Epigastric comes from ”epi,” meaning upon, and ”gastric,” meaning having to do with the stomach. Epigastric pain is localized in the upper abdomen, below your ribs. It’s an umbrella term for pain that could come from various sources.
To diagnose the cause of epigastric pain, doctors will likely look at your medical history and consider what other symptoms you have. They may also order some diagnostic tests, like an ultrasound.
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What does epigastric pain indicate?
Epigastric pain may be a symptom of different conditions. Some of them may be temporary, and others may require medical assistance. Identifying other symptoms may help you determine what steps to follow.
Indigestion and overeating
When you eat, your stomach produces acid to help with food digestion. This gastric acid may irritate the lining of the digestive system and cause epigastric pain.
Eating large quantities of food in little time may also trigger indigestion and epigastric pain.
If you have indigestion, you may also experience:
- nausea
- bloating
- overall discomfort
- belching or passing gas
Indigestion may resolve on its own or with the help of over-the-counter digestive aids.
Gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD)
GER is what some people commonly refer to as heartburn. It happens when food, liquid, or acid from your stomach comes back up your esophagus. It may cause acid reflux.
Heartburn often comes with pain in the chest or upper abdomen. It may happen once in a while when you eat something spicy or extremely seasoned. But for some people, it may be an everyday occurrence.
When you experience GER often, it may lead to additional symptoms and complications, like GERD.
Common symptoms of GER and GERD include:
- nausea
- regurgitation
- difficulty or pain when swallowing
- burning sensation in the esophagus
- intense pain in the upper abdomen or higher
Both GER and GERD are manageable, and relief is possible.
Lactose intolerance
Lactose intolerance may cause epigastric pain when your body cannot break down dairy proteins.
Other symptoms of lactose intolerance may include:
- nausea and vomiting
- diarrhea
- abdominal cramps
- passing gas
You can usually manage lactose intolerance by avoiding dairy.
Peptic ulcer disease
Peptic ulcers may occur when an infection, eating habits, or medications cause sores on the lining of your stomach or small intestine. Peptic ulcers can cause epigastric pain and, in some cases, internal bleeding.
Other symptoms of peptic ulcers may also include:
- nausea and vomiting
- bloating
- blood in your stools
- blood in your vomit
Gastritis
Gastritis is the chronic inflammation of your stomach lining.
Bacterial infections, medications, and high stress levels may lead to the onset of gastritis.
Besides epigastric pain, other symptoms of gastritis may include:
- nausea and vomiting
- feeling bloated
- loss of appetite
- belching and passing gas
Hiatal hernia
Hiatal hernia is when a portion of the stomach moves up into the chest through your breathing muscle, also known as your diaphragm. You may live with a hiatal hernia and experience few to no symptoms. However, epigastric pain is quite common, especially when lying down.
Other symptoms of a hiatal hernia may include:
- halitosis (bad breath)
- bloating
- nausea and vomiting
- acid reflux and heartburn after eating
- difficulty or pain when swallowing
Gallbladder disorder
Conditions related to your gallbladder may cause intense epigastric pain. Organ inflammation or the presence of gallstones may be the cause of the pain.
Other symptoms of gallbladder problems, including stones, may include:
- nausea and vomiting bile (yellow fluid)
- fever
- chills
- jaundice (yellowing of the skin and eyes)
- changes in the color of your urine and stools
- back or shoulder pain
Some gallbladder conditions may become medical emergencies. It is highly advisable to seek medical assistance if you experience severe epigastric pain, fever, and referred pain, among other symptoms.
Alcohol-related irritation
Drinking alcohol, particularly without eating first, can overwhelm the gastrointestinal system and cause inflammation in the lining of the stomach. This may also cause epigastric pain, similar to that experienced in gastritis.
Epigastric pain radiating to the back
If you experience epigastric pain that radiates out into your back and you experience nausea and vomiting, you may have acute pancreatitis. It is highly advisable you receive medical attention as soon as possible.
Acute pancreatitis is inflammation of your pancreas, a large gland behind your stomach that produces hormones and digestive juices.
Symptoms of acute pancreatitis may include:
- nausea and vomiting
- constipation
- high temperature of 38°C (100.4°F) or above
- palpable swelling in the abdomen
- bloating
- indigestion symptoms
- tachycardia (fast heartbeat)
- jaundice
- rapid breathing rate
- radiating pain to the left side or the back
Finding the cause of epigastric pain
Severe epigastric pain or pain that lasts for more than an hour and is accompanied by other symptoms may require a visit to a health professional.
Your health team may gather more information about your symptoms and medical history and recommend a combination of tests, including:
- complete laboratory tests to check liver enzymes, inflammation markers, blood count, and thyroid hormones
- breath or stool tests for bacterial overgrowth and infections like Helicobacter pylori
- ultrasounds of the abdomen area
- CT scan
- upper endoscopy
- urine tests
- electrocardiogram (ECG)
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Get free cardWhen is epigastric pain an emergency?
Epigastric pain may indicate a medical emergency if you experience a combination of the following:
- severe or very sudden pain that does not subside
- increased pain when you touch your stomach
- blood in your vomit
- blood in your poop
- vomiting
- chest pain
- inability to urinate
- inability to poo or pass gas
- difficulty breathing
- dizziness
- fainting
How to treat epigastric pain
The treatment for epigastric pain may vary depending on the root cause. Because it has many possible causes, doctors will first aim to find the reasons behind your symptoms before prescribing a treatment plan.
If your pain does not subside, healthcare professionals may provide pain-relieving medications and anti-inflammatories while they decide on the next steps.
Online care services, including Optum Perks Online Care, may make getting treatment easier. With these services, you can submit an online form answering a few questions about your symptoms, and a US-licensed healthcare professional will respond soon after to prescribe a treatment plan.
Summary
Epigastric pain is in the upper abdomen, below your rib cage. Causes may include indigestion, gastritis, or acid reflux. In some cases, like gallbladder disease and acute pancreatitis, the pain is a medical emergency.
The treatment of epigastric pain may depend on the root cause and the other symptoms you are experiencing.
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