Causes Of Epigastric Pain
Epigastric pain is pain in the upper abdomen. It can be a sign of disease. Common causes include:
Acid reflux (stomach acid flowing up into the esophagus) Gastritis (irritation of the stomach lining) Most often this is from aspirin or NSAID medicines such as ibuprofen, bacteria called H. pylori, or frequent alcohol use. Peptic ulcer disease Inflammation of the pancreas Gallstone Infection in the gallbladder
Pain may be dull or burning. It may spread upward to the chest or to the back. There may be other symptoms such as belching, bloating, cramps or hunger pains. There may be weight loss or poor appetite, nausea or vomiting. Since the cause of your pain is not certain yet, you may need more tests.
What is the treatment of epigastric pain?
10. Pregnancy – It is very common to feel mild epigastric pain during pregnancy. This is commonly caused by acid reflux or pressure on the abdomen from the expanding womb. Changes in hormone levels throughout pregnancy can also aggravate acid reflux and epigastric pain.
- Severe or persistent epigastric pain during pregnancy can be a sign of a more serious condition, so a woman should visit her doctor if experiencing any unusual symptoms.
- Share on Pinterest An endoscopy may be carried out to find the cause of unexplained epigastric pain.
- Diagnosing the cause of epigastric pain is essential to ensure proper treatment.
A healthcare professional will likely ask a series of questions about the pain and any additional symptoms. If the cause is unclear, they may order tests, including:
imaging tests, such as X-rays, ultrasound, or an endoscopy urine tests to check for infections or bladder disordersblood testscardiac tests
Treating epigastric pain will vary according to the cause. For instance, if overeating frequently causes epigastric pain, a person may wish to eat smaller portions and ensure they are eating filling foods, such as lean proteins. They may also want to avoid foods that cause gas.
Conditions such as GERD, peptic ulcers, and Barrett’s esophagus may require long-term treatment to manage symptoms. A person should work with their doctor to find a treatment plan that works for them. If a doctor thinks that taking certain medications is causing the condition, they may recommend switching to a new drug or reducing the dosage.
Over-the-counter or prescription antacids to help reduce frequent acid reflux and epigastric pain caused by stomach acid may be helpful. Occasional epigastric pain is not usually a cause for concern, but anyone with severe or persistent epigastric pain should see their doctor.
difficulty breathing or swallowingintense pressure or squeezing pain in the chestcoughing up bloodblood in the stoolnausea, vomiting, or diarrhea lasting more than 24 hours in adultshigh fever extreme fatigue or loss of consciousness
Many cases of epigastric pain can be treated and prevented by making small changes in the diet or lifestyle. Even chronic symptoms can be managed well with medications and dietary changes.
When should I go to the hospital for epigastric pain?
Emergency care for abdominal pain – If you experience the following severe symptoms, Dr. Shah recommends going to an emergency room instead of urgent care:
Severe stomach pain that makes it difficult to function, move, eat, or drink Sudden onset of stomach pain High fever Blood in your stool or vomit Stomach pain following an accident that has caused trauma to the abdomen
Heart disease can sometimes present as severe nausea or pain in the upper abdomen under the rib cage. If you have any doubt, go to the ER. “Don’t ignore any of these red flags,” Dr. Shah warns. If necessary, dial 911 for an ambulance.
What is the Rome 4 criteria for epigastric pain syndrome?
Rome Diagnostic Criteria and Differential Diagnosis – The Rome IV criteria define dyspepsia as any combination of 4 symptoms: postprandial fullness, early satiety, epigastric pain, and epigastric burning that are severe enough to interfere with the usual activities and occur at least 3 days per week over the last 3 months with an onset of at least 6 months in advance,
- After an accurate history taking and physical exam, in the absence of alarm symptoms and signs, patients are diagnosed as being affected by uninvestigated dyspepsia and can be treated empirically on the basis of their clinical manifestations.
- If the response is unsatisfactory or early relapses occur, a test and treat approach for Helicobacter pylori infection is recommended.
Symptoms of patients diagnosed with H. pylori associated dyspepsia are treated by H. pylori eradication. Patients in whom no identifiable explanation for the symptoms can be detected by traditional diagnostic procedures are diagnosed as being affected by FD.
The umbrella term “FD” comprises patients from the following categories: (1) postprandial distress syndrome (PDS) that is characterized by meal-induced dyspeptic symptoms suggestive of a motility disturbance; (2) epigastric pain syndrome (EPS), that refers to epigastric pain or epigastric burning that do not necessarily occur after meal ingestion, may occur during fasting and can be even improved by meal ingestion, is reminiscent of the clinical features typical of a peptic ulcer and needs to be distinguished from gastro-esophageal reflux disease; and (3) overlapping PDS and EPS, characterized by meal-induced dyspeptic symptoms and epigastric pain or burning.
The pathophysiology of FD is multifactorial and not fully understood. Gastroduodenal motor and sensory dysfunction as well as impaired mucosal integrity, low-grade immune activation, and dysregulation of the gut-brain axis have all been implicated, The main motor abnormalities include delayed gastric empting and impaired distribution of gastric contents with inhibited gastric fundus accommodation and abnormally distended antrum, but they correlate only partially with symptoms’ quality and severity.
- Gastric and duodenal hypersensitivities to distension, acid, lipids and other intraluminal stimuli can be found in subsets of dyspeptics.
- PDS patients are characterized by fasting and postprandial gastric hyper-mechanosensitivity, while EPS patients present decreased gastric compliance.
- Increased permeability of the mucosal barrier exposes the submucosal immune system to luminal noxious agents.
Beyond H. pylori associated gastritis, duodenal eosinophilia has been reported in FD patients, suggesting potential new therapeutic approaches. Infections, stress, duodenal acid exposure, smoking and food allergy have all been implicated in the pathogenesis of duodenal mucosal inflammatory and permeability changes.
- Post-infectious dyspepsia has been reported, although it seems to be short-lived, compared to post-infectious IBS,
- Psychosocial disorders may also play a role: anxiety, depression, neuroticism, as well as physical and emotional abuse and difficulty in coping with life events, are frequent among dyspeptic patients.
A bidirectional relationship probably exists between gut and psyche: studies on the natural history of FGIDs suggest that patients affected by FD and IBS are particularly prone to develop psychological problems,
Why wont my gastritis pain go away?
Lingering gastritis – If you experience persistent symptoms of gastritis that don’t go away despite the absence of NSAIDs, alcohol, stress, and radiation, then you most likely have a serious infection in your stomach or a severely damaged gastric mucosa.
What condition presents with epigastric pain?
|Peptic ulcer disease||Epigastric pain or discomfort is the most prominent symptom.|
|Gastroesophageal reflux disease||Associated with heartburn, regurgitation, and dysphagia.|
|Gastritis/gastropathy||Abdominal discomfort/pain, heartburn, nausea, vomiting, and hematemesis.|