Experiencing upper abdominal pain in the midst of daily activity is always an uncomfortable situation.
The problem is, abdominal pain is both common and complex. Few things puzzle patients and doctors alike more than undiagnosed upper abdominal pain. Not because there are unexplained symptoms, but rather there are too many possibilities.
How do you find out what’s causing it?
This article discusses the major causes of upper abdominal pain and the methods of addressing the condition.
In the event that you experience upper abdominal pain or any other condition you think might be serious, do not self-diagnose.
There is a difference between listing your symptoms and making your own diagnosis. The former can help your caregivers make an accurate evaluation. The other is making an unqualified opinion that can impede in arriving at the correct answer.
Instead, contact your family doctor and get a professional diagnosis. Alternatively, you can also contact the MidSouth Pain Treatment Center for a professional consultation on pain identification and treatment.
Emergency Room Statistics on Abdominal Pain
Around 5-10% of emergency room (ER) visits in the United States point to abdominal pain as the cause. Despite the extensive knowledge gathered from human medicine, undifferentiated abdominal pain is the resulting diagnosis for 25% of patients discharged from the ED results, and 35-41% for admitted patients. Fortunately, almost 80% of patients with that diagnosis report improvements within two weeks.
Patients over 65 years of age account for one-fifth of ED visits, with 3.5% checking in for abdominal pain. 66% of these elderly patients usually require hospitalization and 33% will require surgery. Mortality rates from abdominal pain for the elderly increase if the ED does not result in a diagnosis. This observation supports the need for the correct identification of the symptoms of abdominal pain. Additionally, there is a great need for patients to determine which part of the abdomen is causing pain. Correct and timely information will always help medical professionals make an accurate diagnosis.
What (and Where Exactly) is the Abdomen?
First things first: the abdomen is not an organ. It’s an area between the thorax (chest) and the pelvis. When describing symptoms, using the term “abdomen” points to the general direction of the area between the chest to the pelvis.
The abdomen is not an organ. It is a large body cavity that contains most organs of the digestive system. These organs include the stomach, small and large intestines, colon, and appendix.
The abdomen houses accessory digestive organs such as the liver, gall bladder, and pancreas.
The abdomen also contains some of the organs critical to the urinary system, such as the kidneys, and adrenal glands. In addition, major blood vessels run through the abdomen, including the aorta and the inferior vena cava.
Knowing which organs are within the bounds of the upper abdomen helps patients provide detailed symptoms, which can lead to a faster and more accurate diagnosis.
The illustration above helps track the specific causes of upper abdominal pain. It divides the abdominal region into nine areas. On top are the right and left hypochondria, plus the epigastric region at the center.
At the center are the left and right lumbar regions and the umbilical region. Finally, the lower regions include the hypogastrium and the iliac regions from both sides.
In addition, the abdomen area can also be divided into four quadrants, with the navel acting as the center. Diagnosticians and clinicians use these regions to determine which organs might be the cause of upper abdominal pain.
The upper right quadrant holds the gallbladder and the right kidney, and the head of the pancreas. It also contains areas of the liver, colon, stomach, and small intestine. Meanwhile, the upper left quadrant contains the left kidney, the spleen, and the pancreas.
It also houses the left part of the liver, and some of the stomach, small intestine, and colon.
Identifying Upper Abdominal Pain Through Severity
Describing the type of pain felt also helps health professionals narrow down the cause. Is the pain sharp, like it prods a specific area and often leaves you wincing? Is it a continuous bloated feeling?
It’s best to familiarize yourself with a pain scale when describing the severity of the discomfort being felt. This provides the health practitioner an easier reference when documenting your condition. The pain chart often helps especially when patients cannot communicate properly due to their condition. Below is a graphic representation of the pain scale from 0 (no pain) to 10 (unspeakable).
Types of Upper Abdominal Pain
During your medical interview, doctors will also ask you to describe your pain in terms of sensation. Note the type of pain you experience using some of the common descriptions listed below:
- Dull. Dull upper abdominal pain is more of an annoyance rather than actual pain. There is something noticeable in your stomach, but it’s not too bothersome so as to cancel the day’s activities.
- Bloated. Feeling extremely full, with tightness in the abdomen. The tightness can be painful as you experience a swollen belly. A bloated feeling removes all desire to take in more food.
- Sharp/Stabbing. A sudden rush of pain in a specific area akin to the experience of being punctured. When the pain comes in waves, it’s generally termed as stabbing.
- Tearing. Tearing pain is often described as a body organ being ripped away from its original location. It’s both a painful and helpless experience when you feel something inside your body is being torn from its original place.
