Upper Abdominal Pain

1 Upper Abdominal Pain Summary

Abdominal pain of different kinds is a very common complaint among people. It is not a disease in itself, but a symptom of many different conditions. Intensity and location of pain may differ with the condition.

The severity of pain may range from dull, crampy pain to severe but periodic discomfort. The duration of the pain also varies with the underlying condition and may be generalized or localized.

Localized pain in the abdomen indicates a more serious condition and may require medical attention. Upper abdominal pain refers to the pain above the belly button. It may be localized to the left, right, or center of the abdomen. It may be accompanied by other symptoms like nausea. Medical attention is needed if the pain is severe and persists for few days.

Other symptoms seen along with upper abdominal pain may differ depending on the underlying condition. The pain is often related to conditions affecting the gastrointestinal tract. Most commonly associated symptoms are those related to the gut.

Other digestive tract symptoms often associated with upper abdominal pain include:

Symptoms related to other systems include body pain, cough, enlargement of liver, enlargement of spleen, fever, muscle spasm, numbness or tingling sensation, mass in abdomen, skin rashes, and unexpected weight loss.

Some of the symptoms are serious and indicate immediate medical attention, such symptoms are:

Pain in the upper abdominal region may originate from a cause related to the gastrointestinal tract. Some of the causes originating from the digestive tract include infections of the tract, celiac disease, diverticulitis, food intolerance, gallbladder disease, gastritis, gastroesophageal disease, irritable bowel syndrome, inflammation of liver, pancreatitis, and ulcers.

Other causes of upper abdominal pain include cancer, hiatal hernia, kidney stones, pleurisy, pneumonia, pyelonephritis, and shingles. Upper abdominal pain may also indicate a serious health condition including abdominal abscess, abdominal aortic aneurysm, bowel obstruction, poisoning, twisting of the colon, intussusception, sickle cell disease, and abdominal trauma.

When left untreated upper abdominal pain may lead to complications including internal hemorrhage, bowel infarction, organ failure, rupture of appendix, spread of infection. Physical examination, review of signs and symptoms, and medical history help in the identification of the most probable causes of pain in the abdomen.

Information on onset, intensity, duration and pattern of pain will help in the confirmatory diagnosis. Tests and investigations used in diagnosis depend on the underlying cause of the condition. Blood tests, urinalysis, stool tests, and imaging techniques are recommended based on the suspected cause of pain.

Other tests commonly used include ultrasound abdominal scan, CT scan, and endoscopy. Treatment of upper abdominal pain varies with the cause. Medications, home treatment, and surgery may be suggested. Reducing the stress levels, having and healthy diet, keeping oneself well hydrated, and regular exercise may all help in preventing upper abdominal pain.

2 Causes

There are multiple causes for upper abdominal pain. Some of the causes are gallstones, heart attack, hepatitis, and pneumonia.

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Gallstones – gallstones refer to hard deposits that develop within the gall bladder, and range in size from very small to as large as an apricot. Symptoms of gallstones include fever, nausea or vomiting, clay-colored stools, and upper abdominal pain.

Heart attack – pain and tightness due to a heart attack may be felt not only in the chest, but may occur in the upper abdomen, shoulders, back, neck, and jaws. This discomfort is one of the most common warning signs of heart attack.

Hepatitis – inflammation of liver is referred to as hepatitis. It is usually caused by viral infection and may lead to symptoms like fatigue, dark urine, abdominal pain, and unexplained weight loss.
Location of pain often indicates the cause of pain in the abdomen.

Pain in the upper left part of the abdomen may be caused by: 

Enlargement of spleen – enlargement of spleen or splenomegaly may be caused by a number of diseases and conditions. An enlarged spleen may lead to pain in the upper left part of the abdomen.

Fecal impaction – fecal impaction or hardening of stools is also implicated in the pain in the upper left part of the abdomen. Feces becomes dry and is unable to move through the gut to be excreted from the body. It causes abdominal discomfort including pain, nausea, vomiting, weight loss, and leakage of liquid stool.

Injury – abdominal pain may also be caused by injury to any of the parts of the abdomen.

