Epigastric Pain | Causes, symptoms, diagnosis & Treatment

What is epigastrium?

Epigastrium lies in the upper abdomen precisely over the stomach. The epigastric region includes the stomach, a part of the liver, pancreas, and duodenum.

What is Epigastric Pain?

Epigastric pain occurs in the upper abdominal area just below the ribs. It occurs mainly when the gastric components tend to move upwards towards the back of the throat making a person feel a burning sensation and inflammation. The pain is usually felt while eating or right after eating or lying down immediately after eating. The nature of the pain might vary from mild to severe at times.

It is quite common in pregnant women as a result of increased pressure in the abdominal area and various hormonal changes that slow down the digestive process.

Causes of Epigastric Pain

Different disease can cause this pain, so it becomes quite difficult to find out the exact reason behind it. But the common Aetiologies are the following-

  • Overeating
  • Consumption of alcohol while eating
  • Excessive spicy and rich foods
  • Cancer in the gall bladders, pancreas or stomach
  • Carcinoma of the stomach
  • Cardiovascular issues such as heart attacks
  • Gastroesophageal reflux disease (GERD) occurs due to the casting up of gastric acids into the esophagus leading to a burning pain
  • Heartburn caused by large amounts of gastric acids secreted and refluxed back to the esophagus
  • Peptic ulcers
  • Gastritis (inflammation of the stomach lining)
  • Duodenal ulcer
  • Pancreatitis (acute or chronic)
  • Hepatitis causing inflammation in the liver due to virus infection
  • Stomach disorders may generate pain due to inflammation and infection
  • Gastroenteritis
  • Gallbladder stones or inflammation
  • Abdominal aortic aneurysm
  • Continuous coughing turns chronic and may lead to pain
  • Abdominal muscle strain lead to epigastric pain
  • A hiatal hernia also cause pain in the epigastrium

Symptoms of Epigastric Pain

The pain may come along with other symptoms of the underlying disorder or the original disease. But, it may involve other symptoms like:

  • Heartburn
  • Abdominal pain
  • Indigestion
  • Swelling in the abdomen
  • Abnormal acidic taste in your mouth
  • Frequent belching
  • Throat soreness or hoarseness
  • Constipation
  • Feeling a lump in your throat
  • Ongoing cough
  • Burning sensation in the abdomen or chest area
  • Diarrhea
  • Nausea and vomiting
  • Gas problems

A few cases of epigastric pain may be symptoms of an upcoming heart attack or other life-threatening hazards:

  • Chest pain, tightness and pressure in the chest, even palpitations
  • Pain moving down the shoulder and arm
  • Difficulty in breathing may also lead to choking
  • Presence of blood or black components in vomiting

Diagnosis for Epigastric Pain

The doctor initially examines the patient’s history and conducts a physical examination along with a few tests to diagnose the actual cause:

  • Complete blood count test for determination of levels of hemoglobin & blood cells count
  • Blood test for the evaluation of liver & pancreatic enzymes
  • ESR (Erythrocyte Sedimentation Rate) to detect the rate of inflammation in the body
  • Abdominal X-ray is a must to check if there is any obstruction or mass
  • Endoscopy for assessment of problems in the esophagus such as inflammation or growth of mass
  • Urinalysis to detect urinary tract infection
  • Ultrasound test or CT scan
  • Cardiac tests are also recommended to check if the heart is involved in the pain

Treatment for Epigastric Pain

A few cases of epigastric pain might not need any treatment if further complications do not occur. However, the treatment depends on the diagnosis and the underlying cause of the pain. The following might treat pains arising due to severe disorders:

  • Antacids used to reduce excess of acids produced in the stomach
  • Intake of H2 blockers for curing peptic ulcers and preventing the excess acid formation in the stomach
  • Non-steroidal anti-inflammatory drugs (NSAIDs) might help in pain relieving and also to reduce inflammation and fever.

Home remedies

A doctor must be called in for Epigastric pain, but a few methods can be tried at home to redeem the pain. The following are-

  • Aloe Vera juice diluted into other liquids treats various stomach problems
  • Ginger tea may relieve stomach disorders by neutralizing the acid and reduce inflammation or irritation in the tissue of the digestive tract
  • Baking soda with warm water helps to neutralize acidity
  • Chamomile tea fights symptoms of epigastric pain, relieve heartburn and soothes the stomach
  • Yoghurt for indigestion
  • Eating burnt toast detoxifies the stomach
  • Peppermint tea proves to be a proper remedy except for GERD

Complications associated with Epigastric Pain

Epigastric pain although harmless in most cases may cause serious complications if the symptoms deteriorate. It results in discomfort while eating and can affect eating habits causing a weight loss. Some of these hazards include-

  • Cancer of esophagus, stomach, and other organs
  • Scarring and narrowing of the Esophagus
  • Heart attacks
  • Poor nutrition due to less eating
  • Weight loss
  • Poor life quality
  • Risk of cancer
  • Infection

When to visit a doctor?

Epigastric pain does not usually cause such risks and might go away within an hour or two. But in serious cases, one must visit a doctor when the following symptoms are common:

  • Continuation of pain more than one or two days
  • Regular burning sensation and pain after eating
  • Pain in the chest and stomach
  • Regurgitation of acid in frequent interval

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