Abdominal Pain - Upper
Symptoms
DEFINITION
- Pain is primarily centered in the upper abdomen (i.e., just below rib cage and above belly button)
General Information
- There are multiple causes of upper abdominal pain.
- Gastritis and peptic ulcer disease are common and typically cause pain in the upper abdomen (epigastrium), sometimes accompanied by vomiting.
- Gastroesophageal reflux disease (GERD) causes a burning pain that radiates into chest. Lying down aggravates symptoms. May get a sour or bitter taste in mouth.
- Abdominal pain in the elderly carries with it a higher risk of serious illness.
Top Causes of Upper Abdominal Pain in Men Younger than 50 Years of Age
- Appendicitis
- Gallbladder disease
- Nonspecific abdominal pain
- Peptic ulcer disease
Top Causes of Upper Abdominal Pain in Individuals Older than 50 Years of Age
- Appendicitis
- Bowel obstruction
- Diverticulitis
- Gallbladder disease
- Pancreatitis
- Peptic ulcer disease
Other Causes
- Angina and heart attack
- Abdominal aortic aneurysm
- Hepatitis
- Herpes zoster
- Pneumonia
A Warning about "Indigestion": Some individuals can have a heart attack and just think that it is "indigestion". You should especially consider the possibility of a heart attack if you are over 40 years old or if you have any cardiac risk factors. Cardiac risk factors include: diabetes, hypertension, high cholesterol, obesity, smoking, and a family history of heart attack at an age of less than 60.
See More Appropriate Topic (instead of this one) If
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Should I Call?
WHEN TO CALL YOUR DOCTOR
Call 911 Now (you may need an ambulance) If
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- Passed out (fainted)
- Very weak (can't stand)
- Visible sweat on face or sweat is dripping down face
- Pain lasting more than 5 minutes and any of the following:
- History of heart disease (e.g., heart attack, bypass surgery, angina, angioplasty, heart failure)
- Over 50 years old
- Over 35 years old and you have at least one cardiac risk factor (i.e. hypertension, diabetes, high cholesterol, obesity, smoker or strong family history of heart disease)
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Call Your Doctor Now (night or day) If
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- You feel weak or very sick
- Severe pain
- Constant abdominal pain for more than 2 hours
- Pain lasting more than 5 minutes and age 40 years old and associated chest, arm, neck, upper back or jaw pain
- Vomiting blood or black (coffee-grounds)
- Vomiting bile (bright yellow or green)
- Vomiting and abdomen looks much more swollen than usual
- Blood in bowel movements (black/tarry or red)
- Recent injury to the abdomen
- Fever of 103° F (39.4° C) or higher
- Fever of 100.5° F (38.1° C) or higher and you:
- Are over 60 years of age OR
- Have diabetes mellitus or a weakened immune system (e.g., HIV positive, cancer chemotherapy, chronic steroid treatment, splenectomy) OR
- Are bedridden (e.g., nursing home patient, stroke, chronic illness, recovering from surgery)
- Whites of the eyes have turned yellow (jaundice)
- Pregnant
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Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
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- You think you need to be seen
- Mild pain comes and goes (cramps), but lasts longer than 24 hours
- Over 60 years old
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Call Your Doctor During Weekday Office Hours If
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- You have other questions or concerns
- Abdominal pains are a recurrent problem
- Intermittent burning pains radiating into chest with sour taste in mouth
- Abdominal pains regularly occur about 1 hour after meals
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Self Care at Home If
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- Mild upper abdominal pain and you don't think you need to be seen
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Care at Home
HOME CARE ADVICE FOR MILD UPPER ABDOMINAL PAIN
- Reassurance: A mild stomachache can be from indigestion, stomach irritation, or overeating. Sometimes a stomachache signals the onset of a vomiting illness from a viral infection.
- Fluids: Sip clear fluids only (e.g., water, flat soft drinks or ½ strength fruit juice) until the pain is gone for 2 hours. Then slowly return to a regular diet.
- Diet:
- Slowly advance diet from clear liquids to a bland diet.
- Avoid alcohol or caffeinated beverages.
- Avoid greasy or fatty foods.
- Stop Smoking: Smoking can aggravate heartburn and stomach problems.
- Avoid Aspirin: Avoid aspirin and anti-inflammatory medications (e.g., Motrin, Advil, Aleve, Naproxen). These medications can cause stomach irritation. Try taking acetaminophen (e.g., Tylenol), which does not cause stomach irritation.
- Antacid: If having pain now, try taking an antacid (e.g., Mylanta, Maalox). Dose: 2 tablespoons (30 ml) of liquid by mouth.
- Reflux Symptoms (GERD): Eat smaller meals and avoid snacks for 2 hours before sleeping. Avoid the following foods which tend to aggravate heartburn and stomach problems: fatty/greasy foods, spicy foods, caffeinated beverages, mints, and chocolate.
- Expected Course: With harmless causes, the pain usually lessens or is resolved in 2 hours. With gastroenteritis, stomach cramps may precede each bout of vomiting or diarrhea. With serious causes (such as appendicitis), the pain becomes constant and severe.
- Call Your Doctor If:
- Abdominal pain is constant and present for more than 2 hours.
- You become worse
And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.
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Photo Example
Anatomy - Gastrointestinal
First Aid - Shock
- Lie down with the feet elevated (Reason: counteract shock).
Note: In this illustration the individual in shock is laying down and his feet have been placed up on a stack of blankets.
Source: LMS Inc.
Copyright 2000-12 Self Care Decisions, LLC. Used by Permission.
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Author and Senior Reviewer: David A. Thompson, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.
Last Review Date: 6/1/2011
Last Revised: 6/11/2011
Content Set: Adult HouseCalls Symptom Checker
Version Year: 2012
Portions Copyright 2000-2012 Self Care Decisions LLC; Copyright LMS, Inc.
