Upper Abdominal Pain: Causes by Location, After Eating and Warning Signs

Upper abdominal pain can appear in the centre, under the right ribs or on the upper left side. It may feel burning, sharp, cramping, aching or like pressure, and it may occur after eating, on an empty stomach or together with nausea, bloating or back pain.

So what actually causes pain in the upper abdomen?

The answer depends on more than location alone.

Possible causes include indigestion, acid reflux, gastritis, peptic ulcer disease, gallbladder problems, pancreatic conditions, digestive motility disorders and other gastrointestinal or non-digestive causes.

The most useful clues are:

location + timing + relationship to food + duration + where the pain spreads + associated symptoms

Sudden or severe upper abdominal pain, especially when accompanied by vomiting blood, black stools, jaundice, fainting, chest pain, difficulty breathing or persistent vomiting, requires urgent medical assessment.

Upper Abdominal Pain: Quick Answer

Upper abdominal pain is discomfort between the lower edge of the ribs and approximately the level of the navel.

Pain in this area may originate from the:

• stomach,
• oesophagus,
• duodenum,
• gallbladder,
• bile ducts,
• liver,
• pancreas,
• intestine,
• abdominal wall,
• or sometimes organs outside the digestive system.

The location can provide clues, but it does not identify the cause by itself.

For example:

Middle upper abdominal pain may occur with indigestion, reflux, gastritis, ulcers or pancreatic conditions.

Right upper abdominal pain can raise consideration of the gallbladder, bile ducts or liver.

Left upper abdominal pain may involve the stomach, intestine, pancreas, abdominal muscles or other nearby structures.

The question is therefore not simply:

“Where does it hurt?”

It is:

“Where does it hurt, when does it occur, what triggers it and what other symptoms occur with it?”

Where Is Upper Abdominal Pain Located?

The upper abdomen is generally the area below the rib cage and above the middle or lower abdomen.

Doctors often think about three broad areas:

Upper centre — epigastric region

This is the area many people describe as the “pit of the stomach”.

Upper right abdomen — right upper quadrant

This includes the region beneath the right ribs.

Upper left abdomen — left upper quadrant

This lies beneath the left ribs.

However, internal organs sit close together and pain can be referred or spread away from its source.

That is why:

right = gallbladder

or

left = stomach

are useful clues, but not reliable diagnoses.

What Causes Upper Abdominal Pain?

There are many possible causes.

Common or important possibilities include:

• indigestion or dyspepsia,
• acid reflux,
• gastritis,
• peptic or duodenal ulcers,
• Helicobacter pylori infection,
• gallstones,
• gallbladder inflammation,
• bile-duct problems,
• pancreatic conditions,
• some liver conditions,
• intestinal gas or bloating,
• digestive motility problems,
• certain medicines,
• abdominal muscle or rib problems,
• and non-gastrointestinal causes.

Some are relatively minor and temporary.

Others require prompt investigation.

The pattern of the pain helps determine which possibilities deserve the most attention.

What Does Pain in the Middle of the Upper Abdomen Mean?

Pain in the centre of the upper abdomen is often called epigastric pain.

It can feel:

• burning,
• aching,
• gnawing,
• tight,
• cramp-like,
• or like pressure.

Possible digestive causes include:

• indigestion,
• acid reflux,
• gastritis,
• peptic ulcer disease,
• duodenal problems,
• and some pancreatic conditions.

But epigastric pain is not automatically “stomach pain”.

A doctor will usually want to know:

• whether the pain occurs before or after food,
• whether eating improves or worsens it,
• whether heartburn is present,
• whether there is nausea,
• whether you become full very quickly,
• whether bloating occurs,
• whether the pain wakes you at night,
• and whether it travels to your back or chest.

These details often provide more useful information than location alone.

What Causes Right Upper Abdominal Pain?

Pain beneath the right ribs may have several causes.

Structures in or close to this region include the:

• gallbladder,
• bile ducts,
• liver,
• intestine,
• diaphragm,
• ribs,
• and abdominal muscles.

