The epigastric region is part of the abdomen in the upper, middle region immediately below the ribs. It has the shape of an isosceles triangle with a base that runs along the lower ribs and the apex under the xiphoid process. Another name for this area is epigastric or epigastric. The pains of a different nature that arise with various pathologies of the internal organs are found precisely in the epigastrium.
In the region of the right hypochondrium are liver, gallbladder, right kidney, the initial sections of the small intestine.
In the left hypochondrium region are the spleen, some parts of the large intestine, the left kidney, the pancreas.
The epigastric region, where the stomach is located, as well as the liver, duodenum, spleen, pancreas, adrenals, is located in the center.
Characteristics of pain
The pain on the right under the ribs can be aching or burning and can spread to the chest and back. Such pain can also be a sign of diseases of various organs and a manifestation of the pathology of the digestive process: stones in the gallbladder, peptic ulcer and hernia. Often, pain can occur after eating, and they can go into a chronic form.
Pain in the epigastric region is a very common symptom. If there is heartburn, it is gastroesophageal reflux disease.
Pain in the epigastrium can occur during pregnancy. It is caused by hormonal changes that slow down the process of digestion and because of mechanical reasons: the stomach becomes bigger, the pressure in the abdominal cavity increases and causes discomfort. With increased pressure, pain in the epigastric region is an alarming symptom of preeclampsia.
People experience different levels of soreness: from mild to severe. Intense pain often occurs after eating, and it quickly passes. Expressed pain in the epigastric region, which still gives to the chest, neck, can be so strong that it prevents sleep.
Other symptoms in which the epigastric abdomen is tense or painful: belching, bloating, spasms and hungry pain. Sometimes there is nausea, vomiting, severe weight loss and poor appetite.
Is this a serious disease?
Pain in the epigastric region is not always a manifestation of a serious disease. However, you need to see a doctor immediately if you experience symptoms such as:
- labored breathing,
- pain in the heart,
- blood in the stool together with vomiting,
- fever above 38,
- pain in the abdomen is amplified and / or moved to the right lower obdast.
There are many reasons that can cause pain in the epigastric region. Diverticulitis, lactose intolerance and GERD can cause this symptom. Another possible cause of discomfort is inflammatory diseases and even cancer, which affects the work of the stomach and other digestive organs. In rare cases, heart disease also leads to pain in the epigastric region. Overeating, the use of acute and fatty foods, alcohol are well-known factors, leading to the fact that the epigastric region becomes painful both at rest and during research. Too frequent coffee intake leads to stomach upset. This drink also interferes with the activity of GABA metabolism, which is very important in terms of calming the gastrointestinal tract (GI tract).
Still some diseases at which there is a pain:
- Gastritis is a condition in which the mucous membrane of the stomach becomes inflamed and sensitive.
- Peptic ulcer is open wounds or ulcers in the mucous membrane of the stomach and in the small intestine.
- Dyspepsia or upset stomach.
There are other diseases in which the epigastric region becomes painful. It:
- inflammation of the esophagus, also known as esophagitis;
- hernia of the esophageal opening of the diaphragm;
- stomach cancer;
- oncological processes in the pancreas;
- chronic cough;
- stretching abdominal muscles;
- abdominal aortic aneurysm;
- a side effect of taking medication.
In some forms of urethritis and other inflammatory diseases of the pelvic organs, pains occur in the epigastric region, which are usually accompanied by fever and nausea.
Serious and life-threatening causes
Myocardial infarction and angina are those diseases that can also provoke tenderness in the epigastric region. There is a reflected pain effect that can begin not only in the heart, but also in the pleura or spinal nerves in various diseases.
Some characteristics of pain syndrome
With irritable bowel syndrome, the pain lasts a long time and is associated with bloating and changes in the frequency of the stool or its consistency. The examination, as a rule, passes without discomfort or can cause moderate soreness or a feeling of stretching.
Peptic ulcer is characterized by acute or chronic gnawing or burning pain, especially when non-compliance with dietary recommendations. Usually the pain intensifies at night.
Pancreatitis is accompanied by acute pain, which radiates into the back. This is usually accompanied by vomiting. When you lean forward, the pain syndrome decreases. Symptoms of this disease are different, but include jaundice, tachycardia, stiffness of the abdominal muscles, tenderness and discoloration around the navel or lateral surfaces of the abdomen.
Peritonitis is an acute pain with signs of shock and tension. This can increase with coughing. The abdomen can be flaky.
Gastrointestinal obstruction is accompanied by acute colic pains. Vomiting brings relief. It is accompanied by stretching and listening to intestinal noises.
In diseases of the gallbladder, acute permanent pain with vomiting, fever, local soreness and stiffness is diagnosed. In some cases it is possible to palpate the gallbladder.
The rupture of the aortic aneurysm is a sharp pain that radiates into the back or into the groin. The patient may have cardiovascular collapse. In this case, death occurs in the first minutes or in the first hours.
The cancer of the stomach is most often diagnosed in male patients who are already 55 years old and who smoke. With neglected cases, weight loss, vomiting, hepatomegaly and dysphagia may occur.
Pain in the epigastric region can also be of a psychosomatic origin.
In order to diagnose the main causes, various studies are being conducted. The use of modern technologies plays an important role in achieving excellent results in the detection of the affected area of the body. The following are the most common methods:
- The rate or reaction of erythrocyte sedimentation (ESR) is an inexpensive and simple study that is used to detect the inflammatory process in the body.
- Urinalysis is performed to detect urinary tract infections and other concomitant diseases.
- A biochemical blood test is performed to determine the liver function and the content of pancreatic enzymes.
- Endoscopy is usually performed to assess problems associated with the stomach and esophagus. This test also provides the possibility of performing a biopsy that detects disorders such as inflammation, ulcers and tumors.
- X-rays and ultrasound of the abdominal cavity is done to check the organs of the abdominal cavity (stomach, kidneys, intestines, bladder, liver and pancreas) to identify obstructions or other pathologies.
- MRI and CT are very useful in uncovering the root cause of pain.
- The ECG is performed in cases where epigastric pain is not associated with gastrointestinal diseases. This test helps in the diagnosis of heart attacks.
How to prevent epigastric pain
Most episodes of pain appear immediately after eating. Prevention includes the following activities:
- Avoid overeating.
- Regularly eat.
- There are small portions throughout the day.
- Thoroughly chew food.
- Avoid alcoholic beverages, especially when eating.
- Do not eat foods that cause irritation and even indigestion.
- Do not lie down immediately after a meal, because this will affect the digestion of food. It can also lead to the fact that the stomach acid moves up into the esophagus, causing heartburn.
- Limit consumption of coffee and carbonated drinks.