Pain In The Upper Abdomen / Stomach Area

What Causes Upper Abdominal Pain?

Upper abdominal pain can have various causes, ranging in severity from 'minor' to 'generally fatal'.  Finding the true cause means ruling out or confirming each possibility – in other words, diagnosis.

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Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms.  In order to diagnose upper abdominal pain, we could:

  • Research the topic
  • Find a doctor with the time
  • Use a diagnostic computer system.
The process is the same, whichever method is used.

Step 1: List all Possible Causes

We begin by identifying the disease conditions which have "upper abdominal pain" as a symptom.  Here are eight of many possibilities (more below):
  • Possible Urgent Medical Need
  • Gallbladder Cancer
  • Heart Disease
  • Enlarged Spleen
  • Stomach Ulcers
  • Gallbladder Disease
  • Food Allergies
  • Epstein-Barr Virus

Step 2: Build a Symptom Checklist

We then identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
pain/burning behind breastbone
severe hypogastric pain
having foamy urine
allergies in family members
severe abdominal pain
past non-surgical gallstone removal
burning epigastric pain after meals
regular episodes of diarrhea
pain between shoulder blades
regular unexplained nausea
stabbing epigastric pain after meals
... and more than 150 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of upper abdominal pain:
Cause Probability Status
Enlarged Spleen 93% Confirm
Heart Disease 28% Unlikely
Gallbladder Cancer 17% Unlikely
Gallbladder Disease 4% Ruled out
Epstein-Barr Virus 0% Ruled out
Possible Urgent Medical Need 0% Ruled out
Food Allergies 0% Ruled out
Stomach Ulcers 0% Ruled out
* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

If you indicate abdominal pain unaffected by eating, abdominal pain reduced by eating or abdominal pain increased by eating, The Analyst™ will ask further questions including this one:
UPPER-CENTER abdomen: Do you experience discomfort or pain in the epigastric (stomach) area, below the breastbone?
Possible responses:
→ No / only after meals / don't know
→ Occasional mild discomfort
→ Frequent mild and/or occasional moderate pain
→ Frequent moderate and/or occasional severe pain
→ Frequent or constant severe pain
Based on your response to this question, which may indicate mild epigastric discomfort, moderate epigastric pain, significant epigastric pain or severe epigastric pain, The Analyst™ will consider possibilities such as:
Allergy to Foods (Hidden)

The first part of the body to react to food is often the gastrointestinal tract.  Sometimes mast cells are involved in allergic reactions and release chemicals such as histamine.  If the affected mast cells are in the gastrointestinal tract, a person may suffer vomiting, abdominal pain or diarrhea.

Coronary Disease / Heart Attack

Cardiac pain may occasionally present as upper abdominal pain.  An acute myocardial infarction can cause upper-right or epigastric discomfort that may be similar to that of a gallbladder attack.

Enlarged Spleen

The spleen in located in the upper far left part of the abdomen.  Various conditions can cause it to increase in size and cause abdominal pain.

Gallbladder Disease

A large meal may trigger the pain, but studies have not shown any direct dietary connection; the pain can develop without any apparent cause.

Gastric/Peptic/Duodenal Ulcers

Most patients with ulcers complain of pain or discomfort that is located in the upper part of the stomach, often in the area immediately below or around the lower part of the breast bone.  This is called epigastric pain.  Symptoms may be associated with meals, or occur in-between meals, or sometimes even occur at night to the point where one can be woken up from sleep.  This pain may be relieved by meals also.


One of the most common pancreatitis symptoms is upper abdominal pain, usually centered in the upper middle or upper left part of the abdomen.  It often radiates from the front of the abdomen to the back or below the left shoulder blade and typically lasts for several days.

The pain may come on suddenly or build up gradually.  If the pain begins suddenly, it is typically very severe.  If the pain builds up gradually, it starts out mild but may become severe.  It may become chronic, and may be aggravated by eating or drinking.

Untreated, the pain becomes constant and more severe.  It may be worse when lying flat on one's back.

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