What are the causes of pain in the middle of the upper abdomen?

The upper abdomen includes many organs. From a clinical point of view, if there is pain in the middle part, it may be pancreatitis, gallstones, stomach disease, duodenal ulcer, acute appendicitis, myocardial infarction, left lobe of liver and other diseases. In order to treat it early, it is necessary to diagnose it as soon as possible, determine the cause and then treat it symptomatically; it should be noted that during the treatment, you must pay attention to your diet and never eat spicy and irritating foods.

1. Causes of pain in the middle of the upper abdomen

1) Pancreatitis

Symptoms: The abdominal pain is persistent and gradually worsens, often with referred pain in the back. Upper abdominal pain may be induced when lying flat, and the pain may be relieved when sitting or leaning forward.

2) Gallstones

Symptoms: Sudden onset of upper abdominal colic, followed by worsening right upper abdominal pain that may radiate to the right shoulder, often accompanied by nausea, vomiting, loss of appetite, abdominal distension, etc., with recurrent attacks, which may be triggered by a high-fat diet or excessive cold. Some patients have mild jaundice.

3) Stomach problems

The abdominal pain caused by gastric cancer is irregular and begins with discomfort, bloating, and heaviness in the upper abdomen. Treat it as gastritis and the symptoms can be temporarily relieved.

The upper abdominal pain of gastric ulcer has a certain time pattern and is characterized by regular attacks, with abdominal pain occurring half an hour to one hour after a meal.

4) Duodenal ulcer

Symptoms: Pain usually occurs on an empty stomach and at night.

5) Acute appendicitis

Acute appendicitis initially causes upper abdominal pain, which often shifts to the right lower abdominal pain after a few hours. Often confused with acute gastritis.

6) Myocardial infarction

Some patients with myocardial infarction experience upper abdominal pain and nausea and mistakenly seek medical advice from a gastroenterologist. But it is also accompanied by symptoms such as chest tightness and sweating.

7) Left lobe of liver

Symptoms: There may be pain under the xiphoid process.

2. How to prevent and treat upper abdominal pain?

1. Don’t eat too much before exercise, and don’t eat foods that easily produce gas, such as beans, potatoes, and cold drinks.

2. When sweating during exercise in summer, you should drink appropriate amount of salt water, massage the rectus abdominis locally, and do back extension exercises to lengthen the rectus abdominis to relieve abdominal pain.

3. If the pain is in the upper left abdomen, consider the possibility of peptic ulcer. It is recommended to take oral drugs to protect the gastric mucosa or acid-suppressing drugs.

3. What symptoms are easily confused with upper abdominal pain?

1. Acute gastroenteritis: Abdominal pain is mainly in the upper abdomen and around the umbilicus, often presenting as persistent acute pain with paroxysmal aggravation. It is often accompanied by nausea, vomiting, diarrhea, and may also be accompanied by fever. Physical examination may reveal tenderness in the upper abdomen or around the umbilicus, usually without muscle tension or rebound pain, and slightly hyperactive bowel sounds. Considering the unclean food intake before the onset of the disease, it is not difficult to diagnose.

2. Gastric and duodenal ulcers: They are common in young and middle-aged people. The abdominal pain is mainly in the upper and middle abdomen. Most of the time, it is persistent pain and often occurs when the stomach is empty. It is characterized by being relieved by eating or taking antacids. Physical examination may reveal tenderness in the upper abdomen, but no muscle tension or rebound tenderness. Frequent attacks may be accompanied by a positive stool blood test. Gastrointestinal barium meal examination or endoscopy can establish the diagnosis.

If there is a history of gastric or duodenal ulcer or similar symptoms, sudden severe pain in the upper and middle abdomen, like a knife cutting, which quickly spreads to the entire abdomen, and during examination, the entire abdomen is tender, the abdominal muscles are tense, and there is "board-like rigidity". There is rebound pain, bowel sounds disappear, pneumoperitoneum and transplant dullness appear, and the liver dullness area shrinks or disappears, then it indicates gastric or duodenal perforation. The diagnosis can be confirmed by abdominal X-ray confirming the presence of free gas below the diaphragm and inflammatory exudate obtained by abdominal puncture.