formation of cysts. Surgery to remove the cyst may be necessary in some cases.

Rarity: Rare

Top Symptoms: stomach bloating, vaginal bleeding, pelvis pain, lower abdominal pain, lower back pain

Urgency: Primary care doctor

Ovarian cancer

Neoplasm means "new growth," and an ovarian neoplasm is abnormal tissue appearing on the surface of the ovary. A benign neoplasm is not cancerous, while malignant neoplasm indicates cancer.

Ovarian neoplasm is most common in postmenopausal women with a family history of cancer. Other risk factors include menstruation at a young age with menopause at a late age; having no pregnancies; hormone replacement therapy; endometriosis; and cigarette smoking.

The earliest symptoms of malignant neoplasm, or ovarian cancer, may include abdominal cramping, bloating, and swelling; low back pain; pain during sex; and vaginal bleeding after menopause.

Diagnosis is made through pelvic examination, blood test, and/or ultrasound.

Treatment involves surgery to remove the tumor, followed by chemotherapy and/or radiation therapy.

There is no known prevention, but reducing the number of ovulations a woman experiences in her lifetime seems to reduce the risk of the disease. Late onset of menstruation and earlier onset of menopause lowers the number of cycles, while pregnancy, lactation, and hormonal birth control all suppress ovulation entirely.


Lipoma is a word that translates as "fatty tumor," but a lipoma is not cancer. It is simply a growth of fat between the muscle layer and the skin above it.

The exact cause is not known. The condition does run in families and is associated with other unusual syndromes such as adiposis dolorosa, which is similar. Lipomas most often appear after age 40.

Symptoms include a soft, easily moveable lump beneath the skin, about two inches across. A lipoma is painless unless its growth is irritating the nerves around it. They are most often found on the back, neck, and abdomen, and sometimes the arms and upper legs.

It is a good idea to have any new or unusual growth checked by a medical provider, just to make certain it is benign.

Diagnosis is made through physical examination, biopsy, and imaging such as ultrasound or CT scan.

Most of the time, treatment is not necessary unless the lipoma is unsightly or is interfering with other structures. It can be removed through surgery or liposuction.

Rarity: Uncommon

Top Symptoms: skin-colored groin bump, marble sized groin lump, small groin lump

Symptoms that always occur with lipoma: skin-colored groin bump

Urgency: Wait and watch

Colonic neoplasm

Colonic neoplasm means "new tissue" growing in the colon, or large intestine. This neoplasm may be either benign (not cancerous) or malignant (cancer.)

The exact cause of any cancer remains unknown. Risk factors seem to be:

  • Being over fifty years of age.
  • Family history of the disease.
  • A high-fat, low-fiber diet, typical in the modern world
  • Chronic inflammatory diseases of the colon such as Crohn's disease.
  • Smoking and alcohol use.
  • Diabetes, obesity, and inactivity.

The earliest symptoms are usually polyps, small growths within the colon which can be detected on colonoscopy and removed before they can become cancerous. Later symptoms may be unexplained fatigue; change in bowel habits; persistent abdominal discomfort such as gas or cramps; blood in stool; or rectal bleeding.

Diagnosis is made through colonoscopy and sometimes blood testing.

Treatment is done through surgery, which may be minor or extensive; and through chemotherapy with radiation therapy, usually done before and after surgery. Supportive care to keep the patient comfortable is also an important part of treatment.

Rarity: Rare

Top Symptoms: fatigue, stomach bloating, stool changes, diarrhea, constipation

Urgency: Primary care doctor

Chronic myeloid leukemia (CML)

Chronic myeloid leukemia, or CML, is a rare cancer of the blood. It is also called chronic myelogenous leukemia or chronic granulocytic leukemia.

"Chronic" means the condition appears gradually, over months or years. "Myeloid" cells normally give rise to red, white, and other blood cells but cannot function due to the cancer.

CML is believed to have a genetic cause, though it is not hereditary.

CML is most often seen in older male adults and rarely in children, though anyone can be affected.

Symptoms include bleeding that is slow to clot; pain on the left side of the mid abdomen; fatigue; fever; loss of appetite; unexplained weight loss; pale skin; and night sweats.

