Hi, Painful bulge in central abdomen after bouts of coughing can be due to hernia unless proved otherwise. This can be diagnosed well by clinical examination by a general surgeon and high resolution Ultrasound. The hernia has classical finding of enlargement on coughing and is always reducible unless obstructed. If this is not a hernia then it can be divarication of recti in which the mid-line being weak gives way to cause a bulge. Please get this confirmed and if hernia then get a plan for surgery at an appropriate time. Take care not to strain on abdominal muscles. This can not be a plain strain as there is no bulge in case of spasm, there is local tenderness and the swelling is not reducible. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. T. Chandrakant, General Surgeon