Kidney infection – kidney infection or pyelonephritis usually begins in the urethra and then spreads to the kidney. Other than abdominal pain, it may also lead to frequent urination, groin pain, fever, and blood in urine.

Cancer – cancer of different organs including gallbladder, kidney, liver, pancreas and stomach may lead to progressive abdominal pain. The pain worsens over time and is accompanied by other specific symptoms of cancer.

Heart attack – as mentioned earlier, the pain in the chest may also be felt in the upper part of the abdomen, particularly on the left side.

Pain in the upper right side of the abdomen is often caused by hepatitis, injury, pneumonia, and appendicitis.

Hepatitis – inflammation of liver causes pain in the upper right side of the abdomen. It may also cause fever, unexplained weight loss, and dark-colored urine.

Pneumonia – infection of the lungs that causes inflammation of the air sacs leads to pneumonia. Fever, chills, breathlessness, and pain in the abdomen right under the lungs are the usual indications of the condition.

Appendicitis – appendicitis refers to the inflammation of the appendix, the vestigial pouch that projects from the colon into the lower side of the abdomen. It is characterized by sudden pain that originates around the navel and then shifts to the right side of the abdomen. The pain is more often felt in the lower right side, but may be felt in the upper right side of the abdomen too.

Other causes of the upper abdominal pain include:

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3 Diagnosis and Treatment

Diagnosis of the underlying cause of upper abdominal pain is dependent on review of signs and symptoms, physical examination, and evaluation of medical history. During the physical examination, the doctor may analyze the type of pain – acute, intense, intermittent, chronic, progressing, crampy, sharp, dull, or steady.

Location of pain also provides clues regarding the probable cause of the pain. The doctor may try to analyze the factors that improve or worsen pain. This includes factors like physical activities, coughing, alcohol consumption, food, menstrual cycle, or just stress.

Some type of pain may improve with antacids, having more water, or eating certain foods. Tenderness, swelling, or presence of mass in the abdomen is also checked during a physical examination.

Complete blood test, liver function test, and urinalysis are the common laboratory tests suggested for the diagnosis of upper abdominal pain. The increase in white blood cells indicates the presence of infections. Intestinal bleeding may bring down the count of red blood cells sharply. The presence of white blood cells in stools may be an indication of diarrhea.

Imaging techniques are used in the confirmatory diagnosis of intestinal obstruction, kidney stones, appendicitis, and pancreatitis. Ultrasound scan of the abdominal region helps in diagnosis of kidney stones, appendicitis, and ovarian cysts.

Computed tomography or CT scan, and MRI are useful in diagnosing cancer, appendicitis, and diverticulitis. Imaging studies are also useful in the detection of diseases of arteries. A small pill helps in visualizing the parts of the small intestine in capsule enteroscopy.

Other imaging methods used in the diagnosis of the cause of abdominal pain include colonoscopy, esophagogastroduodenoscopy (EGD), endoscopic ultrasound and balloon enteroscopy.

Treatment of upper abdominal pain varies with the actual cause of the condition. The treatment method is individualized based on factors like age, health, and severity of pain. Treatment focuses on the underlying cause of pain and also helps to reduce pain and discomfort associated with the condition.

It also minimizes the risk of complications associated with the disease. Medications to treat the underlying condition is the best way to control upper abdominal pain. Antibiotics are used to control infections, which in turn reduces pain.

Some conditions like bowel obstruction and appendicitis require hospitalization. Surgery is the suggested for treating conditions like appendicitis and hernia. Indigestion and viral infections may not have a specific treatment, but uses simple home treatment for reducing pain. Hydration and restricted diet help to alleviate the symptoms including pain.

Among the home treatment methods, healthy diet, restricting alcohol, and quitting smoking, help to reduce abdominal pain. Having plenty of fluids, good physical activity, and having smaller meals at regular intervals are useful in minimizing the risk of diseases that cause abdominal pain.

Strict, restricted diet is recommended for some conditions like Crohn’s disease. Including more fiber in the diet makes bowel movement easy and regular, reducing the chances of bowel problems. Including more of fruits and vegetables in the diet is equally useful. This will help to control diverticular disease and constipation, two causes of abdominal pain.

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