One important cause to consider is gallbladder disease.

What Does Gallbladder Pain Feel Like?

Pain related to gallstones can be severe and constant and may occur in the middle upper abdomen or beneath the right ribs. It may last from more than 30 minutes to several hours and may be accompanied by nausea or vomiting.

The pattern may become more suggestive when pain:

• occurs beneath the right ribs,
• develops after meals,
• is particularly noticeable after richer or fatty foods,
• spreads towards the back,
• or extends towards the right shoulder.

However:

Right upper abdominal pain does not automatically mean gallstones.

The clinical pattern usually needs to be combined with examination and, when appropriate, blood tests and imaging.

When Is Right Upper Abdominal Pain More Concerning?

Seek prompt assessment when right upper abdominal pain occurs together with:

• fever,
• persistent vomiting,
• jaundice,
• dark urine,
• pale stools,
• or increasingly severe and persistent pain.

Gallstones can occasionally lead to complications involving the gallbladder, bile ducts or pancreas.

What Causes Left Upper Abdominal Pain?

Pain beneath the left ribs can also have several explanations.

Structures in this region include parts of the:

• stomach,
• intestine,
• pancreas,
• spleen,
• diaphragm,
• and abdominal wall.

People sometimes assume:

“Upper left pain must be my stomach.”

That is not necessarily true.

Doctors consider:

• the type of pain,
• whether it is associated with meals,
• bowel symptoms,
• nausea or vomiting,
• whether movement affects it,
• whether it follows an injury,
• and whether the pain spreads elsewhere.

Persistent or severe left upper abdominal pain therefore deserves assessment based on the full symptom pattern rather than location alone.

Why Do I Get Upper Abdominal Pain After Eating?

Upper abdominal pain after eating is a common search and a common clinical complaint.

Potential explanations include:

• indigestion,
• reflux,
• stomach irritation,
• ulcer-related disease,
• meal-related stomach distension,
• gallbladder disease,
• food intolerance,
• and some disorders affecting digestive motility.

Timing can provide additional clues.

Pain Immediately After Eating

Pain that begins soon after eating may lead doctors to consider:

• meal size,
• upper gastrointestinal symptoms,
• reflux,
• stomach distension,
• nausea,
• and early satiety.

Pain After Fatty Meals

Repeated pain beneath the right ribs or in the upper middle abdomen after richer meals can make the gallbladder more relevant to the assessment.

This pattern alone does not prove gallstones.

Pain Several Hours After Eating

Later symptoms may involve different parts of the digestive process, including intestinal contents, fermentation or other gastrointestinal conditions.

The key point is:

Pain after eating does not automatically mean a stomach problem.

Does Pain After Eating Mean I Have an Ulcer?

No.

A peptic ulcer can cause upper abdominal discomfort in some people, but the timing of pain alone cannot confirm an ulcer.

Upper abdominal pain after food can occur with many conditions.

Doctors become more concerned about possible ulcer complications when symptoms occur with:

• black stools,
• vomiting blood,
• unexplained anaemia,
• persistent vomiting,
• or persistent or worsening pain.

Determining whether an ulcer is present may require H. pylori testing or, in selected patients, gastroscopy.

Why Does My Upper Abdomen Hurt on an Empty Stomach?

Some people notice pain when they have not eaten for several hours or before meals.

This pattern may be clinically useful, but it does not establish one specific diagnosis.

Useful questions include:

• Does eating relieve the pain?
• Does eating make it worse?
• Does the pain wake you from sleep?
• Is there nausea?
• Do you have heartburn?
• Are you taking anti-inflammatory medicines?
• Have your appetite or weight changed?
• Have your stools changed?

Avoid diagnosing an ulcer simply because pain occurs on an empty stomach.

Can Gastritis Cause Upper Abdominal Pain?

Yes, stomach inflammation can be associated with upper abdominal discomfort.

