Causes of Upper Middle Abdominal (Stomach) Pain

The upper abdomen is a part of the trunk between the lower ribs and the navel. Epigastrium is the medical term for the upper middle region which lies high up in the abdomen. It is approximately where the breastbone ends, although some of the abdomen is tucked under the ribcage and behind the breastbone.

Causes of Upper Middle Abdominal Pain

1. Esophageal (Gullet) Disorders

  • Upper central abdominal pain during swallowing may appear in esophageal varices (mainly in chronic alcoholics) or in esophageal ulcers due to prolonged gastric acid reflux
  • Strong painful cramps in the esophagus that may be felt behind and below the breastbone may be due to:
    • Dry food
    • Hard passage of the food because of the dry esophageal mucosa (in dehydration), overgrown fibrous tissue (strictures) in prolonged GERD or, rarely,  in systemic sclerosis
    • Improper relaxation of the muscles that embrace the stomach entrance (cardia) due to damaged nerves (mostly during surgery)

Diagnosis is made from history or by upper endoscopy (esophagoscopy).


2. GERD

Gastro-esophageal reflux disease (GERD) refers to back-flow of gastric acid into esophagus. Burning pain below and behind the breastbone and/or in the throat and acidic taste in mouth are main symptoms. The cause is inadequate closure of the stomach entrance from various reasons, like herniation of the upper part of the stomach through a widened opening in the diaphragm (hiatus hernia). Diagnosis  is made from symptoms, upper endoscopy and measuring of pressures and pH in the esophagus.

3. Gastritis

Gastritis (Latin gaster = stomach; -itis denotes inflammation) is inflammation of the inner layer (mucosa) of the stomach with one or more of the following symptoms:

  • Burning pain below the breastbone, worsening during or after the meal
  • Nausea and vomiting
  • Early satiety
  • Excessive belching (burping)
  • Fever
  • Heartburn, burning feeling behind the breastbone and/or in the throat
  • Abdominal cramps
  • Black stools

The causes of acute (sudden) gastritis include infection with rotavirus (stomach flu) , mainly in children, food poisoning, excessive secretion of gastric acid, painkillers like aspirin or ibuprofen, acidic foods, spices and so on.

The causes of chronic (prolonged or recurrent) gastritis include infection by bacterium Helycobacter pylori, rare autoimmune gastritis (with vit B12 deficiency and anemia), chronic poisoning and so on.

In most cases, diagnosis of gastritis may be made from symptoms. In doubtful cases, X-ray with contrast (barium swallow) and upper endoscopy (gastroscopy) may be performed. White blood cells in the blood may (not necessary) be elevated and stool test for occult blood may be positive.

4. Gastroparesis

Gastroparesis refers to slow stomach emptying due to inadequate relaxation of muscles that embrace the stomach exit (pylorus) because of damaged nerves (mostly in long term atherosclerosis or diabetes), hormonal disorders, psychological reasons or fibrous tissue after healing of chronic gastric ulcer or after stomach surgery . Pain or cramping during or shortly after the meal in the upper middle abdomen, early satiety, heartburn, upper abdominal bloating and excessive belching (burping) are main symptoms. Diagnosis is made by gastric emptying tests.

5. Peptic Ulcer

  • Stomach ulcer is an open sore appearing in the inner layer (mucosa) of the stomach, which causes dull or burning pain in the upper middle abdomen during or shortly after the meal; avoiding eating and losing weight may follow.
  • Duodenal ulcer appears in the duodenum (the first part of the small intestine) and may cause dull or burning pain between meals and typically at night. Black stool from bleeding may appear in both gastric and duodenal ulcers.

Diagnosis of a peptic ulcer is made by upper endoscopy (gastroduodenoscopy).

6. Gastric Carcinoma (Stomach Cancer)

Stomach cancer may appear at any age but mostly in people after 50. Beside upper middle abdominal pain, nausea, poor appetite, losing weight and black stools are common. Diagnosis is confirmed by gastroscopy and examination of the sample of the gastric mucosa under the microscope.

