Many people refer to the entire abdominal area as the stomach. This is an erroneous description since the stomach is only one of the many organs that are located inside the abdominal cavity. Not surprisingly, when people refer to upper stomach pain, they are usually referring to pain in the upper abdominal region, which may or may not be caused by problems in the stomach.
The stomach lies in the upper left quadrant of the abdominal cavity. Therefore, any pain in this region may be caused by problems in the stomach. This is more likely to be the case if the character of the pain changes with feeding. Pain caused by stomach problems may either subside or exacerbate after consumption of food.
There may be other associated symptoms such as nausea, vomiting, abdominal bloating, and excessive belching. Upper abdominal pain can also be caused by problems that are not related to the stomach. For example, problems in the small and the large intestines can result in pain in the upper abdominal region.
In some cases, upper abdominal pain may not even be related to problems within the digestive tract. For example, problems in the abdominal wall or other organs within the abdominal cavity, such as the spleen, pancreas, bile ducts, and kidneys, can also cause pain in the upper abdominal region. Problems within the thoracic cavity that affect the chest wall, heart, lungs, esophagus, and aorta can also cause pain that extends to the upper abdominal region.
Causes of Upper Abdominal (Stomach) Pain
Upper stomach pain or upper abdominal pain can be discussed based on the source of the pain. The following organs may cause pain in the upper abdominal region.
A variety of stomach conditions may be responsible for pain that is felt in the upper left abdominal region. Examples of stomach conditions that can cause upper abdominal pain include gastritis, stomach ulcers, gastroenteritis, hiatal hernia, and obstruction of the gastric outlet.
- Gastritis refers to an inflammation of the internal lining of the stomach. Stomach ulcers are open sores that may develop in the lining of the stomach. These can cause considerable pain.
- Gastroenteritis refers to stomach infections caused by consumption of food and water that are contaminated with pathogenic bacteria or their toxins.
- Hiatal hernia occurs when the upper portion of the stomach protrudes into the thoracic cavity through the opening in the diaphragm.
- Obstruction of gastric outlet blocks the passage of food from the stomach to the intestine.
Pain caused by these problems can exacerbate during hunger state or after eating. Apart from pain, these stomach conditions may also cause excessive belching, nausea, vomiting, and bloating.
Read more on gastric pain.
Problems with the esophagus that can result in upper abdominal pain include esophagitis, ulcers, esophageal rupture, achalasia, and Mallory-Weiss tear.
- Esophagitis refers to inflammation of the esophageal lining.
- Ulcers or open sores within the esophagus can cause pain upon coming in contact with food.
- Esophageal rupture refers to perforations within the esophageal wall.
- A tear that occurs at the level of the junction between the esophagus and the stomach is known as a Mallory-Weiss tear.
- Achalasia refers to a condition in which the lower esophageal sphincter (abbreviated as LES) fails to relax and prevents the transit of food from the esophagus to the stomach.
Upper abdominal pain due to the above mentioned esophageal conditions may occur immediately after eating. The pain due to esophageal problems is also felt in the chest. Excessive belching may also occur along with pain.
Pain in the upper abdominal region can also be caused by conditions that affect the first part of the small intestine (also known as the duodenum). For example, the presence of ulcers in the duodenum can cause upper abdominal pain.
Gastroenteritis, caused by infection of the stomach and the intestinal lining via food and water-borne pathogens and toxins, can also cause pain in the upper abdominal region. Malabsorption and food intolerance can also lead to pain in the upper abdomen.
Since the pancreas lies in close proximity to the stomach, inflammation of the pancreas (technically referred to as pancreatitis) can also be felt as pain in the upper abdominal region.
Gallbladder and bile ducts
Presence of gallstones in the gallbladder or in the bile ducts prevents the flow of bile and causes pain in the upper abdominal region. In addition, inflammation of the gallbladder (technically referred to as cholecystitis) or the bile ducts (technically referred to as cholangitis) can also cause upper abdominal pain.
Conditions affecting the stomach, small intestine, gallbladder, and pancreas adversely affect the digestive processes. Apart from pain in the upper abdominal region, these conditions may also result in other signs and symptoms such as nausea, vomiting, fever, chills, yellow skin (jaundice), fatty stools (steatorrhea), clay-colored stools, dark-colored urine, nutrient deficiencies, weight loss, constipation, and diarrhea.
Read more on upper middle abdominal pain.
Problems in certain regions of the large intestine, such as the transverse colon, splenic flexure, and descending colon, may also cause pain in the upper abdominal region. Some of the conditions that affect these parts of the large intestine include inflammatory bowel disease, irritable bowel syndrome, splenic flexure syndrome, and colitis.
Upper abdominal pain caused by these conditions may also be accompanied by changes in bowel movements (diarrhea or constipation), blood in stool, mucus in stool, and excessive flatulence. Occurrence of fresh blood in stool is referred to as hematochezia, whereas presence of old, dark blood in stool is referred to as melena.
The cause of upper abdominal pain may also be located in the kidneys. Kidney problems such as stones in kidneys (technically referred to as renal calculus), inflammation of kidneys (technically referred to as nephritis), renal abscess, polycystic kidney disease, renal carcinoma, acute kidney failure and diabetic nephropathy can cause upper abdominal pain.
Urinary tract infections of the upper ureters may also cause pain in the upper abdomen. Pain caused by renal problems is usually felt on the sides of the abdomen (flanks) and in the back region. Other accompanying signs and symptoms include pain or burning sensation during urination (technically referred to as dysuria), presence of blood in the urine (technically referred to as hematuria), presence of protein in the urine (technically referred to as proteinuria), urinary retention, incontinence, increased frequency of urination, post-micturition dribble, and changes in urine color or output.
Upper abdominal pain can also be caused by splenic rupture, splenic infarct or splenomegaly (enlarged spleen). The pain caused by these conditions may be aggravated by consumption of large meals, or by deep inspiration during breathing.
Upper abdominal pain may not always be due to conditions that affect the organs within the abdominal cavity. In some cases, the pain may be caused by conditions that affect the tissues of the abdominal wall.
Examples of such conditions include rib fractures, muscle strain, shingles, hematoma, dermatitis, and peritonitis. Pain in these conditions may worsen with breathing, movement, bending, lying or standing erect. The skin of the abdominal wall may also exhibit itchy rashes and redness.
Causes within the thoracic wall or thoracic cavity
Pain caused by conditions that affect the thoracic wall or organs within the thoracic cavity may also get referred to the upper abdominal area. Examples of such conditions include heart attack, pericarditis, pleuritis, pneumonia, trauma to chest wall, abdominal aortic dissection, and abdominal abscess.