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Epigastric pain (epigastric pain): causes and treatments

Epigastric pain (epigastric pain): causes and treatments

May 19, 2024

Epigastralgia is one of the most frequent gastrointestinal pains . In most cases it is due to indigestion, although it can also be caused by physical illnesses, especially esophageal reflux disease.

In this article we will analyze what is the pain in the epigastrium, what other symptoms appear associated with it, what are its most common causes and what treatments are there to fight it.

What is epigastralgia?

The term "epigastralgia" is used to designate the pain that occurs in the epigastrium . This denomination corresponds to the upper medial part of the abdomen, located between the navel and the ribs, behind the sternum.

In the International Classification of Diseases (ICD-10), epigastric pain is recorded as "pain in the epigastrium." In this manual it is roughly equated with indigestion or dyspepsia, although there are many possible causes for this type of pain.

In particular the epigastralgia is related to esophageal reflux disease , which causes heartburn and other gastrointestinal symptoms. Although by itself epigastric pain is not considered a severe symptom, it may be caused by this and other diseases that require medical intervention.

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Associated symptoms

Epigastralgia is itself a symptom of various diseases and transient changes that affect the stomach. It may appear in isolation but it is very common for other gastrointestinal symptoms to occur simultaneously, which vary depending on the specific causes of the discomfort.

Thus, pain in the epigastrium is often accompanied by the following symptoms:

  • Acidity, burning or cracking (pyrosis)
  • Stomach swelling
  • Excessive feeling of fullness after eating
  • Belching with or without regurgitation of food or liquid
  • Loss of appetite
  • Sickness
  • Vomiting
  • Flatulence
  • Constipation
  • Diarrhea
  • Insomnia (as a result of discomfort)

Causes of epigastralgia

The main causes of epigastralgia they are related to the digestive system , although this symptom may also be due to alterations in other parts of the body.

1. Dyspepsia (indigestion)

"Dyspepsia" is the general term with which any disorder that affects digestion is called, so it is a very common syndrome in the general population and among people who come for medical consultation. In addition to epigastralgia can cause other gastrointestinal symptoms, such as heartburn, nausea and flatulence.

It is a mostly benign disorder, which may be transient or chronic and is usually due to an unhealthy diet. Usually indigestion is due to excessive intake , being different types of food more or less susceptible to cause indigestion in each person.

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2. Esophageal reflux disease

Esophageal reflux disease causes stomach acid to move into the esophagus, which connects the stomach to the throat; This damages the esophagus and throat, which are not protected by the stomach mucosa.

This disorder can cause symptoms such as epigastralgia, heartburn, breathing difficulties and swallowing , chronic cough and pain in the chest, which appears as a consequence of the inflammation of the esophagus.

3. Consumption of alcohol

The consumption of large amounts of alcohol, especially if it occurs chronically, irritates and damages the stomach lining, causing this organ to become inflamed and more vulnerable to the acid it produces. In this way, the set of gastrointestinal symptoms that we have previously described may appear.

4. Pregnancy

During pregnancy the fetus presses the abdominal walls , which can cause pain in the epigastrium and other areas of the abdomen. In addition, the hormonal changes that occur in this period can cause acid reflux and other gastrointestinal disorders, and therefore epigastralgia.

5. Gastritis

Gastritis consists of inflammation of the gastric mucosa, which protects the stomach from digestive acid. Like epigastritis, it can be caused by very diverse reasons, from poor diet and psychophysiological stress to infections or abuse of certain substances.

6. Peptic ulcer

Peptic ulcers are lesions that occur in the lining of the stomach. They appear when the defenses of the digestive system are not enough to control the agents that attack it, mainly bacterium infections Helicobacter pylori and the excessive and continuous consumption of non-steroidal anti-inflammatory drugs (NSAIDs).

Treatment and management

The most appropriate treatment for epigastric pain depends on the cause of the pain. The change of habits is usually very effective, especially at the food level; specifically, it is recommended reduce the consumption of fats and the amount of food that is swallowed so that the stomach is in the best possible state.

In some cases medical intervention may be necessary, mainly if the symptoms are very serious or the cause of epigastralgia is one of the diseases mentioned in the previous section, such as peptic ulcer and esophageal reflux disease.

At the symptomatic level, the use of omeprazole and others is usually recommended medicines that reduce the production of gastric acid , but only if they are prescribed by doctors. In general, the best way to manage epigastralgia is to acquire healthier eating habits, since indigestion is the most common cause of this problem.

Caution should be exercised when consuming ibuprofen and other non-steroidal anti-inflammatory drugs since, as we have said, they can be aggressive to the stomach. If these medications are being consumed and symptoms of epigastralgia appear, it is probably more appropriate to change the analgesic.

Treatment for Epigastric Pain at Maxcure Hospitals,Hyderabad. (May 2024).

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