Symptoms may include:

• burning or aching discomfort,
• nausea,
• fullness,
• or upper abdominal pain.

However, symptoms of gastritis overlap considerably with:

• indigestion,
• peptic ulcers,
• reflux,
• and other upper gastrointestinal conditions.

This means that pain alone cannot reliably tell you whether you have gastritis.

Can H. pylori Cause Upper Abdominal Pain?

Helicobacter pylori infection is associated with gastritis and peptic ulcer disease.

However:

Upper abdominal pain does not automatically mean that you have H. pylori.

Testing may be considered depending on:

• the symptom pattern,
• medical history,
• previous ulcer disease,
• medications,
• age,
• and other clinical factors.

Treatment for H. pylori should generally follow appropriate diagnosis rather than taking antibiotics simply because upper abdominal pain is present.

Can Acid Reflux Cause Upper Abdominal Pain?

Yes.

Reflux can produce symptoms including:

• heartburn,
• burning behind the breastbone,
• acid or food coming back into the mouth,
• upper abdominal discomfort,
• and symptoms that become worse after eating or lying down.

However, not every burning sensation in the upper abdomen is reflux.

This distinction is especially important when discomfort occurs with:

• chest pressure,
• shortness of breath,
• sweating,
• dizziness,
• or pain extending towards the arm, shoulder or jaw.

These symptoms may require urgent assessment for causes outside the digestive system.

Can Gas Cause Pain in the Upper Abdomen?

Yes.

Gas can cause:

• pressure,
• cramping,
• fullness,
• bloating,
• and intermittent abdominal pain.

But persistent or severe pain should not automatically be blamed on “trapped gas”.

If abdominal expansion and fullness are more prominent than pain, the symptom pattern may overlap with persistent bloating.

Gas becomes a less reassuring explanation when pain is:

• severe,
• progressively worsening,
• persistent,
• associated with vomiting,
• associated with bleeding,
• or accompanied by unexplained weight loss.

What Causes Upper Abdominal Pain That Spreads to the Back?

Upper abdominal pain that radiates towards the back can occur for several reasons.

The pancreas is one structure doctors may consider when this pattern is present.

Acute pancreatitis can cause sudden, persistent and severe upper abdominal pain that may spread towards the sides or back and can occur with nausea or vomiting. It requires urgent medical assessment and hospital treatment.

However:

Upper abdominal pain extending to the back does not automatically mean pancreatitis.

Other digestive, muscular and non-digestive causes can produce a similar pattern.

Seek urgent assessment when the pain is:

• sudden,
• severe,
• persistent,
• becoming worse,
• or accompanied by repeated vomiting, fever, rapid heartbeat or difficulty breathing.

Upper Abdominal Pain With Nausea: What Does It Mean?

Nausea does not point to one particular diagnosis.

It can occur with:

• indigestion,
• stomach disorders,
• gallbladder conditions,
• pancreatic disease,
• gastrointestinal infection,
• medication effects,
• and many other illnesses.

The pattern becomes more concerning when vomiting is:

• repeated,
• preventing you from drinking,
• associated with severe pain,
• or contains blood.

Persistent nausea together with upper abdominal pain should not simply be managed indefinitely with anti-sickness or acid-reducing medicines without understanding the cause.

Upper Abdominal Pain and Bloating

Bloating may accompany:

• indigestion,
• constipation,
• IBS,
• food intolerance,
• digestive motility problems,
• and other gastrointestinal conditions.

But pain and bloating are different symptoms.

Bloating usually describes:

fullness + tightness + pressure + abdominal expansion

while abdominal pain may be:

burning + aching + cramping + sharp pain

If bloating is your main symptom, read the DRFK guide to persistent bloating, its causes, tests and warning signs.

Upper Abdominal Pain and Early Satiety

Early satiety means becoming full after eating less food than you normally would.

For example:

You begin a normal meal but feel unable to continue after only a small amount.