It is important to see a medical provider with these symptoms, for the disease responds best when treated early.

Diagnosis is made through physical examination, blood tests, and bone marrow tests.

Treatment most often involves therapy with specialized, "targeted" drugs. Other treatments are chemotherapy; therapy to strengthen the immune system; and sometimes a blood stem cell transplant.

Rarity: Ultra rare

Top Symptoms: fatigue, stomach bloating, shortness of breath, unintentional weight loss, feeling of fullness early in a meal

Urgency: Primary care doctor

Hard abdominal lump quiz

Take a quiz to find out what's causing your lump.

Take hard abdominal lump quiz

Cancer of fat cells

Liposarcoma is a type of cancer characterized by tumors growing in fatty tissues. This cancer can occur in any part of the body, but most often involves the thigh or the belly (abdomen).

Rarity: Ultra rare

Top Symptoms: fatigue, unintentional weight loss, abdominal bump, hard palpable mass, painless abdominal lump

Symptoms that always occur with cancer of fat cells: lump below the skin on the chest

Urgency: Primary care doctor

When and how to treat a hard lump on the stomach

When to see a doctor

Since the causes of hard abdominal lumps are varied, it is important to make an appointment with your physician in order to get the proper diagnosis and treatment. Depending on the cause of your symptoms, your physician may suggest:

  • Surgery: If an incisional or an umbilical hernia is causing your hard abdominal lump, your physician may suggest open or non-invasive surgery to relieve discomfort and prevent complications. However, if your hernia is not causing you significant pain or discomfort, your physician may suggest watchful waiting.
  • Antibiotics: If you have swollen lymph nodes due to infection, your physician will provide appropriate antibiotic treatment.
  • Cancer treatment: If your hard abdominal lump and associated symptoms are due to cancer, your physician will discuss treatment options including surgery, radiation or chemotherapy.

When it is an emergency

Seek immediate treatment in an emergency room or call 911 if the following occur:

  • Nausea and/or vomiting
  • Fever
  • Pain that is sudden and increases in intensity
  • Lump changes color
  • Inability to pass gas

These could be signs of an incarcerated hernia. A hernia is incarcerated when it becomes trapped in the abdominal wall. Incarcerated hernias are dangerous because they can wrap around themselves and cut off blood flow to the trapped tissue. When this occurs, this creates a strangulated hernia, which can have life-threatening consequences if not treated promptly.

FAQs about hard abdominal lump

Why can my hard abdominal lump be moved/pushed back into my abdomen sometimes?

This phenomenon is called reducibility. If the protrusion can be pushed back into the opening or weakness with ease, this signals that it can be treated by closing the hole. Reduction of the lump can help alleviate associated symptoms and delay the need for surgery.

Will a hard abdominal lump affect my digestion?

Depending on the cause of your hard abdominal lump, your digestion may be affected. In the case of cancer, a growth may block the flow of food and cause symptoms such as pain, nausea, and vomiting. However, in the case of conditions such as incisional or umbilical hernias, digestion is not usually affected.

Can I still exercise with a hard abdominal lump?

Exercise is acceptable if you are cautious and avoid irritating the abdominal tissues or increasing intra-abdominal pressure. You should not exercise without approval from your physician or care team. Low-intensity or low-impact exercises such as dancing, walking, or water aerobics may be good options. However, activities such as heavy weightlifting can cause you to strain and lead to increased pressure in the abdomen — and thus further bulging of the protrusion.

After repairing my abdominal lump, when can I start exercise?

When you can resume exercise and other physical activity depends on the size of your lump and the type of repair that was performed. However, most people can return to their normal level of physical activity after four to six weeks.

Can a hard abdominal lump be inherited?

Some abdominal lumps related to cancerous processes can be inherited. For example, the mutation that causes some forms of neuroblastoma in children can be inherited. However, for conditions such as surgical or developmental hernias, there is no hereditary component.

Questions your doctor may ask about hard abdominal lump

To diagnose this condition, your doctor would likely ask the following questions:

  • What color is the bump?
  • How would you describe the location of your abdominal lump/bump the best?
  • Do you feel pain when you touch the bump?
  • Do you have a rash?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

Share your story
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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