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When Are Hard Abdominal Lumps Serious?

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Last updated January 25, 2024

Hard abdominal lump quiz

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

A hard lump in your stomach could be from gas, but other causes include a hernia, cyst, and tumor. Getting the right diagnosis is key.

6 most common cause(s)

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Groin Hernia
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uterine fibroids
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Lipoma
Ovarian Cyst
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Stomach neoplasm
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Chronic myeloid leukemia (CML)

Hard abdominal lump quiz

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What is a hard lump in the stomach?

A lump in the abdomen means that there is a swelling or hard bulge in the stomach area. One of the most common causes is a hernia, but other causes include lipomas and tumors. While it is not always an emergency, it should always be checked by your doctor as soon as possible.

Common symptoms

All new lumps should be checked by your doctor. Also contact your doctor if you have any of these symptoms:

  • Pain or discomfort, especially when changing positions
  • Tenderness to the touch
  • Abdominal redness
  • Fever
  • Changes in appearance: The lump may look different when doing activities or standing, coughing, or straining
  • A burning or aching sensation
  • Hardness
  • Lump feels like it is stuck
  • Lump is getting bigger

Causes

1. Hernia

A hernia is from an organ pushing through an opening or weakness in the abdominal muscles or tissues that surround it. It can cause a noticeable lump or bulge in the area.

  • In a groin (or inguinal) hernia, part of the intestines, fat, or pelvic organs pushes through the abdominal wall in the groin.
  • In younger (usually male), groin hernias are usually from a genetic defect in the abdominal wall. In older adults, it is usually from age weakening the abdominal wall.
  • Lifestyle choices, like smoking and long-term steroid use, can weaken the abdominal wall.
  • Pressure on your abdomen—like when coughing, straining, heavy lifting, or pregnancy—can stretch your abdominal wall.
  • A surgical incision can create a weak point in the abdominal wall.

Other symptoms

  • A lump or bulge in the groin area that usually gets bigger when more pressure is put on the abdomen.
  • Pain or discomfort that gets worse when coughing, straining, or standing for a long time.
  • Pain on the inner thigh
  • Difficulty urinating
  • Generalized abdominal pain
  • Constipation

Treatment and urgency:  Not everyone feels pain or has many symptoms from a groin hernia. But see your doctor for an exam and possibly imaging tests. Your doctor may decide to do watchful waiting.

If you have intense pain, a fever, chills, nausea, vomiting, or constipation, go to the ER right away. You may need surgery.

2. Uterine fibroids

Uterine fibroids are benign growths in the wall of the uterus that most often appear during childbearing years. Fibroids are not usually cancerous.

Fibroids can cause pelvic pressure and pain, severe menstrual cramping, and heavy menstrual bleeding that leads to anemia. Fibroids can cause infertility or make it harder to become pregnant.

Other symptoms

  • Vaginal bleeding
  • Pelvis pain
  • Stomach cramps
  • Painful periods
  • Irregular periods

People at higher risk for fibroids include black women and women who had their first period at a young age. Other risk factors are vitamin D deficiency, poor diet, obesity, drinking alcohol, and family history of fibroids.

Treatment and urgency: A gynecologist can diagnose fibroids with a pelvic exam and an ultrasound. They can also prescribe medication to relieve symptoms and help regulate your menstrual cycle. There are many minimally invasive surgical options that shrink or remove the fibroids while keeping the uterus. In some cases, you may want to consider a hysterectomy, which involves removing the uterus.

3. Stomach neoplasm (tumor)

While not common, a lump in the stomach can be a tumor— benign or malignant (cancerous). A stomach neoplasm is a cancer in the lining of the stomach.

Other symptoms

  • Feeling full or bloated after small amounts of food (early satiety)
  • Severe heartburn
  • Stomach pain
  • Fatigue
  • Unexplained weight loss
  • Nausea and vomiting

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

Treatment and urgency: Diagnosis is made with upper endoscopy, CT scan, X-ray with barium swallow, and sometimes with exploratory surgery.

