7 causes of Epigastric Pain with their Diagnosis & Treatment

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Epigastric pain is the discomfort in the middle of your upper abdomen just below your right rib cage. It may be a symptom of digestive system diseases alongside the other symptoms. These systems can be a pain. Discomfort or heartburn.

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Sometimes this pain is not a reason for concern, such as epigastric pain right after the meal. Many times this pain is a symptom of some underlying digestive disorders such as infections, GERD, or inflammation. Therefore, it is very important to differentiate the cause of pain before starting treatment.

Epigastric Pain Causes

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There are many causes of epigastric discomfort or pain that cause it. They include


Gastroesophageal reflux disease or GERD is a disease in which acidic food of your stomach returns back into your esophagus. This acidic food then touches the wall of the esophagus causes chest discomfort, heartburn or epigastric pain. Your doctor should monitor it on a regular basis.

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This acid reflux disease shows the following symptoms.

  • Chest discomfort
  • Heartburn,
  • Indigestion
  • Ongoing cough
  • Hoarseness
  • Abnormal acidic taste in your mouth
  • Throat soreness
  • The feeling of a lump in your throat

2- Lactose intolerance

This problem comes when your body is unable to digest dairy products like milk or cheese. All dairy products have a component LACTOSE, a type of sugar molecule. Normally all humans have lactase enzymes in their body which is present at the brush border of small intestines.

These lactase enzymes are responsible for the breakage of lactose into glucose molecules to get energy. Some patients don’t have lactase enzymes or defective enzymes in their intestines that are unable to catalyze the lactose, so they can’t digest these dairy products and causes abdominal discomfort.

Common symptoms that come with the lactose intolerance are

  • Stomach pain or epigastric pain
  • feeling bloated
  • pressure in your abdomen from gas
  • Nausea
  • diarrhea

3- Indigestion

Indigestion comes after having a meal. It happens when you take a meal, your stomach produces acid to digest the food. This acid irritates the lining of your stomach and causes irritation.

You can have the following symptoms with the indigestion

  • Nausea
  • burping
  • bloating in the abdomen
  • feeling full or bloated

4- Gastritis/ Esophagitis

Esophagitis is an inflammation of the lining of the esophagus, while Gastritis is an inflammation of the lining of the stomach. Both inflammatory diseases are an important cause of epigastric pain. Esophagitis and gastritis can be caused by some immune system disorders, acid reflux disease, infections, and reactions of certain medications. This inflammation of the digestive tract can cause scar or ulcer, if not treated soon.

5- Peptic Ulcer Disease

Peptic ulcer disease can cause acute or chronic epigastric pain. It has the two most important clinical features. If this burning pain improved by food, most probably you have a duodenal ulcer and if your burning pain worsens by food, you have a gastric ulcer. Therefore, proper history should be taken from the patient about pain, its relieving, and aggravating factors. Typically the pain is worse at night in both cases.

6- Pregnancy

Epigastric pain or stomach discomfort is very common to feel during pregnancy. The reason behind this is acid reflux or pressure on the stomach from the expanding uterus or womb. This stomach pressure washed back the food up into the stomach and cause burning and discomfort sensation. Furthermore, hormonal changes can also facilitate acid reflux disease and heartburn.

This mild stomach pain is considered to be normal during pregnancy, but severe or persistent epigastric pain during pregnancy can be an indication of a more serious condition, so in this case, a woman should call to her health care provider and should discuss her properly.

7- Overeating

A very common problem which is seen in most of the people is overeating.
Your stomach is very fragile and flexible. When you eat more than necessary, it causes your stomach to expand beyond its normal limit. If the stomach expands more than its limit, it puts pressure on its adjacent organs and causes stomach pain or heartburn. This overeating or excess amount of food in the stomach can also cause indigestion, acid reflux into the esophagus, and heartburn. Therefore, take the meal according to your need and do walk for at least 10 minutes after having a meal. It will keep your stomach healthy and safe.

How Actual Cause Of Epigastric Pain Can Be Diagnosed?

Before starting the treatment, the diagnosis of the actual cause is very important. The following steps are followed to diagnose the cause of this epigastric discomfort.

  • Take proper history of the patient
  • Physical and clinical examination

Most diagnoses are made by asking relevant questions from the patients. But if still, it remains unclear, your doctor goes to next steps

  • Ultrasound, x-ray or endoscopy
  • Complete blood test
  • Urine test to detect the infection
  • Cardiac test
  • ECG to rule out the angina pain

Epigastric Pain Treatment

Treatment of epigastric pain depends on the cause of this burning pain and the duration of this happening. If the cause is overeating, ask the patient to eat the small food in smaller portions. Make sure the patient to take green vegetables, fresh salad, fresh fruits in his diet and avoid spicy and junk food.

If the cause of epigastric pain is GERD, Barrett’s esophagus, or peptic ulcer, your doctor will recommend you proton pump inhibitors, antibiotics, and pain killers to overcome it. It takes a long time to recover.

It the cause of stomach pain is esophagitis or gastritis, anti-inflammatory medication can treat it.

In short, treatment varies from patient to patient and cause to cause. A proper plan is made by your doctor to manage your symptoms with minimum side effects.

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