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 edges and the top under the xiphoid process. Another name for this area is the epigastric, or epigastric. Pain of a different nature, which occurs in various pathologies of internal organs, is found precisely in the epigastrium.
In the area of the right hypochondrium are the liver, gallbladder, right kidney, the initial sections of the small intestine.
In the left subcostal 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, adrenal glands, is located in the center.
Characteristic of pain
The pain on the right below 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: gallstones, peptic ulcer and hernia. Often pains can occur after eating, and they can become chronic.
Epigastric pain is a very common symptom. If heartburn occurs, it is a gastroesophageal reflux disease.
Epigastric pain can occur during pregnancy. This is caused by hormonal changes that slow down the digestive process and due to mechanical causes: the abdomen becomes larger, the pressure in the abdominal cavity increases and becomes the cause of discomfort. With increased pressure, pain in the epigastric region is an alarming symptom of pre-eclampsia.
People experience varying levels of soreness: from mild to severe. Non-intense pain often occurs after eating, and it passes quickly. Severe pain in the epigastric region, which is still at the same time and gives to the chest, neck, can be so strong that it interferes with sleep.
Other symptoms in which the epigastric region of the abdomen is tense or painful: belching, abdominal distension, cramping and hunger pains. Sometimes nausea, vomiting, sudden weight loss and poor appetite occur.
Is this a serious disease?
Epigastric pain is not always a manifestation of a serious illness. However, it is necessary to consult a doctor immediately if you experience symptoms such as:
- labored breathing,
- pain in the heart,
- blood in the stool along with vomiting
- fever above 38,
- abdominal pain increases and / or moves to the right lower obdast.
There are many reasons that can cause epigastric pain. Diverticulitis, lactose intolerance and GERD can cause this symptom. Another possible cause of discomfort are inflammatory diseases and even cancer, which affects the functioning of the stomach and other digestive organs. In rare cases, heart disease also leads to pain in the epigastric region. Overeating, eating spicy and fatty foods, and alcohol are well-known factors that cause the epigastric region to become painful both at rest and in the study. Too frequent use of coffee leads to indigestion. This drink also interferes with the activity of GABA metabolism, which is very important in terms of calming the gastrointestinal tract (GIT).
Some other diseases for which pain occurs:
- Gastritis is a condition in which the mucous membrane of the stomach becomes inflamed and sensitive.
- Peptic ulcer disease is an open wound or ulcer in the gastric mucosa and small intestine.
- Dyspepsia or indigestion.
There are other diseases in which the epigastric region becomes painful. It:
- inflammation of the esophagus, also known as esophagitis;
- hiatal hernia;
- stomach cancer;
- oncological processes in the pancreas;
- chronic cough;
- stretching the abdominal muscles;
- abdominal aortic aneurysm;
- side effect of medication.
In some forms of urethritis and other inflammatory diseases of the pelvic organs, sometimes there is pain in the epigastric region, which is usually accompanied by fever and nausea.
Serious and life-threatening causes
Myocardial infarction and angina are those diseases that can also provoke pain in the epigastric region. In this case, there is the effect of reflected pain, which can begin not only in the region of the heart, but also in the pleura or spinal nerves in various diseases.
Some characteristics of pain syndrome
In irritable bowel syndrome, the pain lasts quite a long time and is associated with abdominal distention and a change in stool frequency or consistency. Examination, as a rule, passes without discomfort or may cause mild pain or stretching.
A peptic ulcer is characterized by acute or chronic gnawing or burning pains, especially when dietary recommendations are not followed. Usually the pain intensifies at night.
Pancreatitis is accompanied by acute pain that radiates to the back. This is usually accompanied by vomiting. When leaning forward, pain syndrome decreases. The symptoms of this disease are different, but include jaundice, tachycardia, stiff muscles, tenderness, and discoloration of the skin around the navel or side surfaces of the abdomen.
Peritonitis is a sharp pain with signs of shock and tension. This can be aggravated by coughing. The abdomen may be planted.
Gastrointestinal obstruction is accompanied by acute colicky pain. Vomiting brings relief. Accompanied by stretching and listening to intestinal noise.
In diseases of the gallbladder, acute, constant pain with vomiting, fever, local tenderness and stiffness is diagnosed. In some cases it is possible to palpate the gallbladder.
Aortic aneurysm rupture is a sharp pain that radiates to the back or groin. The patient may have a cardiovascular collapse. In this case, death occurs in the first minutes or in the first hours.
Stomach cancer is most often diagnosed in male patients who are over 55 years old and who smoke. In advanced cases, weight loss, vomiting, hepatomegaly and dysphagia may occur.
Pain in the epigastric region can also be of psychosomatic origin.
In order to diagnose the underlying causes, various studies are conducted. The use of modern technology 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:
- Erythrocyte sedimentation rate (ESR) is an inexpensive and simple study that is used to detect the inflammatory process in the body.
- A urine test is performed to detect urinary tract infections and other associated diseases.
- Biochemical analysis of blood is performed to determine the function of the liver and the content of pancreatic enzymes.
- Endoscopy is usually performed to assess problems related to the stomach and esophagus. This test also provides the ability to perform a biopsy that detects disorders such as inflammation, ulcers and tumors.
- An abdominal x-ray and ultrasound scan is done to check the abdominal organs (stomach, kidneys, intestines, bladder, liver and pancreas) to detect obstructions or other pathologies.
- MRI and CT are very helpful in uncovering the root causes of pain.
- ECG is performed in cases when 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 occur immediately after eating food. Prevention includes the following activities:
- Avoid overeating.
- Eat regularly.
- Eat small meals throughout the day.
- Chew food thoroughly.
- Avoid alcoholic beverages, especially when eating.
- Do not eat foods that cause irritation and even upset stomach.
- Do not go to bed immediately after a meal, because it will affect the digestion of food. It can also cause stomach acid to move up into the esophagus, causing heartburn.
- Limit coffee and carbonated beverages.