“When should I go to the ER for upper abdominal pain?”

When is is severe, unbearable at home

Upper abdominal pain occurs from one of several possible root causes - and the root cause is what would need to be diagnosed. Possible root causes include: 1-acute gastritis; 2-acute pancreatitis; 3-peptic ulcer; 4-peptic ulcer with bleeding; 4-gallstone that has moved into common bile duct; 5-small bowel obstruction due to acute peptic ulcer in duodenum; 6-acute cholecystitis; 7-acid reflux from stomach into esophagus with spasm and esophagitis. Each of these has characteristic features, such as vomiting with or without blood, fever or not, radiation of the pain from center to right or center to back. And the preceding hours before your acute upper abdominal pain are relevant to deduce actual the root cause. So, really, if your pain is self-limited, less than 1-2 hours, and has a precipitant, such as spicy or fatty food or alcohol, then an ER visit may not be compelling; on the other hand, if pain is persistent, with or without vomiting, then an ER visit is compelling for exam, blood work, and ultrasound.

Rex