7. Pancreatic Disorders

  • Inflamed pancreas. Acute pancreatitis is inflammation of the pancreas, mainly due to long term alcohol abuse or gallstones and may cause central or left side upper abdominal pain and nausea. Chronic pancreatitis usually results from repeating attacks of acute pancreatitis.
  • Pancreatic cancer may be preceded by long term chronic pancreatitis, but it may arise from the healthy pancreas. Main symptoms are upper middle abdominal pain, poor appetite, losing weight and white diarrhea or floating stools.

Diagnosis. In acute pancreatitis, pancreatic enzymes in the blood are elevated. Diagnosis of chronic pancreatitis is usually made by CT; pancreatic enzymes in the blood are not typically changed. In pancreatic cancer, pancreatic amylase and CA-19-9 marker (not always) are elevated.

Video on Upper Middle Abdominal Pain

8. Muscle Tear

Muscle tear is usually due to injury (hit with a hard object, stitch with a sharp object or rupture during exercise). The injured spot is tender to the touch. Hematoma (blood collection) may build within the muscle and can cause a small visible (bluish) and palpable (soft) bulge. Diagnosis is made by physical examination and ultrasound.

9. Intestinal Hernia

A part of small intestine may protrude through a cleft in upper abdominal muscles. Pain and a soft bulge of a golf ball size are main symptoms. Doctor can usually give diagnosis after physical examination.

10. Broken Breastbone

  • Broken xiphoid (the lower part of the breastbone) may cause upper middle abdominal pain. Diagnosis is made by X-ray.
  • Costohondritis – inflammation of the connection between the bony and cartilaginous parts of the lower ribs (about an inch from the breastbone on each side) may appear as chest and upper middle abdominal pain. Lower rib(s) may be tender to the touch. Diagnosis is made by physical examination.

11. Spinal Disorders

Bulging or herniated disc, spondylitis (spinal arthritis), broken vertebra or other disorder in the chest or lumbar part of the spine may cause upper middle abdominal pain and middle or lower back pain. Pain usually changes with moving or body position, aggravates with sitting and is relieved by walking. Diagnosis is made by CT or MRI.

12. Aneurysm or Dissection of Abdominal Aorta

In patients over 50 years of age, the wall of the aorta may be weakened due to atherosclerosis or other disorder leading to aortic wall bulging (aneurysm) or splitting of its layers (dissection). Constant dull upper abdominal pain that worsens during or after the meal is the main symptom. Diagnosis is made by the ultrasound, CT or MRI.

13. Heart Attack

Heart attack may appear with upper middle or left upper abdominal pain and is rare before 40 years of age. Smoking and high blood cholesterol are two important risk factors. Diagnosis is made on the basis of symptoms, ECG and elevation of certain enzymes in the blood.

14. Lymphoma

Enlarged lymph nodes near the stomach, appearing in gastric lymphoma may be painful. Low grade fever, paleness, fatigue and losing weight are other symptoms of lymphoma. Diagnosis is made by CT or MRI.

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About Jan Modric (249 Articles)
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  • daniel

    i need full information about upper stomach pain

  • Maggie

    Hi!I’m an 18 yes old female yesterday when I started eating my lunch I started to get stomach pain I thought it was my period coming. I took pain killer and it went away later and then started hurting again. Then I realize it was my upper middle stomach. Hurting because usually it would be my lower stomach when my period usually comes, but it didn’t come so I thought it was something else like watt I ate but I couldn’t think of anything. The pain got better then at 4am the pain started again then took another pill and it went away. It’s been going on and off the pain of my stomach do u guys know any causes and what should I do thank you

    • Jan Modric

      Maggie,

      pain in the upper middle abdomen occuring during eating may originate from the stomach (organ); it can be stomach inflammation (gastritis) or an ulcer for example. If pain persists you may visit a gastroenterologist.

