Why Do I Have a Bulge Below My Rib Cage?

September 29, 2025 •

4 min read

Approximately two percent of all abdominal hernias are epigastric, causing a bulge in the upper abdomen. Understanding the potential reasons behind why you have a bulge below your rib cage is essential for proper health management and peace of mind.

Quick Summary

A bulge below the rib cage could be a number of things, including an epigastric hernia, a benign fatty tumor known as a lipoma, or an enlarged internal organ. Proper diagnosis is critical for differentiating between harmless causes and those requiring medical intervention.

Key Points

Consider an epigastric hernia: A common cause of a bulge in the upper abdomen, often made more prominent by straining or coughing.
Assess for a lipoma: This harmless, slow-growing fatty lump is soft, rubbery, and can move easily under the skin.
Watch for signs of organ enlargement: An enlarged liver or spleen can cause a bulge, with location indicating the potential organ involved.
Monitor for emergent symptoms: Seek immediate medical help if the bulge is accompanied by severe pain, fever, or changes in color.
Get a professional diagnosis: A doctor can perform a physical exam and imaging tests to determine the precise cause of the bulge and provide appropriate treatment.

Common Reasons for a Bulge Below the Rib Cage

When you discover a new lump or bulge on your body, it's natural to be concerned. In the area just below the rib cage, several conditions could be the cause. While most are not life-threatening, a medical evaluation is the only way to get a clear diagnosis and determine the best course of action.

Epigastric Hernia

An epigastric hernia is one of the most frequent causes of a bulge in the upper abdomen, located between the breastbone (sternum) and the belly button. This occurs when fatty tissue or part of the intestine pushes through a weak spot in the linea alba, the connective tissue that runs down the front of the abdomen.

Symptoms may include:

A noticeable bulge that might appear when you stand and disappear when you lie down.
A dull ache or sharp pain, which can worsen with straining, such as coughing or lifting heavy objects.
Sometimes, they cause no symptoms at all, and the bulge is the only sign.

Lipoma

A lipoma is a non-cancerous, fatty growth that develops just beneath the skin. These lumps are typically:

Soft and doughy to the touch.
Easily moveable with slight finger pressure.
Slow-growing and often painless, unless they grow large enough to press on a nerve.

Lipomas can occur anywhere on the body, including the abdomen, and are a benign explanation for a bulge below the ribs.

Organ Enlargement

The upper abdomen is home to several major organs, and their enlargement can sometimes present as a bulge.

Liver Enlargement (Hepatomegaly): The liver is located primarily under the right rib cage. Conditions like fatty liver disease or hepatitis can cause it to become enlarged, potentially creating a palpable mass or bulge on the right side.
Spleen Enlargement (Splenomegaly): Situated on the left side, the spleen can enlarge due to infections, liver disease, or blood disorders, sometimes becoming large enough to feel.

Other Abdominal Masses

In some cases, the bulge could be caused by other types of growths or fluid collections:

Pancreatic Pseudocyst or Abscess: Following a bout of pancreatitis, a fluid-filled sac (pseudocyst) or a collection of pus (abscess) can form on the pancreas, located behind the stomach.
Hematoma: An accumulation of blood under the skin after an injury can form a hard lump that usually resolves on its own.
Cysts: Various types of benign or malignant cysts can develop in the abdominal region.
Tumors: While less common, tumors can sometimes grow on or around the ribs or internal organs.

Comparison of Common Bulge Causes


Cause	Characteristics	Associated Symptoms
Epigastric Hernia	A soft bulge, often appears with straining. Can be small or large.	Dull ache or sharp pain, especially with strain. May be asymptomatic.
Lipoma	Soft, rubbery, moveable lump under the skin. Slow-growing.	Usually painless, unless pressing on a nerve. Harmless and benign.
Enlarged Liver/Spleen	Firm, non-moveable mass under the right (liver) or left (spleen) rib cage.	May include pain, discomfort, fatigue, jaundice (with liver issues).
Pancreatic Pseudocyst	Lumpy, tender mass in the upper abdomen.	Pain, nausea, vomiting, possibly related to recent pancreatitis.

When to Seek Medical Attention

While many causes are benign, a medical evaluation is crucial to rule out more serious conditions. You should see a doctor if:

The bulge is new, rapidly growing, or changes in color.
You experience severe, sudden abdominal pain, especially with nausea and vomiting.
The bulge becomes tender, firm, or discolored.
You have a fever or other systemic symptoms in conjunction with the bulge.
You have a known hernia and its symptoms worsen or it becomes incarcerated (stuck outside the abdominal wall).

What to Expect at the Doctor's Office

During your appointment, a healthcare provider will conduct a physical examination, feeling the area of the bulge. They will ask about your symptoms, medical history, and when the bulge appeared. Depending on their findings, they may recommend further diagnostic tests to confirm the cause. These tests can include:

Ultrasound: Uses sound waves to create images of the inside of your body, which can help visualize soft tissues, organs, and fluid collections.
CT Scan: Provides detailed cross-sectional images, offering a clear view of abdominal structures and potential masses.
MRI Scan: Creates highly detailed images of organs and soft tissues, which can be particularly useful for complex cases.

For more detailed information on abdominal issues, you can consult reputable sources like the Cleveland Clinic. Learn more about different hernias and treatments here.

Conclusion

While a bulge below the rib cage can have multiple causes, from the relatively harmless lipoma to a more complex epigastric hernia, it should always be evaluated by a healthcare professional. Early and accurate diagnosis is the best way to ensure proper management and treatment. Ignoring a new or changing mass is not recommended, as some conditions, while rare, can lead to serious complications if left untreated. By being proactive and seeking a medical opinion, you can address any concerns and maintain your overall health.

Frequently Asked Questions

Yes, weight gain, especially around the abdominal area, can sometimes create the appearance of a bulge or increase the visibility of an existing hernia. However, it's still crucial to have any new lump or mass evaluated by a doctor to rule out other medical causes.

Not necessarily. Many potential causes, such as a lipoma or a small epigastric hernia, can be painless. While the absence of pain may be reassuring, it does not rule out all medical conditions. A professional diagnosis is still recommended.

A doctor typically begins with a physical examination, feeling the bulge and surrounding area. They may also order imaging tests like an ultrasound, CT scan, or MRI, which provide detailed images of the internal organs and tissues to help pinpoint the cause.

While it is a rare possibility, a lump in the abdomen can sometimes be a tumor. A doctor will evaluate the characteristics of the bulge, such as its firmness and texture, and may order further testing like a biopsy if cancer is suspected. The vast majority of such bulges are benign.

Treatment for an epigastric hernia depends on its size and symptoms. A small, asymptomatic hernia may simply be monitored. For larger or painful hernias, surgical repair is typically required to push the tissue back into place and close the weak spot in the abdominal wall.

An enlarged liver can cause symptoms such as fatigue, jaundice, and abdominal pain on the right side. An enlarged spleen, on the left, can cause pain or a feeling of fullness after eating small amounts. These conditions often have other systemic symptoms related to the underlying cause.

A bulge that becomes more prominent when you strain, cough, or lift heavy objects is highly suggestive of a hernia. The increased pressure inside the abdomen pushes the internal tissue or organ through the weak spot in the muscle wall, making it more visible.