Gastric Pain – Causes of Pains in the Stomach

Identifying abdominal pain as being isolated to the stomach is often difficult. The stomach is surrounded by many organs and structures that may be the cause of the pain.

However, the following features may be an indication of stomach related condition resulting in pain :

  • Pain that worsens or improves after eating or drinking
  • Pain that improves after taking antacids or worsens after drugs like NSAID’s and certain antibiotics, among others.
  • Pain due to stress (cardiac pain must be excluded – refer to Cardiac Pain vs Non Cardiac Pain)
  • Pain in the left or right upper quadrant of the abdomen but more specifically :
    • Pain under the left ribcage (left hypochondrium/hypochondriac region)
    • Upper middle abdominal pain (epigastrium/epigastric region)
    • Upper left flank (upper left lateral region)
    • Pain above the umbilicus (upper umbilical region)
    • Refer to the Stomach Location article for the approximate position of the stomach in the body.

Causes of Gastric Pain

The pain due to a stomach disorder is usually burning in nature but can range from a dull, gnawing ache to sharp, severe pain. The stomach-related conditions listed below may cause gastric pain or diffuse abdominal pain along with other signs and symptoms.

  • Abdominal Wall and Peritoneum
  • Pain originating from the abdominal wall anterior to the stomach as well the peritoneum surrounding the stomach may result in gastric pain with the characteristic clinical features mentioned above. These causes include :
    • Trauma to the regions mentioned above – assault, accident (fall, motor vehicle), other injuries
    • Muscle strain
    • Costochondritis – 6th left costal cartilage downwards when supine (lying flat)
    • Rib fracture – 6th left rib downwards when supine (lying flat)
    • Peritoneal abscess (intraperitoneal, retroperitoneal)
    • Peritonitis
  • Gastric (Stomach) Ulcers
    • Burning pain and nausea that is worse at night and when the stomach is empty but improves upon eating.
  • No other signs or symptoms may be evident or less common signs and symptoms include :
    • Gastric bleeding – vomiting of blood (hemoptysis), black tarry stools (melena)
    • Increased or decreased appetite
    • Unexplained weight loss
  • Gastroenteritis
    • Nausea and vomiting
    • Diarrhea
    • Fever
  • Food intolerance
    • Nausea and/or vomiting
    • Heartburn
    • Stomach cramps
    • Diarrhea
    • Headaches
  • Postoperative
    • History of stomach surgery – gastric resection, bypass surgery
    • Reduced appetite
    • Nausea
    • Vomiting

Other Causes of Gastric Pain

Pain in the left upper quadrant of the abdomen may also be due to :

  • Spleen
    • rupture
    • abscess
  • Aortic aneurysm
  • Delayed gastric emptying (gastroparesis, gastric outlet obstruction) – slow stomach
  • Perforated colon
  • Pyelonephritis (left kidney)
  • Pneumonia of the left lung
  • Perforated esophagus
  • Other causes of LUQ pain

Pain in the medial part (towards the midline of the body) of the right upper quadrant  include :

  • Myocardial infarction (heart attack)
  • Pneumonia of the lower lobe of the right lung
  • Acute pancreatitis
  • Radiculitis
  • Herpes zoster (shingles)
  • Acute cholecystitis (gallbladder)
  • Duodenal ulcer
  • Hepatitis
  • Other causes of RUQ pain and upper middle abdominal pain (epigastrium)

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