Upper Abdominal Pain: When to Seek Medical Attention

Right upper quadrant pain, mid-upper abdominal pain?

Hello doctor, I am 23 years old and have issues with gastroesophageal reflux and bloating.
Recently, the bloating has become more severe, and for the past few days, I have felt significant bloating in the lower middle part of my ribcage, especially after meals.
I have taken medications for bloating, which have provided some relief.
Sometimes, I also experience pain in the lower right rib area, as well as in the lower left rib area.

Today, after having lunch, I went to take a nap without much thought or attention.
As a result, I am not sure if it was my sleeping position or something else, but I am experiencing pain in the lower middle part of both sides of my ribcage.
It hurts when I move, and it also hurts when I stand up straight and breathe.
The only way to relieve the pain is to bend my body forward.
When I press on the middle area, it feels hard and painful, and the area below the right rib is also hard and painful.
The painful area is in the middle, but when I press below the left rib, it feels a bit hard but does not hurt.
I keep feeling the urge to burp, and I am very worried that there might be an issue with my liver or something else.
However, due to the current pandemic, I am hesitant to go out and see a doctor.
Should I see a doctor immediately?

Chen, 20~29 year old female. Ask Date: 2021/05/26

Dr. Chen Shidian reply Gastroenterology and Hepatology

If discomfort persists, it is advisable to seek medical attention.

Reply Date: 2021/05/26

More Info

Upper abdominal pain can be a complex issue, especially when accompanied by symptoms such as bloating, discomfort after eating, and localized tenderness. Given your age and the symptoms you've described, it's essential to consider several potential causes and when to seek medical attention.

Possible Causes of Your Symptoms
1. Gastroesophageal Reflux Disease (GERD): Since you have a history of GERD, it's possible that your symptoms are related to acid reflux. This condition can cause pain in the upper abdomen and chest, especially after meals. The bloating and discomfort you experience could be exacerbated by certain foods or eating habits.

2. Gastritis or Peptic Ulcer Disease: Inflammation of the stomach lining (gastritis) or ulcers can lead to pain in the upper abdomen, particularly after eating. Symptoms may include a burning sensation, bloating, and discomfort.

3. Gallbladder Issues: Conditions such as gallstones or cholecystitis can cause pain in the upper right abdomen, especially after fatty meals. This pain may radiate to the back or shoulder.

4. Musculoskeletal Pain: Given that your pain worsens with movement and certain positions, it could be related to muscle strain or rib dysfunction. Poor sleeping posture can lead to muscle tension and discomfort in the rib area.

5. Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain, typically in the upper abdomen, which may radiate to the back. However, this is less common in younger individuals without risk factors such as alcohol use or gallstones.

6. Anxiety and Stress: Psychological factors can also manifest as physical symptoms, including abdominal pain and bloating. Anxiety can lead to increased muscle tension and gastrointestinal disturbances.

When to Seek Medical Attention
Given your symptoms, it is advisable to seek medical attention if:
- The pain is severe or worsening.

- You experience additional symptoms such as fever, jaundice (yellowing of the skin or eyes), persistent vomiting, or changes in bowel habits.

- You have difficulty breathing or chest pain.

- The pain persists despite over-the-counter medications.

Recommendations
1. Consult a Healthcare Provider: Even though you may be hesitant due to the pandemic, it’s crucial to consult a healthcare provider. They can perform a physical examination, assess your symptoms, and may recommend imaging studies (like an ultrasound or CT scan) or laboratory tests to rule out serious conditions.

2. Keep a Symptom Diary: Documenting when the pain occurs, its intensity, and any associated symptoms can help your doctor make a more accurate diagnosis.

3. Dietary Modifications: Consider keeping a food diary to identify any triggers that may worsen your bloating and discomfort. Avoiding spicy, fatty, or acidic foods may help alleviate symptoms.

4. Posture and Movement: Pay attention to your posture while sleeping and during daily activities. Gentle stretching or physical therapy may help if musculoskeletal issues are contributing to your pain.

5. Stress Management: If anxiety is a factor, consider stress-reduction techniques such as mindfulness, yoga, or deep-breathing exercises.

In conclusion, while some causes of upper abdominal pain may be benign, others can be serious. Given your symptoms and their impact on your daily life, it is prudent to seek medical evaluation to ensure appropriate diagnosis and treatment. Your health is paramount, and addressing these symptoms early can lead to better outcomes.

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