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What’s Causing My Epigastric Pain and How Can I Find Relief?

Is this cause for concern?

Epigastric pain is a name for pain or discomfort right below your ribs in the area of your upper abdomen. It often happens alongside other common symptoms of your digestive system. These symptoms can include heartburn, bloating, and gas.

Epigastric pain isn’t always cause for concern. This condition has many possible causes, especially when it happens right after eating.

It’s important to be able to tell the difference between pain that’s a result of something harmless, like overeating or lactose intolerance, and pain that happens because of an underlying condition, such as GERD, inflammation, or infection.

Keep reading to learn more about what may be causing your symptoms.

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Acid reflux

1. Acid reflux

Acid reflux happens when some of your stomach acid or the food in your stomach washes back up into your esophagus. When this happens, it can cause pain in your chest and throat. Over time, constant acid reflux can cause gastroesophageal reflux disease (GERD). GERD requires regular monitoring by your doctor.

Common symptoms of acid reflux include:

  • heartburn
  • indigestion
  • abnormal acidic taste in your mouth
  • throat soreness or hoarseness
  • feeling a lump in your throat
  • ongoing cough

Learn more: What are the differences between heartburn, acid reflux, and GERD? »

Identifying gallbladder problems »

Heartburn and indigestion

2. Heartburn and indigestion

Heartburn is a result of acid reflux. This can cause burning chest pain. Indigestion (dyspepsia) is a name for digestive symptoms that happen when you eat types of foods that don’t seem to agree with you.

The most common symptom of heartburn is a burning feeling in your chest after you eat. This burning feeling usually is worse when you lie or bend down. This is because the acid moves farther up your esophagus.

Common symptoms of indigestion include:

  • feeling bloated
  • burping
  • getting full even if you haven’t eaten much
  • nausea
  • pressure in your abdomen from gas

Learn more: How to stop overeating »

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Lactose intolerance

3. Lactose intolerance

Lactose intolerance happens when your body has trouble digesting dairy products, such as milk or cheese. Dairy products all contain a type of sugar called lactose. Typically, symptoms will occur every time you eat dairy.

Lactose intolerance often develops when you don’t have enough lactase in your body. This enzyme is important in breaking down the sugar lactose.

Common symptoms of lactose intolerance include:

  • feeling bloated
  • stomach pains
  • pressure in your abdomen from gas
  • diarrhea
  • nausea
  • throwing up

Alcohol

4. Alcohol

Drinking alcohol in moderation, or about one drink per day, normally doesn’t cause stomach pain. But drinking too much alcohol at one time or over a long period of time can cause your stomach lining to become inflamed. Long-term inflammation can lead to bleeding.

Drinking too much can also cause conditions such as:

These conditions can all cause epigastric pain, too.

Check out: Gastritis diet: What to eat and what to avoid »

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Overeating

5. Overeating

When you eat too much, your stomach can expand beyond its normal size. This puts a lot of pressure on the organs around it. This pressure can cause pain in your gut. It can also make it hard to breathe because your lungs have less room to expand when you inhale.

Overeating can also cause stomach acid and contents to back up into your esophagus. This can cause heartburn and acid reflux. These conditions can make the epigastric pain that you feel after eating much worse.

If you have an eating disorder related to binge eating, repeated vomiting after eating can also cause epigastric pain.

Learn more: Identifying gallbladder problems »

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Hiatal hernia

6. Hiatal hernia

A hiatal hernia happens when part of your stomach gets pushed up towards your diaphragm through the hole that the esophagus passes through, which is called the hiatus.

Hiatal hernias don’t always cause pain or discomfort.

Common symptoms of a hiatal hernia can include:

  • indigestion
  • burning feeling in your chest
  • irritated or sore throat
  • burping loudly
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Esophagitis

7. Esophagitis

Esophagitis happens when your esophagus lining becomes inflamed. Common causes include acid coming back up from your stomach, allergies, infection, or chronic irritation from medications. If you don’t treat it, over time esophagitis can eventually lead to scarring on your esophagus lining.

