The pain felt in the middle of the upper abdomen is called epigastric pain. While gastric is defined as ‘of the stomach,’ epigastric pain can also start from other areas including the pancreas, small intestine, and the gallbladder.
Considered a symptom rather than a condition, epigastric pain can be attributed to medical conditions that can be mild, moderate, or severe. Most Singaporeans refer to this discomfort or pain as ‘gastric.’
Other symptoms that can accompany gastric pain can include belching, bloating, nausea, and heartburn. Gastric pain without ulcers are sometimes known as non-ulcer dyspepsia or functional dyspepsia.
Causes of Gastric Pain
Gastric pain can be attributed to various causes. Below are some of the most common causes of gastric pain:
Bowel Obstruction
Bowel obstruction occurs when tumors, fibrous scar tissues, and inflamed intestinal walls create a blockage in the intestinal pathway. The obstruction disrupts digestive waste passage. Bowel obstruction can be very painful and debilitating.
It can also be accompanied by constipation, vomiting, abdominal swelling, and intense gastric pain. Bowel obstruction is considered a medical emergency. If doctors suspect bowel obstruction, medical intervention is given immediately.
Pancreas or Liver Issues
In some cases, gastric pain can be a symptom of problems in the pancreas or liver. Hepatitis (inflammation of the liver) can result in vomiting, nausea, and gastric pain that manifests in the body’s upper right side.
While stomach pain is not always considered a symptom, pain that is felt in the ribcage’s lower right portion can be a potential symptom of liver cancer.
In most people, pancreatitis (the inflammation of the pancreas) can be accompanied by bloating, nausea, and indigestion. The management and treatment of pancreatitis will depend on the severity of the condition.
Gallstones
The stone-like particles that can develop in the gallbladder are called gallstones. The gallbladder is located under the liver. This small organ is situated under the liver. Gallstones are typically made of bilirubin or cholesterol.
Gallstones are also components of bile. Gallstone sizes can range from small grains to something the size of a golf ball. Some of the symptoms of gallstones can include fatigue, vomiting, and gastric pain.
Stomach Virus (Stomach/Gastric Flu)
Gastrointestinal tract inflammation is known as gastroenteritis. Stomach flu can affect both the small and large intestines. Stomach flu is often caused by viruses.
However, parasites and bacteria can also cause stomach flu. A bout with stomach flu can result in vomiting, discomfort, weakness, and vomiting. Typically, the illness can suddenly occur. Fortunately, it is often short-lived.
Most will fully recover from stomach flu without any long-term consequences. However, dehydration is one of the most common complications associated with the condition.
Indigestion (Dyspepsia/Peptic Ulcer Disease)
Indigestion is often described as a full and uncomfortable sensation in the upper abdomen. Indigestion often occurs after eating. Often, it can also be accompanied by a burning sensation in the stomach or esophagus because of the acid that builds up in the stomach. Indigestion can also feel like gastric pain.
Indigestion is often caused by eating too fast or overeating. However, indigestion can also be triggered by certain foods. Greasy, fatty, and spicy foods can increase one’s risk of developing indigestion. It can also develop if you lie too soon after eating or if you exercise after a heavy meal.
Exercising after eating or lying down right away can make it hard for the body to digest food, increasing the risk for developing abdominal discomfort. Indigestion can also be caused by medications like non-steroidal anti-inflammatories.
Most indigestion or peptic ulcers can be caused by Helicobacter pylori (H. Pylori). To rule out H. pylori infection, a urea breath test, blood test, or stool test may be done. If indigestion is recurring and accompanied by weight loss or severe gastric pain, visit your doctor right away so the condition can be diagnosed and managed properly.
Flatulence (Gas)
Gas is considered a normal part of the digestive process. When it builds up, it can cause a bloated feeling. Oftentimes, it can also be accompanied by swelling of the abdomen and mild pain.
Flatulence or a build up of gas can also occur after eating certain foods such as cauliflower, garlic, beans, and other foods high in fiber. Flatulence is often felt in waves and is not a cause for concern.
Gastro-Esophageal Reflux Disease (GERD)
This chronic condition occurs when the bile or stomach acid flows back into the esophagus (or food pipe), irritating the lining in the process. An endoscopy may be recommended to rule out GERD. During an endoscopy, a thin tube with a tiny camera will be passed through the mouth. An endoscopy is done to examine the stomach, duodenum, and the esophagus.
Cancer
Liver, pancreatic, and stomach cancer can also cause gastric and abdominal pain. Cancer can also be ruled out during endoscopy. During the procedure, small tissue samples will be obtained to check for cancerous cells. A barium meal X-ray examination may also be recommended.
When to Visit Your Doctor
Occasional and mild cases of gastric pain will usually go away on its own. However, recurrent and severe cases will merit a visit to the doctor so any underlying condition can be diagnosed and the right treatment can be recommended. Visit your doctor right away if gastric pain is accompanied by the any of the following symptoms:
- Debilitating and extremely intense pain
- Gastric pain caused by consumption of medication or after injury
- Persistent bowel movement changes (i.e., black, pale, or bloody stools)
- Fever
- Rapid and drastic weight loss
- Persistent vomiting after eating
- Vomiting blood or passing out black stools
Diagnosis methods can include an examination of the patient’s lifestyle and diet. Imaging methods like colonoscopy, gastroscopy, or CT scans may also be requested. Only a doctor can determine the root cause of the gastric pain and can prescribe the correct treatment to address the root problem.
Gastric Pain Treatment
Non-Ulcer Dyspepsia Treatment
Stress is suspected as the likely cause of non-ulcer dyspepsia. In similar scenarios, low doses of anxiety-relieving drugs and antidepressants may be prescribed to alleviate the symptoms.
Some may also be given medications that can help reduce stomach acid. The two types of medications that can reduce stomach acid are:
- H2 blockers (histamine-2 blockers)
- Proton pump inhibitors (PPIs)
While the two types of medications work in different ways, they have both been proven effective in lowering the amount of acid produced by the stomach.
Peptic Ulcer Treatment
If the gastric pain is caused by peptic ulcer, medications that can reduce stomach acid will also be given. However, if the ulcer is caused by an H. pylori infection, you might be given short-term triple therapy.
This consists of two antibiotics and one acid-reducing agent. Triple therapy has been able to eradicate the bacteria successfully in 90 percent of the cases. During the recovery process, it is best to stick to foods that are easy to digest.
Avoid salty, oily, and spicy foods. Good food choices can include:
- Broths
- Bananas
- Fresh fruits
- Oatmeal
- Toast
- Saltine crackers
- Baked or poached meats
Ways to Prevent Gastric Pain
Whether your gastric pain is caused by non-ulcer dyspepsia or another condition, simple lifestyle changes can help lower your risk of experiencing the symptoms.
- Manage your stress. High stress can increase the production of gastric juices in the stomach. Adopting relaxation activities (i.e., yoga, meditation, etc.) and exercising regularly can help keep your stress in check.
- Quit smoking. Smoking will not only increase the production of acids in the stomach, it can also slow down healing and increase one’s risk of developing stomach cancer.
- Drinking in moderation. Drinking excessive amounts of alcohol can weaken the protective lining of the stomach. This makes you more prone to developing ulcers.
- Consuming foods that are not irritating. Cutting down on fatty, fried, acidic, and spicy food can help reduce the gastric symptoms. It can also allow the stomach to heal.
- Eating on time. Eating on time can accustom your stomach to release gastric juices only during mealtimes and not erratically.
- Eat smaller meals. If you have indigestion, it is ideal that you eat five to six small meals daily instead of three square meals.
