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Upper Stomach Pain – Causes and Other Symptoms

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Upper stomach pain is often used to describe upper abdominal pain in general.  Although the stomach lies mainly in the left upper quadrant, it is difficult to correlate pain in this area specifically with stomach related conditions. A number of other structures and organs lie in this part of the abdomen and have to be considered as possible causes of upper abdominal pain.

Any pain in this area is more likely to be associated with the stomach if it changes after eating – either arises, exacerbates or eases during or after a meal. Other symptoms may also be present which are indicative of a stomach, or upper gastrointestinal cause and this includes :

When assessing upper stomach pain, it is also important to consider conditions related to the organs in the thoracic cavity. The close proximity often means that chest pain (chest wall pain or pain of the organs/structures in the chest cavity) may be referred to or radiate to the upper abdomen.

In the context of this article, upper stomach pain will refer to pain in the left hypochondrium and epigastrium. Based on the anatomical location of the stomach, most of it lies within these abdominal quadrants. For more information on upper abdominal pain, refer to these articles on :

Causes of Upper Stomach Pain

Esophagus

  • Esophagitis – inflammation of the esophagus lining.
  • Esophgeal ulcer – open sore in the lining of the esophagus.
  • Esophageal rupture -perforation of the esophagus wall.
  • Achalasia – failure of lower esophageal sphincter (LES) to relax.
  • Mallory-Weiss tear – tear of the esophagus as the junction with the stomach.

Other symptoms that may be present includes :

Stomach

  • Gastritis – inflammation of the stomach lining.
  • Gastroenteritis – infection of the stomach due to food or water borne pathogens or toxins.
  • Stomach ulcer – open sore in the lining of the stomach.
  • Hiatal hernia – protrusion of a portion of the stomach through the diaphragmatic opening.
  • Gastric outlet obstruction – blockage of the passage of food/chyme out of the stomach into the intestines.

Other symptoms that may be present include :

Small Intestine (Duodenum)

  • Gastroenteritis – infection of the intestinal lining due to food or water borne pathogens or toxins.
  • Duodenal ulcer – open sore in the lining of the duodenum. Refer to Peptic Ulcer.
  • Gallstones – calculi in the gallbladder or bile ducts (gallbaldder stones or bile duct stones).
  • Cholecystitis – inflammation of the gallbladder.
  • Pancreatitis – inflammation of the pancreas.
  • Cholangitis – inflammation of the bile ducts.
  • Food malabsorption, intolerance – difficulty or inability to digest or absorb certain nutrients.

Other symptoms that may be present include :

  • Nausea and/or vomiting – projectile vomiting, bile vomiting
  • Fever with/without chills
  • Yellow skin – jaundice
  • Stools – pale or clay colored, steatorrhea (fatty stools)
  • Dark urine
  • Pain that starts shortly after eating and may be related to certain foods/drinks
  • Malabsorption syndromes – signs of mineral or vitamin deficiencies, unintentional weight loss
  • Change in bowel movement – diarrhea, constipation

Large Intestine (Transverse Colon, Splenic Flexure, Descending Colon)

  • Irritable bowel syndrome
  • Inflammatory bowel disease
  • Splenic flexure syndrome (trapped gas)
  • Colitis

Other symptoms that may be present include :

Kidney

  • Kidney stone (renal calculus)
  • Nephritis
  • Renal abscess
  • Renal carcinoma
  • Acute kidney failure
  • Polycystic kidney disease
  • Diabetic nephropathy
  • UTIs (urinary tract infection – upper ureter)

Refer to Kidney Pain Causes for other conditions causing kidney pain. Kidney pain is felt in the back and flank/loin as outlined under Kidney Pain Location.

Other symptoms that may be present include :

Spleen

  • Splenic infarct
  • Splenic rupture
  • Splenomegaly – (enlarged spleen rarely causes pain of the spleen but may press against surrounding structures)

Refer to Spleen Pain for other causes.

Other symptoms that may be present include :

  • Pain aggravated by deep breathing, especially inspiration.
  • Pain after eating large meals.

Abdominal Wall

  • Skin – dermatitis, shingles, hematoma, trauma
  • Muscle – muscle strain, torn muscle
  • Rib – trauma, fracture
  • Peritoneum – peritonitis

Other symptoms may include :

  • Skin features – rash, itching, redness
  • Pain worse upon movement, standing erect, bending forward, lying on side
  • Pain upon breathing

Other Causes

Article reviewed by Dr. Greg. Last updated on January 4, 2011