The earlier a cancerous tumor is found, the easier it is to treat. Early stage tumors can be surgically removed. Later stage treatment may involve removing part or all of the stomach (gastrectomy.) Radiation therapy and chemotherapy may also be needed.

4. Ovarian cyst

Ovarian cyst may be caused by hormonal imbalances, endometriosis tissue that attaches to the ovary, and by severe pelvic infections that spread to the ovaries. Cysts may also form during pregnancy. They are not usually cancerous. You may notice swelling or pressure when you push on your stomach.

Other symptoms

  • Stomach bloating
  • Vaginal bleeding
  • Pelvis pain
  • Lower abdominal pain
  • Lower back pain
  • Pain during sex

Treatment and urgency Diagnosis is made through ultrasound. Sudden, severe abdominal pain could be a ruptured cyst. This is a medical emergency and you should go to the ER or call 911. In some cases, you may need surgery to remove the cyst.

Hormonal birth control, like the pill, injection, or patch, prevents cysts from forming by stopping ovulation.

5. Lipoma

Lipoma is a fatty tumor, but a lipoma is not cancer. It is a growth of fat between the muscle layer and the skin above it that sometimes grows in the stomach area.

Other symptoms

  • Soft, easily moveable lump beneath the skin
  • Skin-colored bump
  • Painless unless pressing on nerves around it.

The exact cause of a lipoma is not known. They are more common in people after age 40. Lipomas are most often found on the abdomen, back, and neck.

Treatment and urgency: Always have any new or unusual growth checked by a medical provider. Diagnosis is made through physical examination, biopsy, and imaging like ultrasound or CT scan.

Lipomas do not usually need to be treated. But if they are bothering you, causing pain, or are getting too big, they can be removed.

6. 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. If the spleen gets enlarged, you may feel a hard lump on the left side near the ribcage.

Other symptoms

  • Stomach bloating
  • Pain on the left side of the mid abdomen
  • Fatigue
  • Fever
  • Shortness of breath
  • Unexplained weight loss
  • Loss of appetite
  • Night sweats

CML is believed to have a genetic cause, though it is not hereditary. It is most often diagnosed in older male adults and is rare in children.

Treatment and urgency: It is important to see a medical provider if you have these symptoms. Early treatment can make a difference. 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, strengthening the immune system, and sometimes a blood stem cell transplant.

When and how to treat a hard lump on the stomach?

Always see your doctor right away if you have a lump in your abdomen as there are many conditions that can cause it.

Go to the ER or call 911 if you have a stomach lump and

  • Nausea and/or vomiting
  • Fever
  • Sudden, intense pain
  • Lump changes color
  • Not able 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 cut off blood flow to the trapped tissue. When this happens, it creates a strangulated hernia, which can be life-threatening if not treated immediately.

FAQs

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

This is called reducibility. If the lump can easily be pushed back into the opening or weakness, it is a sign that it can be treated by closing the hole and delay the need for surgery.

Will a hard abdominal lump affect my digestion?

Depending on the cause, your digestion may be affected. If it’s cancer, a growth may block the flow of food and cause symptoms like pain, nausea, and vomiting. But for conditions like some hernias, digestion is not usually affected.

Can I still exercise with a hard abdominal lump?

You can exercise if you are careful and don’t irritate the abdominal tissues or increase intra-abdominal pressure. Always check with your provider before exercising. Low-intensity exercises like dancing, walking, or water aerobics may be good options. But activities like heavy weightlifting can cause you to strain and put more pressure on the abdomen.

After my abdominal lump is repaired, when can I start exercising?

When you can exercise and do other physical activity depends on the size of your lump and how it was treated. Generally, most people return to their normal level of physical activity after four to six weeks.

Can a hard abdominal lump be inherited?

Some abdominal lumps that are cancerous can have an inherited risk. But for conditions like surgical or developmental hernias, hereditary does not play a role.

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?
  • What is the location of your abdominal lump/bump?
  • Do you feel pain when you touch the bump?
  • Do you have a rash?
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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
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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