  • nncout

    My dad has a recurring burning sensation in upper middle chest area. Heart conditions were ruled out. He experiences this pain only in the morning, 2 hours after waking. He is very healthy, no health concerns and is in his 60’s. Any ideas???

    • Jan Modric

      nncout,

      burning chest pain in the chest in the morning could be from the reflux of gastric acidid from the stomach upwards into the esophagus. A gastroenterologist may give him an exact diagnosis.

  • Jasmine

    I’m an 18 y/o female, and whenever I swallow anything besides my saliva, I get a sort of cold burning sensation that travels up and down my esophagus from my throat to my stomach. The pain isn’t intense, just uncomfortable, but it stays for a while after swallowing and gradually dulls down. Then it feels like a little bit of whatever I swallowed is still at the entrance of my stomach and hasn’t passed from my esophagus to my stomach yet, and it feels like it wants to come back up. This is not from over-eating, and I don’t think it’s just heartburn. This has been going on for about a week now, since after I got over bronchitis and a sinus infection.

    • Dr. Chris

      Hi Jasmine

      There are a number of conditions affecting the esophagus, both congenital (present since birth) and acquired (developed during life) that can cause this symptom and even with congenital causes the condition may only become apparent later in life. Many of the acquired causes are unlikely to occur at this age. However, the immediate concern at this point is esophagitis (inflamed esophagus) possibly as an extension of the infections you recently had. You need to see a doctor as soon as possible and further investigations may be necessary.

  • damian

    Hi, I’m a 30 year old male who has never experienced any prior symptoms of esophogeal or upper gastric pain until very recently. Beginning 3 days ago, and persisting with decreasing severity, I woke up with an extreme pain located at the base of my xiphoid/top of my stomach as well as a painful lump in my throat (and perhaps a slightly acidic taste in the back of my mouth/throat). The pain in the throat was gone by the end of the first day, but the stomach pain persists as a dull pain accompanied by the feeling of pressure. When I swallow food it is somewhat painful (severity dependant on the type of food), and when I drink it can be exceptionally painful depending on the liquid (I.e. crown royal is extremely painful, almost to the point of wanting to vomit; beer is somewhat painful; red wine or gin are fairly painful; acidic juice is slightly painful; water is minimally painful, if at all).
    I have a history of drinking regularly, but generally not excessively (1 or 2 drinks per day, if at all), and a history of taking advil regularly (150 mg, 3-4 times a week for various reasons), as well as a history of taking 5-10 mg of hydrocodone with limited regularity in the recent past (once a week or less), but a distant past (5+ years ago) chronic use of 10mg hydro (2-3 per week, sometimes more).
    Other possible symptoms: excessive flatulation (much more than the average person); and occasional blood on tissue when wiping after bowel movements; also, I have congenital spondylolysthesis/losis which on rare occasion causes my left leg to go numb, and with regularity causes mild pain in my lower back.
    I took a zantac pill from someone yesterday around 3 because I was desperate to get rid of the discomfort, and it seemed to lesson the pain while eating somewhat spicy food, but it did not totally eliminate it. However, the pain eventually showed back up in full force when I tried to have a sip of whiskey before dinner around 830.
    Thank you for any help you might be able to lend.

  • Thomas

    At night, I sometimes get a sudden sharp pain in my stomach, just below my breastbone. The pain is severe, and radiates upward. It typically lasts 5 to 10 minutes, then subsides.

    • Hi Thomas. This could definitely be gastrointestinal conditions like peptic ulcer disease as the stomach acid production does increase at night. Other possibilities are gallbladder diseases like gallstones, a hiatal hernia and even acid reflux. But what is more concerning is that this may also be related to cardiac problems even though you are not experiencing centralized chest pain typical of common painful heart conditions. The close proximity to where the heart sites does raise the issue that this may be cardiac in nature and therefore very serious. Of course there are other possibilities as well, such as pancreatic problems, but your doctor will be in the best position to advise you further especially after doing further tests.

      • Thomas

        Thank you very much for your reply. I will consult my doctor, but my feeling is that this is more likely gastrointestinal in nature.

