Epigastric Pain

What is Epigastric Pain and where is it located?

The epigastrium is a quadrant of the abdominal cavity located between the costal margins and the subcostal muscular plane situated in the center of the abdomen. This region contains many vital organs such as stomach, pancreas, duodenum, a part of the liver along with some muscles, fascia and peritonium. Epigastric pain can be a result of dysfunctioning of any of these organs. It may also be possible that the pain is being radiated to the epigastric area from another diseased organ. There are many characteristics attributed to epigastric pain. It can occur during feeding or after the meal, it can occur at a particular time or irregularly at any time. It can also range from dull or moderate to a severe one.

Being a common symptom of the gastroesophageal reflux disease (GERD) commonly knows as heartburt, it is commonly associated with movement of gastric contents upwards the esophagus, into the throat, which causes a burning pain and inflammation.

Gastric pan is a benign ailment and is seen to resolve on its own, though, immediate medical therapy should be sought for, if the pain is persistent.

What are the causes of Epigastric Pain?

Underneath is a detailed account for various causes leading to an epigastric pain.

Acid reflux: the term acid reflux is used to indicate throwing up or anti-peristaltic movement of food along with stomach acids, back into the esophagus which causes a common condition known as heartburn. If this condition becomes constant and persistent, it may cause GERD or gastroesophageal reflux disease, which may require proper medication.

Common symptoms associated with acid reflux are:

• Indigestion
• Heartburn
• Soreness or hoarseness in throat
• Continuous coughing
• Feeling of lump in the throat
• Bitter acidic taste on the tongue

Heartburn and Indigestion: heartburn results from acid reflux which may lead to a sharp pain in the chest. Dyspepsia or indigestion happens when food that is eaten cannot be casually digested and hence shows various symptoms. During heartburn, acid from the stomach moves up faster n a bent down or lying position, producing inflammation in the chest.

Various symptoms of indigestion are:

• Bloated abdomen
• Constant burping
• Nausea
• Constricted bowel movement due to gas pressure in the abdomen
• Stomach feels full without eating much

Lactose Intolerance: This occurs when proper digestion of dairy products, that is, food items containing lactose, does not take place because of lack of lactase enzyme in the body, which breaks down lactose into its simpler forms. This might be for a short period of time, but in some individuals, lactose intolerance produces allergic inflammatory reactions.

Here are some common symptoms of lactose intolerance.

• Epigastric pain
• Gas pressure in abdomen
• Diarrhea
• Nausea
• Bloating

Alcoholism: if too much alcohol is consumed everytime for a long period of time so as to cause addiction, may cause inflammation of the lining of stomach. In the long run, this may lead to internal bleeding.

Alcoholism can cause condtions like:

• stomach inflammation also known as Gastritis
• Liver diseases
• Pancreatic inflammation also known as pancreatitis

Overeating: this is the leading cause of acid reflux and hence leads to epigastrc pain felt after consuming a heavy meal. Eating disorders such as vomiting after consuming food or bringe eating may also account for epigastric pain.

Hiatal Hernia:this condition arises when the stomach is pushed upwards through the hiatus, a hole in the diaphragm for passage of esophagus. These generally ar painless.

Symptoms may include:

• Heartburn
• Sore throat
• Loud burps
• Indigestion

Esophagitis: this happens when the internal lining of the esophagus is inflamed by acid reflux, allergies, chronic irritation due to medication or infection. If this condition goes untreated, it leads to scarring and abberations of the esophageal lining.

Common symptoms include:

• Heartburn
• Unpleasant taste in the mouth
• Having trouble in swallowing
• Continuous coughing

Gastritis: this condition arises when the mucosal lining of the stomach is irritated due to bacterial infection, damaged stomach or immune system disorder. It can be short-lived or can become chronic if not treated on time.

Other causes may include gallstones, Barrett’s esophagus, peptic ulcer disease, stomach cancer, pre-eclampsia, ruptured aortic aneurysm, irritated bowel syndrome etc.

Diagnosis and Treatment of Epigastric Pain

The medical practitioner feels for tenderness or rigidness in the abdomen. Pain generally subsides without any medication but for severe ailments the following might be required.

• Medication should be given to stop vomiting, pain , reduce stomach acids or for treating an infection.
• Blood and urine tests are performed.
• X-Ray can be carried out to check proper functioning of kidneys and bladder.
• Ultrasound can be carried out to rule-out gallstones or various blockages
• Faecal sample may be tested for occult blood to verify internal bleeding.

FAQs Related to Epigastric Pain

How can epigastric pain be avoided?

A record of all the symptoms, their intensity, duration and frequency should be noted for future referencing. A lot of healthy foods should be eaten and body should be kept hydrated by consuming good abount of water and other fluids.

When should immediate care be sought?

In case of severe, sudden pain, vomiting, coughing up blood, blood in bowels or urine, drowsiness, heavy breathing, immediate care should be sought.