Early satiety can occur with upper abdominal discomfort and deserves more attention when it is:

• new,
• persistent,
• progressively worsening,
• associated with nausea,
• accompanied by vomiting,
• associated with loss of appetite,
• or accompanied by unexplained weight loss.

Early satiety is a symptom rather than a diagnosis, but it can influence which investigations are appropriate.

What Does Upper Abdominal Pain With Black Stool Mean?

Black, tarry stool can sometimes indicate bleeding higher in the gastrointestinal tract.

Upper abdominal pain accompanied by:

• black tarry stool,
• vomiting blood,
• marked dizziness,
• fainting,
• or significant weakness

requires prompt medical assessment.

Some foods, iron supplements and medicines can affect stool colour, but a new black tarry stool combined with pain or other concerning symptoms should not be diagnosed at home.

Can Upper Abdominal Pain Come From the Heart?

Yes.

Not every pain felt around the upper abdomen or lower chest is gastrointestinal.

Cardiac symptoms can sometimes be perceived as:

• upper abdominal pressure,
• indigestion-like discomfort,
• nausea,
• or chest discomfort.

Urgent assessment is particularly important when upper abdominal or chest discomfort is associated with:

• shortness of breath,
• sweating,
• dizziness,
• faintness,
• pressure in the chest,
• or pain extending towards the arm, shoulder, neck or jaw.

Do not assume these symptoms are simply acid reflux or indigestion.

When Is Upper Abdominal Pain Serious?

Many episodes of upper abdominal discomfort are temporary.

However, seek urgent medical assessment when upper abdominal pain is:

• sudden and severe,
• rapidly worsening,
• persistent and intense,
• accompanied by vomiting blood,
• associated with black tarry stool,
• accompanied by jaundice,
• associated with fainting,
• accompanied by chest pain,
• associated with difficulty breathing,
• accompanied by repeated vomiting,
• or associated with a rapid deterioration in your general condition.

Severe abdominal pain accompanied by jaundice, high temperature or pain spreading towards the back can indicate conditions requiring urgent assessment.

When Should I See a Doctor for Upper Abdominal Pain?

Even without emergency symptoms, medical assessment is appropriate when pain:

• keeps returning,
• persists for a prolonged period,
• wakes you at night,
• happens after most meals,
• is becoming more frequent,
• affects your ability to eat normally,
• is associated with early satiety,
• occurs with persistent nausea,
• is associated with changes in appetite or weight,
• or does not improve despite repeated treatment.

Repeatedly using acid medication without knowing the cause can delay appropriate assessment.

How Is Upper Abdominal Pain Diagnosed?

There is no single test for “upper abdominal pain”.

Assessment begins with understanding the pattern.

A gastroenterologist may ask:

• Where exactly is the pain?
• When did it begin?
• Is it constant or intermittent?
• How long does each episode last?
• Does it occur before or after food?
• Does fatty food trigger it?
• Does the pain travel towards the back or shoulder?
• Do you experience heartburn?
• Is bloating present?
• Is there nausea or vomiting?
• Do you become full quickly?
• Have you lost weight?
• Have your bowel movements changed?
• Is your stool black?
• Are you taking aspirin, ibuprofen or other medicines?
• Have you experienced similar symptoms before?

The pattern helps determine which investigation is most useful.

The diagnostic approach should generally be:

symptoms → clinical assessment → focused investigation

rather than:

upper abdominal pain → automatic endoscopy.

What Tests May Be Needed for Upper Abdominal Pain?

Not every patient needs the same tests.

Investigations depend on:

• age,
• pain location,
• duration,
• severity,
• associated symptoms,
• medical history,
• medication use,
• examination findings,
• and previous investigations.

Possible tests include blood tests, H. pylori testing, ultrasound, other imaging or upper gastrointestinal endoscopy.

Blood Tests

Depending on the clinical picture, blood tests may help assess:

• anaemia,
• infection or inflammation,
• liver function,
• bile-duct abnormalities,
• pancreatic enzymes,
• or other relevant abnormalities.

