A linea alba hernia occurs when tissue protrudes through a defect in the midline tendinous seam of the abdominal wall, most commonly at or just above the umbilicus. Because the defect is small and lies between the rectus muscles, symptoms are often subtle but may include:

1. Midline bulge
   A soft, round or fusiform swelling appears along the midline when standing, coughing, or performing sit-ups; it reduces spontaneously when supine.
2. Local discomfort or ache
   A dull, pulling pain is felt precisely at the defect, especially after prolonged standing, lifting, or core exercise; it is relieved by rest and manual pressure.
3. Tenderness on palpation
   Pressure over the linea alba reproduces pain even when the hernia is reduced; fingertip may feel a small slit-like gap (usually 0.5–2 cm).
4. Heaviness after meals
   Some patients note increased fullness or tension in the epigastrium after large meals or carbonated drinks, probably due to raised intra-abdominal pressure.
5. Absence of skin changes
   Overlying skin remains normal; redness, warmth, or rapid enlargement are unusual unless incarceration occurs.
6. Incarceration/strangulation flags
   Sudden sharp pain, nausea, vomiting, and a firm, tender, non-reducible midline mass with skin discoloration indicate compromised contents and mandate emergency evaluation.

Because the bulge is small and may be hidden between rectus muscles, diagnosis often requires ultrasound or dynamic MRI during Valsalva manoeuvre. Any persistent midline swelling or exercise-related epigastric pain should prompt imaging.