  • nerina

    I was diagnosed with an hiatus hernia a few years ago, despite taking the medication etc that the doctor gave me just lately ive been having lots of pain, its very sharp and keeps me awake at night, I also seem to be very tired and have lots of wind and loose bowel movement, my doctor just says its the hernia, but im not so sure and the medication does nothing, any ideas at all, the pain is sharp in the middle of my stomach, just below my rib cage and the pain radiates to my upper back.

    • Hi Nerina. It is possible that this could be the hernia. You may need to have it surgically repaired at this point. However, it could also be other possibly causes and further investigation may be necessary. For example. gallbladder problems can cause pain in this region of the abdomen and radiate to the upper back. So can pancreas and even heart problems. There are many possibilities. If you feel that your current doctor’s approach is not satisfactory then get a second opinion.

  • Linda Addison-Mueller

    I had Gall Bladder surgery in 2003 and they had to moved my stomach back to where it suppose to be. I hurt in the middle of my stomach. In 2013, I had 2 blockages in the small intestine and thought this would be my cure. Well it helped but the middle of my stomach feels like someone is taking their hand and squeezing my stomach and it causes me to cramp. I do have a hiatus hernia and I feel like it needs to be fixed plus I need to be checked in the stomach to see why I can’t digest into the small intestine as well as I should and even when I don’t eat, my stomach feels like it is being squeezed. Do you think this could be another blockage or is it the small intestine feeling this way instead of the stomach? I cannot do anything with my family unless I start hurting pretty bad. Laying down does ease me off some.

    • Hi Linda. We cannot say if this problem is in the stomach or small intestine. You should see your doctor who can advise you further and do the necessary investigations (like imaging studies) to identify the problem. You do not mention the type of blockage that occurred. Adhesions are scar tissue that forms on the bowels after surgery and can constrict it. This could be the problem here. A hiatal hernia could also be the cause of the discomfort that you are experiencing as well. You should not leave this condition unattended seen that you are in severe pain. See your doctor immediately or go to the ER.

  • Dana Holley

    I have cramp like pain in my upper abdomen that goes through to my back and down my lumbar. I also am fatigue and gas. Should I see a doctor?

    • Hi Dana. It is always a good idea to have it checked if it is persisting.While it could be trapped gas or a relatively minor digestive problem, there are also conditions like pancreatitis, gallstones, hiatal hernia and so on that need to be excluded. This may mean further diagnostic investigations like an endoscopy, barium x-ray and so on depending on what you doctor finds during the physical examination.

  • Carrie

    I am a 30 year old female a few months ago I had some severe upper middle pain that radiates to back, lasted an hour and a half, came on strong and left quickly, couldn’t breath that we’ll, it’s happened twice since then lasting the same amount of time the pain is like a squeezing swelling pain, very bad. Now 5 days ago I started to get cold chills and started vomiting for 2 days, every time I tried to eat, then I got diarrhea at night in my sleep! 3 or 4 times that night, couldn’t control it, I still have watery diarrhea, if I try to eat or drink anything, water or bread my stomach, upper stomach starts hurting and gurgling and burning, pretty dang bad, I’m scared to eat or drink, my upper abdomen is bloated. What is this!?!?

    • HI Carrie. We cannot say for sure but you given you age and gender you may want to look at gallstones or related gallbladder disease. Alternatively the possibility of pancreatitis needs to be considered especially if you have been binge drinking (alcohol) recently. However, many cases of gastroenteritis (stomach flu) can persist beyond the 2 days that we most often expect. It is advisable to see your doctor as 5 days is a bit too long for these symptoms to be persisting in conditions like gastroenteritis.