The precise tests should be selected according to the suspected cause.

When Is an Abdominal Ultrasound Useful?

Ultrasound can be particularly useful when doctors need to examine structures such as the:

• gallbladder,
• bile ducts,
• liver,
• or other abdominal organs.

For suspected symptomatic gallstones, NHS guidance notes that investigation commonly includes ultrasound and blood tests.

However:

Upper abdominal pain does not automatically mean you need an ultrasound.

The investigation should answer a specific clinical question.

When Is CT or MRI Used for Upper Abdominal Pain?

CT or MRI may be considered when the clinical picture suggests that more detailed imaging is necessary.

Examples can include investigation of selected pancreatic, biliary, abdominal or other structural conditions.

These tests are not necessary for every patient with mild or uncomplicated upper abdominal discomfort.

More testing is not automatically better testing.

The most useful test is the one capable of changing the diagnosis or management.

Do I Need a Gastroscopy for Upper Abdominal Pain?

Not necessarily.

Gastroscopy, also called upper gastrointestinal endoscopy, allows a specialist to examine the:

• oesophagus,
• stomach,
• and duodenum.

A gastroenterologist may consider gastroscopy when symptoms or clinical findings make direct examination useful.

Examples can include selected patients with:

• persistent upper abdominal symptoms,
• difficulty swallowing,
• possible gastrointestinal bleeding,
• unexplained anaemia,
• recurrent vomiting,
• unexplained weight loss,
• or previous findings that require review.

But the important rule is:

Upper abdominal pain ≠ automatic gastroscopy.

Assessment should come first.

You can learn more about the investigation pathway through DRFK's gastroenterology and digestive health service.

What Is the Best Treatment for Upper Abdominal Pain?

There is no universal treatment because upper abdominal pain is a symptom.

Treatment differs significantly depending on whether the cause is:

• reflux,
• gastritis,
• H. pylori,
• peptic ulcer disease,
• gallstones,
• pancreatitis,
• digestive motility,
• a medication effect,
• or another condition.

The useful pathway is:

identify the cause → treat the cause → monitor the response

rather than repeatedly treating every episode as “acid”.

Can I Treat Upper Abdominal Pain at Home?

Mild, short-lived discomfort associated with an obvious temporary trigger may improve without specific treatment.

Depending on the situation, simple measures can include:

• smaller meals,
• eating more slowly,
• avoiding lying down immediately after food when reflux is present,
• maintaining adequate hydration,
• and noticing whether particular meals repeatedly trigger symptoms.

But home management becomes less appropriate when pain:

• persists,
• repeatedly returns,
• becomes more severe,
• wakes you at night,
• limits food intake,
• or occurs with warning symptoms.

Can Painkillers Cause Stomach Pain?

Some medicines can affect the stomach and upper gastrointestinal tract.

This makes medication history particularly important when evaluating upper abdominal pain.

Tell your doctor about:

• prescription medication,
• over-the-counter painkillers,
• aspirin,
• anti-inflammatory medicines,
• supplements,
• and how frequently you use them.

Do not stop prescribed medication without medical advice.

Instead, make sure the clinician evaluating your abdominal pain knows exactly what you take.

What Should I Track Before Seeing a Gastroenterologist?

Rather than simply saying:

“My stomach hurts,”

try to record the pattern.

Useful information includes:

• where the pain occurs,
• what time it starts,
• how long it lasts,
• whether it occurs before or after eating,
• whether particular meals trigger it,
• whether it spreads to the back or shoulder,
• whether you experience heartburn,
• whether you feel bloated,
• whether nausea or vomiting occurs,
• whether you become full quickly,
• whether your stool has changed,
• and what medicines you have taken.

These details can significantly narrow the diagnostic possibilities.

Upper Abdominal Pain in European and International Patients

Patients from the UK, Ireland, Germany, France, the Netherlands, Belgium, Switzerland, Scandinavia and other European countries sometimes seek a gastroenterology second opinion when upper abdominal symptoms continue despite initial treatment.

