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Epigastric Pain

Medically reviewed by Last updated on May 1, 2023.

What do I need to know about epigastric pain?

Epigastric pain is felt in the middle of the upper abdomen, between the ribs and the bellybutton. The pain may be mild or severe. Pain may spread from or to another part of your body. Epigastric pain may be a sign of a serious health problem that needs to be treated.

What causes epigastric pain?

The cause of your pain may not be known. The following are common causes:

  • Inflammation of your stomach, liver, pancreas, or intestines
  • Heart problems, such as a heart attack
  • Digestion problems, such as indigestion, GERD, or lactose intolerance
  • Medical conditions, such as an ulcer, a hernia, irritable bowel syndrome (IBS), or cancer
  • A blockage in your bowels or gallbladder
  • A bladder infection
  • An injury or previous surgery in your abdomen

What other signs and symptoms may I have with epigastric pain?

Signs and symptoms will depend on what is causing your pain.

  • Nausea, vomiting, bloating, constipation, or diarrhea
  • Loss of appetite, weight loss, feeling of fullness as you start to eat
  • Movement relieves the pain or makes it worse, or only certain positions are comfortable
  • Pain when you eat, or pain that is relieved when you eat or have a bowel movement
  • Sore throat or a hoarse voice

How is epigastric pain diagnosed and treated?

Your healthcare provider will feel your abdomen to see if it is tender or rigid. Your provider may change or stop any medicine you are taking that is causing your pain. Your pain may go away without treatment, or you may need any of the following:

  • Medicines may be given to treat pain or stop vomiting. You may also need medicines to reduce or control stomach acid, or treat an infection.
  • Blood or urine tests may show problems such as infection or inflammation. The tests may also show how well your liver is working.
  • An x-ray is used to check your kidneys and bladder.
  • An ultrasound is used to check your gallbladder for stones or other blockage.
  • A bowel movement sample may be tested for blood.

How can I manage my symptoms?

  • Keep a record of your symptoms. Include when the pain starts, how long it lasts, and if it is sharp or dull. Also include any foods you ate or activities you did before the pain started. Keep track of anything that helped the pain.
  • Eat a variety of healthy foods. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Ask if you need to be on a special diet. Certain foods may cause your pain, such as alcohol or foods that are high in fat. You may need to eat smaller meals and to eat more often than usual.
  • Drink liquids as directed. Ask how much liquid to drink each day and which liquids are best for you. Do not have drinks that contain alcohol or caffeine.

Call 911 for any of the following:

  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest
    • You may also have any of the following:
      • Discomfort or pain in your back, neck, jaw, stomach, or arm
      • Shortness of breath
      • Nausea or vomiting
      • Lightheadedness or a sudden cold sweat
  • You have severe pain that radiates to your jaw or back.

When should I seek immediate care?

  • You have severe pain that starts suddenly and quickly gets worse.
  • You cannot have a bowel movement and are vomiting.
  • You vomit or cough up blood.
  • You see blood in your urine or bowel movement.
  • You feel drowsy and your breathing is slower than usual.

When should I contact my healthcare provider?

  • You have a fever or chills.
  • You have yellowing of your skin or the whites of your eyes.
  • You vomit often or several times in a row.
  • You lose weight without trying.
  • You have symptoms for longer than 2 weeks.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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