  • karthik

    Hi I am 31 year old male. I used to drink very rarelywhich i have stopped doing totally. A year back i had drunk heavily and had continuously vomitted. Whatever i ate or drank the next day had also come out. When i vomitted i had a very sharp pain in the abdomen a little left side below the ribs, as if something moved up. A month passed off and the pain in the abdomen was still dull and I had started to bloat. Used to burp alot after every meal and felt heavy very soon. After that one day I had difficulty in breathing and the local doctors thought i had an attack. I got admitted and when through few tests, ecg, TMT(came positive). So the doctor had asked me to undergo angeogram to avoid any doubts of blockage. Went through that and it came out negative. So the doctors confirmed later that it could be because of gas trapped somewhere in chest. As the months passed the abdomen pain kept increasing. I cut down on food as i was feeling full and has lot of acid reflux. Not a month passed since sep that i have been visiting doctors for the same problem. Every doctor would give me a med that would supress the acidity in the stomach. Once the cource of the medicine is done within a week the symptoms would come back. Have done blood test, abdomen and pelvic ultrasound and all of them have come negative. For the past 3 to 4 months my stool has changed its appearence from solid to semi solid and now irregular bowel movement. 3 times a day. Sometimes semi solid and sometimes liquid. The last time i decided to visit a gastroenteritis. He had given me a 3 weeks course of medicine and informed me that if it still doesnt help then i will have to undergo an endoscopy. I am now worried as the course is completed and its been over a week and the problem has started again. This time i am also feeling as if the food is stuck in my throat even after 4 to 5 hrs after eating. When i burp the acid reflux brings out the food. Is it something very serious? I havent got any blood till now from my mouth or in stool or urine. Have done urine and stool test last month too. I am very worried. Please help me.

  • Eddie Miller

    I’ve had black stool for a few days and have started getting a uncomfortable pressure behind my sternum . I am a 48 yr old male in pretty good shape.

    • Hi Eddie. If this black stool is not related to something you ate or drank with a strong coloring then it is possible that this black color is due to old and degraded blood. It means that there could be bleeding somewhere in your digestive tract, even as high up as in your stomach. There is no way of knowing for sure without your doctor running further tests like a stool test, colonoscopy and/or upper GI endoscopy. Don’t ignore it. Black stool is known as melena and can be a serious symptom. You may have to consult with a gastroenterologist for further assessment.

  • Courtney King

    My daughter who is six has been having stomach achs alot last night I.noticed her stomach was swollen on the lower left side when she got up this morning it no longer swollen but when I push on her stomach in the middle between the bottom of both ribs right above the belly button she says it hurts and makes her feel pucky

  • Rick

    Hi I am a 50yo male. I had an M.I. two months ago which required a quad bypass. A few days ago I fell and caught myself. In doing so I pulled the upper area of my sternum that was wired back together. At first I had a dull ache but within 24 hours the area became extremely painful and sensitive to the touch and I had difficulty breathing. I called my cardiologist who brought me in immediatly. After several tests he determined I had “Costochondritus” and gave me Celebrex and Percocet. That was a couple of days ago and his office is currently closed. I now am having terrible pain in my lower ribs just below and to the right of my sternum and just above my abdomen. I was wondering if the Costochondritus could have spread down to that area or if it was even possible. I don’t have to tell you that any chest pain now makes me extremely nervous. Thanks for any advice and help you could give. Rick

    • Hi Rick. Hopefully you have seen your cardiologist by now. Given your medical history it is best that you keep consulting with him about your condition. Even if his office is closed and you do not have a direct line to him, there should be a referral system in place for you to consult with another cardiologist in the event of an emergency. It is possible that costochondritis is also affecting the other ribs but it is difficult to say on an online platform and without the results of further investigations. If all else fails, speak to your family doctor.

  • one year ago i started having abdominal pains that are severe with nausea in the mornings. occassionally Im nauseous in the day time too. Ive had many many tests all come back normal. had gallbladder removed that didnt help. Had exploritory female surgery nothing. im miserable. It doesnt seem to be food related but sometimes after eating its bad. when I sit it feels like my abdomen is pinched or something.sometimes laying down doesnt help pain. doesnt seem stress related. I need help!

