Upper Abdominal Pain: Causes and Recommended Tests - Gastroenterology and Hepatology

Abdominal pain

Hello Dr.
Lin: Recently, I have been experiencing hardness in the upper abdominal area near the chest, which is often painful when pressed.
Occasionally, after meals, I feel a burning sensation in my abdomen, along with nausea and belching, and my stomach appears to be quite distended.
I visited a gynecologist two weeks ago, and I am not pregnant, but I have irregular menstrual cycles; my last period started on January 18 and ended on February 10.
I am unsure what kind of tests I should undergo.

Mei, 30~39 year old female. Ask Date: 2017/02/25

Dr. Lin Minghui reply Gastroenterology and Hepatology

Upper abdominal pain, occasional burning sensation after meals, and regurgitation with burping may indicate functional gastrointestinal issues.
Conditions such as gastritis and esophagitis suggest the need to pay attention to dietary habits, including chewing food thoroughly, eating slowly, and avoiding irritating and greasy foods.
If symptoms persist, an upper gastrointestinal endoscopy may be arranged to check for esophageal, gastric, or duodenal diseases, or an abdominal ultrasound to assess for liver, gallbladder, or pancreatic conditions.

Reply Date: 2017/02/25

More Info

Upper abdominal pain can be a complex issue, as it may arise from various underlying conditions affecting different organs. Given your symptoms of hardness in the upper abdomen, pain upon pressure, postprandial burning sensation, regurgitation, and bloating, it is essential to consider a range of potential causes and appropriate diagnostic tests.

Possible Causes of Upper Abdominal Pain
1. Gastroesophageal Reflux Disease (GERD): The burning sensation after meals and regurgitation could indicate GERD, where stomach acid flows back into the esophagus, causing discomfort and inflammation.

2. Peptic Ulcer Disease: Ulcers in the stomach or the first part of the small intestine can lead to pain, especially after eating, and may be associated with bloating and discomfort.

3. Gallbladder Issues: Given your history of gallbladder surgery, it is essential to consider post-cholecystectomy syndrome, which can cause similar symptoms due to changes in bile flow.

4. Functional Dyspepsia: This is a common condition characterized by chronic indigestion without an identifiable cause. Symptoms include bloating, discomfort, and nausea.

5. Pancreatitis: Inflammation of the pancreas can present as upper abdominal pain, especially if it is related to gallstones or alcohol consumption.

6. Hormonal Imbalances: Since you mentioned irregular menstrual cycles, hormonal fluctuations can also contribute to gastrointestinal symptoms.

Recommended Diagnostic Tests
To accurately diagnose the cause of your upper abdominal pain, the following tests may be recommended:
1. Upper Endoscopy (EGD): This procedure allows direct visualization of the esophagus, stomach, and duodenum to check for ulcers, inflammation, or other abnormalities.

2. Abdominal Ultrasound: This imaging test can help assess the gallbladder, liver, and pancreas for any structural issues or abnormalities.

3. Esophageal pH Monitoring: This test measures acid levels in the esophagus and can help confirm GERD.

4. H. pylori Testing: Since H. pylori infection is a common cause of peptic ulcers, testing for this bacterium can be beneficial.

5. Complete Blood Count (CBC) and Liver Function Tests: These blood tests can help identify signs of infection, inflammation, or liver dysfunction.

6. Hormonal Panel: Given your menstrual irregularities, checking hormone levels may provide insights into any underlying endocrine issues.

Conclusion
It is crucial to consult with a healthcare professional who can evaluate your symptoms in detail and recommend the appropriate tests based on your medical history and current condition. Keeping a symptom diary, noting when the pain occurs, its intensity, and any associated symptoms, can also be helpful for your healthcare provider in making an accurate diagnosis.

In the meantime, consider dietary modifications, such as avoiding spicy or fatty foods, eating smaller meals, and staying upright after eating to help manage your symptoms. Stress management techniques, such as mindfulness or relaxation exercises, may also be beneficial, especially if anxiety is a contributing factor to your gastrointestinal symptoms.

Remember, persistent or severe symptoms warrant prompt medical attention to rule out any serious conditions.

Similar Q&A

Understanding Persistent Upper Abdominal Pain: Causes and Solutions

Hello, Doctor. Nine years ago, I had a cold, and during that time, I experienced severe coughing, which caused intense pain in my upper abdomen. After recovering from the cough, I noticed that the upper abdominal pain persisted, especially at night. When I consulted a doctor, I m...

Dr. Ye Qianyu reply Family Medicine
Hello, the pancreas is located in the retroperitoneal space, and ultrasound examination has its limitations. Although you are fasting, it is quite easy for gastrointestinal gas to obstruct the ultrasound evaluation. Pancreatitis has its risk factors, and the pain associated with ...

Understanding Upper Abdominal Discomfort: Causes and Solutions

Hello Doctor, I have been experiencing a dull pain in my upper abdomen for almost eight months now, located around the epigastric area. Currently, the symptoms persist as dull pain, and I have issues with bowel movements, sometimes having difficulty passing stool and needing to s...

Dr. Chen Shidian reply Gastroenterology and Hepatology
If weight, cancer markers, and lipase blood tests are normal, there is generally no need for further imaging studies. However, if there are still concerns, you may opt for out-of-pocket testing.

Understanding Upper Abdominal Pain: Causes and When to Seek Help

Hello doctor, I have been experiencing sharp pain in my upper abdomen, sometimes triggered by eating. Recently, the pain has started to occur intermittently, and I am quite worried.

Dr. Chen Shidian reply Gastroenterology and Hepatology
You can visit the gastroenterology outpatient clinic for examination and avoid sweet, acidic, and irritating foods.

Understanding Upper Abdominal Pain: Causes and Treatments

Hello Dr. Chen: I have been experiencing mild pain in my upper abdomen for about two months. I went to the hospital for an abdominal ultrasound, which indicated a slight inflammation of the stomach. I also had liver and gallbladder blood tests that came back normal. The doctor me...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Dear Mr. Abin, 1. The presence of Helicobacter pylori causing gastritis or ulcers needs to be confirmed by endoscopy; therefore, if there is no improvement, endoscopy should be considered. 2. General dyspepsia is typically not related to bacterial infection, and the infection ra...