A common symptom of an epigastric hernia is a lump or bulge along the center of the abdomen between the breastbone and naval. The bulge is often small, causing little or no pain and may even go unnoticed. Tenderness or pain that does occur is often caused by pressure on the abdomen when lifting, bending, coughing, or straining the abdomen in other ways. The lump or bulge may be more noticeable when coughing or after eating a large meal. If the bulge grows larger, hard, and increasingly painful, these are symptoms of hernia complications that require immediate medical attention.