    • Hi Andrea. It would be helpful to keep a food diary and see whether this pain is related to any specific food. The problem food may not always be as obvious as you think. Since you have undergone significant investigations, other conditions like a hiatal hernia would have been identified. Hopefully you are seeing a gastroenterologist (digestive system specialist). Pain on its own without other specific symptoms can be difficult to identify. Your doctor may need to do further investigations to find the possible cause.

    • Crystal

      Did you ever figure this out. I just wonder as my trouble sounds similar to yours.

  • naara ochoa

    Hi I am a 22 year old female presenting with strong abdominal pain in the mid upper section of my stomach. Its pain that last 5-10 minutes. I have had this pain come and go for about a week if not more. I don’t know what to do. It almost feels like labor pain yet only on the top part of my stomach. It happens at any time. Whether I ate or not the pain always seems to come back.

    • Hi Naara. Pain on its own with other symptoms is difficult to diagnose. You should consult with a doctor. pain in this region can occur for many different reasons. Peptic ulcer disease, gallstones and so on are some of the more common causes but it is difficult to say with any certainty until you undergo medical tests. Speak to your doctor as soon as possible.

  • Sam

    Hi I’m a 62 year old male with pre-diabetes. I have had dull pain post dinner for the past 3 days in my upper center chest area. I did not get nauseated, but one evening I experienced excessive saliva secretion. The pain eventually subsides after a few hours, but one night it lasted until the morning. Any Idea what his might be?

  • Lily Macias

    Hello, my 12 year old is complaining of pain right above his ribs, saying it doesn’t feel like heart burn. He’s taken Pepto and an otc antacid. Any thoughts?

  • Tyler

    Hi my name is Tyler and I am 21 years old. I woke up, went to work. I lift something up that wasn’t really heavy for me and all sudden I felt this burning pain between Lower ribbs and upper stomach. And I felt a minor burning pain all day and through my right arm blood vessel I should say, I felt throbing pain. I walked evey day. I didn’t eat anything that morning and the pain lasted most of the day. It got harder for me to breathe. Is this something I should be concerned about? Or does anybody have any idea what this could be?

    • Hi Tyler. Given your age, it is more likely musculoskeletal in nature. In other words you may have strained the muscles, tendons, ligaments or joints in your arm and on your chest. The other possibility is that this could be a hernia. Really difficult to say through an online platform. You should see your doctor and get the appropriate treatment before it worsens or lead to complications.

  • Allie

    Hi, im writing for help for my boyfriend. Hes 21 years old, and has been having this chronic pain in the middle upper abdomen with chronic vomitting. We have done several tests for the pancreas, gallbladder (gallstones), had a colonoscopy, endoscopy, CT scans, etc. everything has been done and nothing has came back. So we have no idea what it could be but he is miserable. Sometimes when he wakes up for work at/around 5AM, he’ll get this severe pain, sometimes he wont. And mostly on the weekends he doesnt ever get it no matter if we got up early too. Please help!! Hes miserable..

    • Hi Allie. Given his age and the symptoms, conditions like pancreatitis are one of the many concerns but as you mentioned this has been investigated and excluded. Gallstones and a hiatal hernia as well could be a problem but once again you have excluded this with tests. The doctors would have also looked at the possibility of conditions such as gastritis, hepatitis and so on. It would be advisable to seek a second opinion from another gastroenterologist. Less common conditions like gastroparesis could be a possibility here. The weekend onset is unusual unless it is related to alcohol consumption but our doctor will advise your accordingly.

  • brenda

    I have stomach ache. it starts below the breast. right in the middle. it then goes down to my belly button. it hurts so bad. I have taken prilosect and gas pills and pepto bismo. it wont go away. have had it since yesterday

  • Lisa

    I’m having pain in between my upper ribs. That spot in the middle underneath my breast bone. Has anyone ever experienced this?