- Cramps. A cramp is an involuntary contraction or tightening of muscles that caused abdominal pain in waves. They can last from a few seconds to recurring pain every few minutes.
- Twisting. Twisting pain is often a symptom of an upset stomach. It often makes the sufferer unable to stay still for quite some time, as they feel the stomach contents moving about.
The more detail the patient can provide about the pain being experienced, the better the diagnostician can make an assessment.
Acute or Chronic Upper Abdominal Pain?
Know the difference between upper abdominal pain that is acute (sudden onset) or chronic (pain felt over time). This can help narrow down the causes of the pain.
Acute abdominal pain happens with warning or indication. It is often severe and may indicate a serious cause. For acute pain, especially those that rate high on the pain scale, it’s best to head directly to your nearby medical center.
Common causes of acute upper abdominal pain include pancreatitis, gallbladder infection, and gastroesophageal reflux disease (GERD). In these cases, medical intervention is sometimes needed immediately.
Chronic upper abdominal pain, while seemingly more manageable, needs the same attention given to acute pain. Upper abdominal pain in waves or recurring often points to a bigger problem building up. Pain may last for a few days or weeks, or they can show up one day, disappear the next, then return again. Or, chronic pain in the abdomen starts as a minor annoyance.
Pain gets more noticeable as it builds up in severity and duration.
As a rule, don’t ignore recurrent pain, no matter how dull. Get yourself checked when upper abdominal pain keeps coming back. Leaving them untreated may cause greater damage to major organs such as the stomach, gall bladder pancreas, liver, kidneys, or intestines.
Minor Common Upper Abdominal Pain Causes
Knowing which causes of upper abdominal pain are common and non-serious can help you save a trip to the hospital. Usually, these conditions disappear in a few hours or days. If pain persists or it affects your ability to perform routine tasks, then it’s a good time to see the doctor.
Common causes of upper abdominal pain include:
- Pulled muscle
- Food allergies
- Lactose intolerance
- Mild food poisoning
- Gas/stomach cramps
Often, the cure for these minor conditions requires letting the stomach settle down. Avoid eating solid foods for a couple of hours. Instead, try drinking water or taking clear fluids in small amounts. If you’re having an episode after eating a rather heavy meal, an antacid may come in handy.
While the above are minor conditions, they may also be early warning signs for more serious issues. If these problems continue for more than a few days, or you feel a change for the worse, it’s a good time to see the doctor.
Major Upper Abdominal Pain Causes
Sometimes, the pain doesn’t go away even after ignoring it. What’s worse, they get more pronounced as the days go by. Apart from medical consultation, doctors might require additional tests to confirm the diagnosis.
This is worth repeating, but remember that only a qualified medical professional can determine the exact cause of your upper abdominal pain. Once you feel uncomfortable with the pain, or have cause to worry, visit your friendly neighborhood medical center.
Moving on, some of the major causes of upper abdominal pain include the following:
Indigestion, or ordinary dyspepsia, can often be traced to a particular food or drink taken by the patient. On the other hand, functional dyspepsia is indigestion without a definite cause. Either way, pain in one or both sides of the upper abdomen is the main symptom. Other symptoms can also include fullness or bloating.
Gallstones are naturally forming deposits of bile and other fluids. By themselves, they are a minor source of inconvenience. However, once these accumulate and become large enough to block your gall duct, then the symptoms start. You’ll feel a sharp pain in your right side, nausea, and back pain between shoulders.
Unless the condition merits an emergency procedure due to pain, your doctor can prescribe medicine to dissolve gallstones. However, this will take months or years. Meanwhile, a cholecystectomy will require minor surgery to remove your gallbladder. Like the appendix, the absence of a gallbladder won’t change how you digest food.
Gastritis is when your stomach lining becomes inflamed, leading to pain in your upper abdomen characterized as a burning sensation. Bacteria is the common culprit for gastritis, but excessive alcohol consumption and pain relievers can similarly irritate the lining. The pain you’ll feel with gastroenteritis can get worse when you try to eat or drink. Gastritis is mostly-symptom free, but when can also manifest as upper abdomen pain. Left untreated, it can lead to stomach ulcers, bleeding, or tumors.
Gastroesophageal reflux disease (GERD) is when stomach acid escapes the stomach and irritates your esophageal lining. This presents as pain in your upper abdomen and a somewhat sour taste in the back of the mouth. Left untreated, GERD can lead to complications in the esophagus such as esophagitis, esophageal stricture, and Barrett's esophagus.
GERD can lead to heartburn, that painful sensation moving up from the stomach to the chest. The pain is prominent in the upper abdomen, although it also manifests in the chest. A general feeling of sourness in your stomach often accompanies acid reflux attacks.
