A wide variety of conditions, ranging from benign to life threatening, can cause upper abdominal pain.
"Stomach pain" is one of the top 20 reasons people seek medical care, accounting for 1.5 percent of outpatient office visits in the U.S. Although upper abdominal pain may be related to your stomach, it could stem from other organs. When evaluating your abdominal pain, your physician will typically ask where your pain is; how long it has been present; whether it is sharp, dull, constant or intermittent; and whether other factors aggravate or alleviate your discomfort, such as eating, having a bowel movement or changing position. These and other details will help your doctor eliminate some of the many possible causes of upper abdominal pain.
Right Upper Abdominal Pain
Dull, persistent pain beneath your right ribs could be generated by inflammation, infection or a mass in your liver. Intense, recurrent pain in this area is often a sign of gallbladder disease, particularly if the discomfort begins an hour or two after a meal, reaches a peak within a few minutes and lasts for several hours before decreasing. If your pain is relieved by having a bowel movement or passing gas, you could be constipated, suffering from irritable bowel syndrome or feeling the effects of diverticulosis, a condition characterized by bubble-like protrusions along the wall of your colon. Although they are more likely to cause flank or lower abdominal pain, kidney stones can cause upper abdominal pain, too.
Middle Upper Abdominal Pain
The most common causes of pain in the pit of your stomach are peptic ulcer disease, acid reflux and gastritis, or inflammation of the stomach lining. If your pain is worse when your stomach is empty and abates when you eat, you may have an ulcer. Most ulcers are caused by Helicobacter pylori, a bacterium that infects the stomach lining and triggers inflammation. However, people who routinely take aspirin, ibuprofen (Motrin, Advil) or other antiinflammatory drugs are also at increased risk for ulcers. Antiinflammatory drugs can cause gastritis, too, as can alcohol, smoking and excess consumption of coffee or other irritants. The pain of gastritis behaves much like that of ulcers. Persistent pain in the upper middle portion of your abdomen could indicate damage to your lower esophagus, the hollow tube leading from your throat to your stomach. Many people with acid reflux disease develop erosions, or ulcerations, at the bottom of their esophagus, and these injuries may generate upper abdominal pain. Pancreatitis -- inflammation of the pancreas -- and pancreatic cancer are less common causes of middle upper abdominal pain. The pain from these conditions can vary from dull to severe, is usually fairly constant and often radiates to your back. People who have gallstones or drink heavily are at heightened risk for pancreatic diseases.
Left Upper Abdominal Pain
Left upper abdominal discomfort most often stems from constipation, irritable bowel syndrome or, less commonly, diverticulosis of the colon. These conditions are typically associated with a change in the form or frequency of your stool, and having a bowel movement usually changes the character of the pain. Because the вЂњtailвЂќ of your pancreas stretches toward your left side, pancreatitis can cause left upper abdominal pain. Likewise, pain from your left kidney can radiate to this region. Your spleen, which is tucked beneath your left lower ribs, is rarely a source of discomfort, but it can generate pain if it becomes swollen or damaged. Infectious mononucleosis, certain cancers and sickle cell disease -- an inherited blood disorder -- are possible causes of spleen-generated pain.
Most upper abdominal pain is associated with conditions that are not serious. However, up to 10 percent of people who present to emergency rooms or family doctors with abdominal pain have problems that are potentially life threatening or require hospitalization or surgery. In some cases, upper abdominal pain is traced to sources outside the abdomen, such as heart disease. If twisting, bending or stretching aggravates your pain, you may be dealing with a muscular strain in your abdominal wall. Pain that persists or becomes severe or that is accompanied by persistent vomiting, high fever, weight loss, blood in the stool or any other worrisome signs or symptoms warrants immediate medical attention.