  • Crystal

    I have stomach pain that is constant and in middle of stomach above navel but below chest. I have given up dairy and coffee and added probiotics but still not good. I used to go to bathroom 1 time a day now I go 4-6. I also have pain under right rib and pelvic area that has started up and I’m nauseous more. I remember it started last June but has gotten worse. I have been teste for c diff celiac and all kinds of bacteria but all negative. I have lost 30 lbs in last year. Thanks.

  • Crystal

    I posted some symptoms earlier but they didn’t show up

  • Kat Bradley

    Hello. I am a 47 yr old female. For a few weeks I found a lump between my upper left ribs. It’s tender to the touch most of the time, but always sore enough to remind me it’s there. It’s hurts more when sitting. I can’t lay on my left side. No nausea.
    Not sure if my sciatic disk could have anything to do with it. I read where they maybe linked. I was diagnosed with osteoarthritis last year

  • Janean

    Hi, I’m a 40 year old female. this morning about 1am i woke up to upper middle stomach pain, between my lower ribs. it lasted about 20 mins and felt like contractions with each one getting worse and more severe. If i would touch the area it was so tender and would hurt worse. i then got this extreme pain (worse i have ever felt). like someone had stabbed me. once that haapened all the pain went away and has not returned. i just moved to a new state and do not have a pcp yet. any ideas?

  • Zoya

    Hey, I’m a fifteen year old girl, and I’ve been experiencing dull pain in my upper middle abdomen and just above my navel. It’s been happening for the past two to three days and intensifies if I put pressure on it, or I move around. Also, I’m supposed to take 75 mg of Zoloft everyday, but I recently stopped taking it recently, without titrating myself off of them (against my psychiatrist’s orders). Could that have anything to do with it?

  • Nina Bates

    I just started having pretty severe pain in my upper stomach region. It started two days ago. I have no appetite at all and it’s hard to touch even. I’m 56 years old and do not know my family history

    • Hi Nina. There are seveal possibilities for you symptoms, ranging from gallstones to gastritis, peptic ulcers, pancreatitis and so on as you can see from the article above. Pain on its own without other more specific symptoms can be difficult to diagnose. Some of the possible causes may not be too much to worry about but other causes can be very serious. It is therefore advisable that you speak to your doctor so he/she can do the necessary tests to diagnose the problem.

  • Dee Ann Rawlings

    I have upper abdominal pain that is right under my breast bone and runs to under my left ribs. Sometimes it goes through to my back. I tis worse after meals. Esp greasy or spicy. I had gastric bypass and gall bladder removal in 2004. I am a 54 yr old female. I have had 4 other abdominal surgeries as well. I have been experiencing “attacks” where the pain bores through to my back. I have frequent loose yellow stools that leave a oil film in the toilet water. my abdomen is increasingly swollen and tender. It is very uncomfortable to bend over and sit for long periods of time. T have some degree of pain most days and frequent nausea. I drank heavily for 20 years, but now just drink occasionally. Alcohol seems to cause increased pain also. Could this possibly be chronic pancreatitis? I am also anemic. Antacids don’t seem to help. Thanks for any opinions/recommendations you may have.

    • Hi Dee Ann. The pain and other symptoms are typical of pancreatitis. You could possibly have chronic pancreatitis but it is difficult to say for sure. Your lack of a gallbladder would further complicate your condition and contribute to symptoms like oily stool and loose stool. However, there may also be other conditions at play here as well which may have contributed to the overall clinical presentation, namely possible liver disease. This could be related your previous history of drinking or even be a result of other diseases. It is highly advisable that you see an internist and possibly a gastroenterologist as well as soon as possible.

  • alicat

    Hi, I’m 19 and I’ve had a tight squeezing pain in the upper middle part of my abdomen right below my chest. It started maybe about 3 years ago and is not constant it happens randomly about once or twice each year. It has only occurred in the morning time. It usually goes away after about an hour. Sometimes the pain is so intense that my hands starts shaking and none of the positions I try to get in help to relieve it. However, usually when I get this pain I’ll have to go to the bathroom which occasionally helps with the pain. My mom always days it’s because I sleep with a bra on, but I don’t think that’s the problem because then wouldn’t it hurt all the time? Please give me some recommendations on what this could be or even how to relieve the pain so when it happens again I can try to decrease the pain. Thank you!