Reasons may include:

• recurring pain despite acid medication,
• uncertainty about whether symptoms are caused by reflux or the stomach,
• suspected gallbladder disease,
• unexplained symptoms despite previous tests,
• uncertainty about whether gastroscopy is necessary,
• a previous endoscopy that requires specialist review,
• or symptoms that continue despite treatment for H. pylori.

International patients should bring previous:

• blood-test results,
• ultrasound reports,
• CT or MRI reports,
• H. pylori results,
• gastroscopy reports,
• biopsy/pathology results,
• medication lists,
• and relevant previous diagnoses.

Reviewing existing results first can help avoid unnecessarily repeating investigations.

Second Opinion for Persistent Upper Abdominal Pain

A second gastroenterology opinion can be useful when symptoms continue but the explanation remains uncertain.

For example, you may have been told the pain is:

• gastritis,
• reflux,
• an ulcer,
• gas,
• gallbladder pain,
• or functional dyspepsia,

but symptoms have not improved as expected.

A second opinion does not automatically mean undergoing another endoscopy.

The first step can be:

symptoms + previous blood tests + imaging + endoscopy + pathology + treatment response

followed by deciding whether additional testing would actually change the diagnosis or treatment.

Gastroenterology Assessment for International Patients

European and other international patients can undergo specialist digestive assessment at DRFK.

Adult gastroenterology care is led by Dr. Ali Ibrahim Shorbagi, a European Board-Certified Gastroenterologist and Internist with more than two decades of postgraduate clinical experience.

Depending on the individual case, assessment may involve:

• consultation,
• review of previous investigations,
• laboratory testing,
• abdominal imaging,
• H. pylori testing,
• gastroscopy,
• endoscopic ultrasound,
• or another targeted investigation.

The objective is not to order the maximum number of tests.

It is to identify:

Which test can actually explain the symptoms or change the treatment plan?

When Should You See a Gastroenterologist for Upper Abdominal Pain?

Consider specialist gastroenterology assessment when upper abdominal pain:

• keeps coming back,
• remains unexplained,
• does not improve with initial treatment,
• repeatedly occurs after meals,
• is accompanied by persistent nausea,
• is associated with early satiety,
• occurs with unexplained weight loss,
• affects appetite,
• is associated with abnormal blood tests,
• or requires interpretation of previous imaging or endoscopy.

A gastroenterology consultation does not automatically mean you will need an endoscopy.

DRFK's current gastroenterology pathway includes evaluation of stomach, oesophageal, gallbladder, biliary and pancreatic conditions, with imaging and endoscopy selected according to clinical need.

Book an Assessment for Persistent Upper Abdominal Pain

If upper abdominal pain is persistent, recurring after meals or accompanied by nausea, early fullness, changes in appetite or other digestive symptoms, specialist assessment can help determine the next appropriate step.

European and international patients can book a gastroenterology consultation with DRFK and provide previous blood tests, ultrasound, CT/MRI, H. pylori testing or endoscopy reports for review.

The goal is not simply to suppress the pain.

It is to answer:

What is causing the upper abdominal pain, and does it require treatment, imaging or endoscopy?

Frequently Asked Questions About Upper Abdominal Pain

What is the most common cause of upper abdominal pain?

There is no single cause. Indigestion, reflux and other stomach-related symptoms are common possibilities, but gallbladder, pancreatic, intestinal, muscular and non-digestive causes can also produce upper abdominal pain.

What organ causes pain in the upper middle abdomen?

The stomach and duodenum are located in this region, but pain can also arise from the oesophagus, pancreas, gallbladder or other nearby structures. Location alone cannot identify the organ responsible.

Why does my upper abdomen hurt after eating?

Possible causes include indigestion, reflux, stomach disorders, meal-related distension and gallbladder disease. The timing, location, meal type and associated symptoms help narrow the possibilities.

What causes pain under the right ribs after eating?

