Upper Abdominal Pain: Causes, Symptoms and When to See a Doctor

What causes upper abdominal pain?

Upper abdominal pain is most often caused by indigestion, gastritis, peptic ulcers, acid reflux, gallstones and trapped gas. Other causes include pancreatitis, liver inflammation, functional dyspepsia, a strained muscle and, less often, problems with the spleen. A heart attack can also cause upper abdominal pain, so pain with shortness of breath, sweating or chest pressure is an emergency.

What does the type of upper abdominal pain tell me?

Burning or gnawing upper pain points to gastritis, ulcers or reflux; steady severe pain under the right ribs after fatty meals points to gallstones; severe pain boring through to the back points to pancreatitis; crampy pain that moves and eases after passing gas points to gas; and pressure or squeezing with shortness of breath points to the heart. Fullness and discomfort after small meals suggest functional dyspepsia or slow stomach emptying.

Is upper abdominal pain after eating a concern?

Upper abdominal pain after eating is common and usually due to indigestion, gastritis, an ulcer, reflux or gallstones. It is a concern when it happens after most meals, wakes you at night, comes with weight loss, vomiting, trouble swallowing or black stools, or occurs in someone over 60 with new symptoms. These patterns deserve testing.

See stomach pain after eating and pain above the belly button.

When is upper abdominal pain an emergency?

Upper abdominal pain is an emergency when it is sudden or severe, spreads to the back, comes with chest pressure, shortness of breath, sweating or pain in the arm or jaw, or occurs with persistent vomiting, vomiting blood, black stools, fever, yellow skin or eyes, or a rigid belly.

How can I ease mild upper abdominal pain?

For mild upper abdominal pain that seems digestive, eat smaller, low-fat meals, avoid alcohol, spicy foods and late meals, stay upright after eating, and avoid ibuprofen, naproxen and aspirin. Antacids may ease indigestion. Pain that lasts more than a few days or keeps returning should be evaluated.

How is upper abdominal pain diagnosed?

Diagnosis begins with a history and exam, then targeted tests: an ECG when the heart is a concern, blood tests including liver tests, lipase and a blood count, an H. pylori test, an abdominal ultrasound for the gallbladder and liver, CT imaging for pancreatitis or other problems, and an upper endoscopy (EGD) to look for gastritis, ulcers and reflux damage.

Learn about upper endoscopy and abdominal pain by location.

Key takeaways

• Upper abdominal pain most often comes from indigestion, gastritis, ulcers, reflux, gallstones or gas.
• The side and type of pain help point to the organ involved.
• Pain into the back may signal pancreatitis; pain with pressure and shortness of breath may be the heart.
• Pain after most meals, with weight loss or bleeding, deserves testing.
• Ultrasound, blood tests and upper endoscopy are common next steps.

Frequently asked questions

Sources

1. NIDDK — Indigestion (dyspepsia)
2. NIDDK — Gastritis and gastropathy
3. NIDDK — Gallstones
4. NIDDK — Pancreatitis
5. MedlinePlus — Abdominal pain
6. NHLBI — Heart attack symptoms

Where to be seen in Katy and Cypress

United Gastroenterology Associates has two offices: Katy, at 23920 Katy Freeway, Suite 555, next to Memorial Hermann Katy Hospital, and Cypress, at 21216 Northwest Freeway, Suite 640, on US-290. Both are open Monday through Friday, 8:30 AM to 5:00 PM, closed for lunch from 12:00 to 1:30 PM, and serve patients from Fulshear, Richmond and across Greater Houston. Call (346) 340-4414 for either office.

If you have severe pain, vomit blood, pass black stools or have chest pain, call 911 or go to the nearest emergency room.