    • Hi Alicat. There are many possible conditions that could cause these symptoms as you can see from the article above. Pain on its own is difficult to diagnose so it would be worthwhile to speak to a doctor who can assess you further before making a diagnosis. Some of the possible conditions that may be considered from what you describe would be gastritis, a hiatal hernia and even gallstones. The bra issue cannot be entirely discounted but it would be difficult to exclude since this pain occurs so infrequently. Given the situation it is difficult to say for sure. We do not provide any advice on treatment on this Q&A platform. That has to be decided by your doctor.

  • Avery

    Hi, i am 23 y/o female who has never experienced any types of gastric pain until recently. I never went to a doctor but based on the symptoms that i googled around, i found out that i have an anxiety. Two weeks ago i feel burning sensations in my stomach that comes and goes… The pain is lesser when i laid down. Now, the pain has gone but instead replaced by this uncomfortable feeling in the middle of the abdomen just below the ribcage. The feeling isnt exactly painful but rather feels like something tight and squeezing and its really uncomfortable when i sit down… It lasts from few days ago till present. The pain feels the same before and after meals. I also burped a lot which sometimes relieved the pain a bit but only for a moment like 1 to two minutes… Please give me some advices on this… Also on whether i should consult a doctor right away since i have a medical check up appointment in one month. Thank you.

    • Hi Avery. Yes, you should consult with a doctor about your symptoms. There are many possible conditions, from gastritis and peptic ulcers to a hiatal hernia or gallstones. As you can see from the article above there are many different conditions that cause pain in the same region. Your doctor will have to examine you further and take all your symptoms into consideration. Further diagnostic investigation may be necessary to confirm/exclude conditions that are suspected.

  • Peter Kenny

    Hi, I’m 57 years old male and have recently had a bout of gastroenteritis. This occurred while on holiday in Florida. When I returned I was still ill for approximately 5 days. I then went back to work and everything was fine for about 8 days. However several days ago I began to get dull stomach pains just below my breastbone. This tends to get worse as the day goes on. It seems to spread to the ribs. I was hoping you would know whether this is related to the gastroenteristis or do I need to have it looked at. Thanks in advance.

    • Hi Peter. It is difficult to say for sure whether this would be related to the previous bout of gastroenteritis. Usually gastroenteritis is viral and quickly resolves on its own. Complications (apart from dehydration) are not common. While this can be due to a number of other conditions, it is difficult to exclude whether this persisting pain is a complication of gastroenteritis. For example, dehydration that may arise with gastroenteritis can increase the risk of gallstones which may be responsible for your current pain. Best that you speak to your doctor if it is still present.

  • Rie

    I have had pain located under the middle of my ribs for the past few months, when it started I would touch the spot gently or lay onto my stomach and it would feel like I was being stabbed. The pain went away but it comes back here and there, and now it’s progressed and causing me to be nauseous.
    I’m not sure what it is, I assume it had to do with my liver but that also includes yellowing of the skin/eyes and I don’t have those symptoms.
    I don’t have money to really go see a doctor and live miles away from the nearest hospital.
    I’m not sure if it can be caused by the poor diet, or taking medication growing up.
    I’m not sure what it is. Neither do the nurses in my family understand what it is either.

    • Hi Rie. Many possible causes as you can see from the article above. Tenderness in the area in addition to the other symptoms you mention makes it more likely to be a gallbladder or pancreas problem. Both can cause pain and nausea. Of course it could be some other cause and even something as mild as muscle strain. However, there is no way of saying for sure at this point. Despite the financial restriction you need to seek professional medical attention even if it means attending a public health facility. The fact that it has been there for months and not got any worse till now should not mislead you into believing that everything will be fine. The condition can suddenly progress and possibly lead to complictions which could be very serious. A doctor will be able to advise you further.