Common symptoms of esophagitis include:

  • burning in your chest or throat
  • abnormal acidic taste in your mouth
  • coughing
  • having trouble swallowing or having pain when swallowing

Gastritis

8. Gastritis

Gastritis happens when the lining of your stomach (mucosa) becomes inflamed due to a bacterial infection, an immune system disorder, or ongoing damage to your stomach. It can be acute and last for only a brief time, or it can be chronic, lasting for years or more if you don’t get treatment.

Common symptoms of gastritis can include:

  • pain or discomfort in your upper body or chest
  • nausea
  • vomiting, or throwing up blood or something that looks like coffee grounds
  • passing black stool
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Peptic ulcer disease

9. Peptic ulcer disease

Peptic ulcer disease happens when the lining of your stomach or small intestine gets damaged due to a bacterial infection or by taking too much of certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief.

Common symptoms of peptic ulcer disease can include:

  • nausea
  • vomiting
  • feeling easily full
  • stomach pains that food can make better or worse
  • signs of bleeding that can include tiredness, paleness, or shortness of breath

Barrett’s esophagus

10. Barrett’s esophagus

Barrett’s esophagus happens when the tissue that lines your esophagus starts to become more like the tissue lining your intestines. This is known as intestinal metaplasia. This condition requires close follow-up. Unchecked, Barrett’s esophagus can lead to cancer of the esophagus. GERD, smoking, consuming alcohol, and obesity are also risk factors for this type of cancer.

This condition doesn’t have any unique symptoms of its own. If it happens because of GERD, you may have symptoms such as:

  • throat soreness or hoarseness
  • abnormal acidic taste in your mouth
  • burning in your stomach
  • heartburn
  • having trouble swallowing

Gallbladder inflammation or gallstones

11. Gallbladder inflammation or gallstones

Epigastric pain can develop when your gallbladder becomes inflamed as gallstones block the opening of your gallbladder. The condition is known as cholecystitis. This can be painful and may require hospitalization or surgery.

Common symptoms of gallbladder inflammation can include:

  • not having an appetite
  • intense pain around your gallbladder (upper right side of your stomach)
  • nausea and vomiting
  • bloating and gas
  • high fever
  • clay-colored stools
  • skin that looks yellow (jaundice)
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In pregnancy

12. Epigastric pain in pregnancy

Mild epigastric pain is common while you’re pregnant due to the pressure that your growing pregnancy puts on your abdominal area. It’s also common because of the changes in your hormones and your digestion. You may also experience frequent heartburn while you’re pregnant.

However, significant epigastric pain in pregnancy is sometimes a symptom of a serious condition known as preeclampsia. It requires close monitoring by your doctor and can become life-threatening if severe. You’ll require close observation, blood pressure checks, blood tests, and urine tests to rule this out as a cause of epigastric pain.

Treatment

Treatment options

Treatment for epigastric pain depends on the cause. If your pain is a result of your diet or overeating, your doctor may recommend that you change your diet or lifestyle.

This may include exercising for about 30 minutes each day or eating healthier foods. Eating foods like ginger and taking vitamin B supplements may help relieve symptoms like nausea and throwing up.

If the pain is a result of taking certain medications, such as NSAIDs, your doctor may tell you to stop taking these medications and help you find another way to manage pain. Your doctor may recommend antacids or even acid blocking medicines to relieve your pain.

If an underlying condition such as GERD, Barrett’s esophagus, or peptic ulcer disease is causing your epigastric pain, you may require antibiotics as well as long-term treatment to manage these conditions. Treatment may last for months or even the duration of your life, depending on the cause.

See your doctor

When to see your doctor

See your doctor right away if your epigastric pain is severe, ongoing, or interfering with your daily life.

You should go to the emergency room if you have any of the following symptoms:

  • trouble breathing or swallowing
  • throwing up blood
  • blood in your stool or black, tarry stool
  • high fever
  • chest pain
  • difficulty breathing
  • passing out

You should also see your doctor if your symptoms last for more than a few days without getting any better with over-the-counter or home treatments. Many causes of epigastric pain can easily be treated, including chronic conditions. Seeing your doctor as soon as you notice epigastric pain that isn’t going away can help you relieve your symptoms and get any underlying conditions under control.

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