Hepatitis is an infection of the liver that can cause pain in the right side of your upper abdomen. It’s an inflammation of the liver tissue. Left untreated, it can lead to other complications such as cirrhosis (scarring), liver failure, and liver cancer. There are three types of hepatitis: Hepatitis A, a highly contagious infection from contaminated food or drink, or through an infected person; Hepatitis B, a chronic liver infection of the liver that can lead to failure, cancer, or cirrhosis; and Hepatitis C, a viral infection of the liver transmitted through infected blood. All three types can lead to inflammation and/or liver damage.
A hiatal hernia happens when part of the stomach goes through the muscle separating the abdomen from the diaphragm. The pain will resonate in the upper left side of the abdomen. A small hiatal hernia shouldn’t pose any problems, and will not show any symptoms. When the stomach keeps moving upward, the hernia enlarges, and that’s where the problems start.
Liver abscesses are sacs filled with pus due to bacterial infection. A number of common bacteria can lead to an infection that causes abscesses, but there are other ways to get it. Blood infection, liver damage, or appendicitis can also lead to more bacteria converging on the liver.
Pain from liver abscesses manifests in your right upper abdomen, where your liver resides.
Think of peptic ulcers as next-level gastritis. Ulcers are sores in your stomach lining (gastric) or in your small intestines (duodenal). Bacterial infections often cause peptic ulcers or excessive use of certain pain relievers such as aspirin. Peptic ulcer victims cite burning pain in the stomach (left upper abdomen) as a primary symptom. They also often report bloatedness, burping, heartburn, and nausea.
Pneumonia, while a respiratory infection, can manifest as pain in either side of the upper abdomen. Pneumonia causes a tightening of the chest and lungs, which can lead to painful coughs. Pain in either side of your upper abdomen often accompanies these coughs.
An enlarged spleen is often a complication of infections or advanced liver disease. While it sometimes will not show any symptom, pain, or fullness in the left upper abdomen will often indicate some problems with the spleen. In some cases, the pain will radiate towards the left shoulder.
A tear or rupture in your spleen can happen when the body receives a blow. A ruptured spleen can lead to internal bleeding if not attended to immediately. Intense pain will emanate from the left side of the upper abdomen.
Upper Abdominal Pain with Back Pain
Sometimes abdominal pain can radiate to the back, adding even more pain than before. Oftentimes, it can indicate a much deeper issue such as the liver, kidneys, or pancreas. For problems exclusive to the back, with respect to the spine, check out some potential causes of back pain. Here are three of the most common causes of upper abdominal pain with back pain.
Acute Pancreatitis can occur when the pancreas becomes inflamed. The pancreas is a small organ next to the stomach and the small intestine and produces hormones, enzymes, and insulin for the body. A number of things can trigger inflammation, including excessive alcohol, medications, gallstones, high calcium levels, and even excessive triglycerides. When this condition occurs, pain will manifest in the upper abdominal region, and often radiates to your back.
Diverticulitis happens when small sacs develop along the lining of the colon as people age. When infected, these sacs get inflamed, becoming a condition called diverticulitis. While diverticulitis sometimes presents itself as symptom-free, inflammation can produce stomach pain that radiates to the back or groin. Interestingly, both diarrhea and constipation can present as symptoms. If not treated, diverticulitis can cause bleeding in the colon, and can also puncture the colon wall.
Pregnancy can come with both stomach ailments and back pain. Among the most common symptoms of pregnancy in the first trimester is nausea, and an increase of frequency in back pain. As the baby develops, it takes up room in the abdomen and puts more pressure on the back. Pressure in the organs can also increase nausea. While inconvenient, they often go away on their own.
What pregnant women should look out for is cholestasis or the reduction of the flow of bile from the liver. Apart from yellowing of the skin and eyes, women who have itchy skin to go along with back pains and nausea should see a doctor immediately.
Listen to Your Pain
No matter how inconsequential or dull the pain, always note its location, frequency, and degree of pain. The human body is like a machine with precision parts that run in sync. Choosing to ignore a small problem can sometimes lead to bigger problems later on.
The abdomen houses some of the body’s most important organs. The digestive, urinary, and reproductive processes are located there. Meanwhile, major respiratory, spinal, and coronary processes pass through. With all these organs and systems crowded, isolating a single cause of upper abdominal pain can prove difficult.
It’s always the best course to note what’s happening, record your impressions, then bring the information to a qualified health practitioner. Doctors and other medical professionals will be more than happy to share their extensive knowledge to isolate and treat the problem you’re having.
If you would like to know more about pain causes and treatment (not just upper abdominal pain, of course), let MidSouth Pain Treatment Center help find a treatment option that works for you. After all, you don’t have to live with your pain.