The gallbladder is one possibility, particularly when pain occurs after meals and may extend towards the back or right shoulder. However, several other conditions can cause right upper abdominal pain.

What causes upper abdominal pain on the left side?

The stomach, intestine, pancreas, abdominal muscles and other nearby structures can all contribute. Left-sided pain does not automatically mean a stomach disorder.

What causes upper abdominal pain that radiates to the back?

Several conditions can cause this pattern. Pancreatic disease is one important possibility, especially when pain is severe and persistent with nausea or vomiting, but radiating pain is not specific to the pancreas.

Can gastritis cause upper stomach pain?

Yes, gastritis can be associated with burning or aching upper abdominal discomfort, but symptoms overlap with indigestion, ulcers and reflux. Symptoms alone cannot confirm gastritis.

Can H. pylori cause upper abdominal pain?

It can. H. pylori is associated with gastritis and peptic ulcer disease. However, upper abdominal pain alone does not prove infection, and appropriate testing is needed.

Can gas cause pain under the ribs?

Yes. Gas can cause pressure and cramp-like discomfort beneath the ribs, but persistent or severe pain should not automatically be attributed to gas.

Does upper abdominal pain mean an ulcer?

No. Ulcers are one possible cause, but many other conditions produce similar symptoms.

When should I worry about upper abdominal pain?

Seek urgent medical help when pain is sudden or severe, or accompanied by vomiting blood, black stools, jaundice, fainting, difficulty breathing, chest pain or persistent vomiting.

What tests are used for upper abdominal pain?

Depending on the clinical pattern, testing may include blood tests, H. pylori testing, ultrasound, other imaging or gastroscopy. Not everyone needs every test.

Does right upper abdominal pain mean gallstones?

Not necessarily. Gallstones can cause right upper or central abdominal pain, but symptoms need to be interpreted together with examination and appropriate testing.

Do I need an ultrasound for upper abdominal pain?

Not always. Ultrasound is particularly useful when the gallbladder, bile ducts, liver or certain other abdominal structures need evaluation.

Do I need an endoscopy for upper abdominal pain?

Not automatically. Gastroscopy is selected when symptoms, medical history or clinical findings suggest that direct examination of the oesophagus, stomach and duodenum may be useful.

Can upper abdominal pain be caused by the heart?

Yes. Some cardiac symptoms can resemble indigestion or upper abdominal discomfort. Pain or pressure accompanied by breathlessness, sweating, dizziness or pain extending towards the arm or jaw requires urgent assessment.

Which doctor should I see for persistent upper abdominal pain?

A gastroenterologist assesses disorders involving the oesophagus, stomach, intestine, liver, gallbladder, bile ducts and pancreas and can determine which investigations are appropriate.

Conclusion: Location Is a Clue, Not the Diagnosis

When trying to understand upper abdominal pain, do not rely on location alone.

Instead, consider:

Where is the pain?

When does it start?

Is it related to food?

How long does it last?

Does it extend to the back or shoulder?

Is nausea or vomiting present?

Do you become full unusually quickly?

Have your appetite or weight changed?

Is there jaundice, black stool or bleeding?

For some people, upper abdominal pain may be related to indigestion, reflux or another relatively common digestive problem.

For others, assessment may identify a stomach ulcer, H. pylori, gallbladder disease, pancreatic disease or another gastrointestinal condition requiring targeted treatment.

The most useful approach is therefore not:

“What medicine should I take for upper abdominal pain?”

but:

“What is causing my upper abdominal pain?”

Once the pattern is understood, the doctor can decide whether observation, blood tests, H. pylori testing, ultrasound, other imaging or gastroscopy is actually appropriate.

Medical review: Dr. Ali Ibrahim Shorbagi, Gastroenterologist & Internist, DRFK.

Medical disclaimer: This article provides general health information and does not replace personalised medical assessment. Seek urgent medical care for sudden severe abdominal pain, vomiting blood, black tarry stools, jaundice, fainting, chest pain, breathing difficulty or rapidly worsening symptoms.