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Upper abdomen hurts, what should I do? What to do if you have pain in the navel area? Causes of pain in the area above the navel

Pain in the middle of the abdomen provokes various pathological conditions. If the middle of your abdomen hurts, should you worry? And what could this mean?

Pain in the middle of the abdomen, which manifests itself at night and intensifies after hunger, is a clear sign of a stomach ulcer or ulcer. duodenum.

If the pain appeared in the middle of the abdomen and after a few minutes began to spread further - along the chest and began to radiate to the left arm, then this is pain indicating a disruption in the functioning of the cardiovascular system.

Pain in the middle of the abdomen occurs in people from overeating, as well as after experiencing emotional shock or stress.

But, in most cases, pain in the middle of the abdomen occurs as a result of gastritis. So, how can you understand that unpleasant sensations concentrated in the middle of the abdomen are disorders of the gastrointestinal tract?

The cause of pain in the middle of the abdomen is gastritis

The cause of pain in the middle of the abdomen in 80% of cases is gastritis.

So, gastritis is an inflammatory process focused on the inner mucous membrane. It is this pathological process that leads to disruption of the complete functioning of the gastrointestinal tract.

Causes of pain in the middle of the abdomen

Pain in the middle of the abdomen occurs for the following reasons:

  • Stress;
  • Increased emotionality;
  • Depression;
  • Voltage;
  • Violation of the daily routine;
  • Violation of nutritional culture - consumption of fast food, as well as harmful low-quality food;
  • Smoking;
  • Alcohol;
  • Penetration of bacteria Helicobacter pylori into the body;
  • Human autoimmune diseases can provoke inflammation of the mucous membrane;
  • Irregular meals;

Symptoms of abdominal pain

External signs of the disease are:

  • Vomit;
  • Nausea;
  • Heaviness in the abdomen;
  • Pain in the middle of the abdomen.

If you do not pay attention to the symptoms and ignore abdominal pain, this can lead to the formation of a stomach ulcer or inflammation of the duodenum. These diseases will then be much more difficult to eliminate.

Treatment of pain in the middle of the abdomen

Pain in the middle of the abdomen, but below the navel:

  • Cystitis;
  • Endometriosis;
  • Inflammatory process in the pelvic cavity;
  • Uterine fibroma;
  • Benign or malignant formations of the genital organs;
  • Ovarian cancer;
  • Irritable bowel;
  • Abdominal aortic aneurysm.

Women are at risk for abdominal pain. Their discomfort may be directly related to gynecological diseases.

Doctors also provide another list of suspected causes of pain in the middle of the abdomen.

  • Chronic hepatitis;
  • Hernia;
  • Dysbacteriosis;
  • colitis;
  • pancreatitis;
  • pleurisy;
  • diarrhea;
  • erysipelas;
  • cervical erosion.

Pain above the navel may be a sign of a serious illness.
Pain in the abdominal area has always been and is one of the most unpleasant for us. After all, when our stomach hurts, we definitely can’t do anything, not even walk normally.
Often, determining the causes of pain above the navel is very difficult. In certain situations, even a consistent detailed study of the causes of pain is impossible. Often, a high-quality diagnosis and treatment prescription requires extensive experience of the attending physician, because sometimes the picture of the disease can be incomprehensible and blurred.

What diseases cause pain above the navel?

Pain just above the belly button is usually associated with stomach problems. Among the culprits of this pain will be gastritis, stomach ulcers, and increased stomach acidity. Persistent pain in this area indicates problems with the duodenum, pancreas and gall bladder.

The stomach is located above the horizontal line passing through the navel, under the costal arch of the chest (this place is called the epigastric region).

Acute gastritis is characterized by the following symptoms: nausea, unpleasant and painful sensations in the pit of the stomach, pain above the navel, dizziness, general malaise, diarrhea, and constant vomiting. The mucous membranes and skin have a pale tint, the tongue has a gray coating, and the mouth is dry.

The most characteristic manifestation of a peptic ulcer is pain in the upper abdomen (“spoon-shaped”) and above the navel, which often occurs on an empty stomach, i.e. between meals. Pain can also occur at night, forcing the patient to wake up and take food or medications (which either suppress the secretion of hydrochloric acid in the stomach or neutralize it - so-called antacids). The pain usually subsides within the first 30 minutes after eating or taking these medications.
Less specific, but common symptoms of peptic ulcer disease are nausea, heaviness after eating, a feeling of fullness in the stomach, less often vomiting that brings relief, loss of appetite, body weight, heartburn.

Stomach cancer. Clinical symptoms Gastric cancer in the initial stages of the disease is scanty and uncertain. Not only the patients themselves, but also doctors often regard them as a manifestation of gastritis and, without conducting a full gastrological examination, limit themselves to prescribing various medications. At the same time, after carefully analyzing the complaints, you can detect a number of symptoms that are alarming regarding the diagnosis of cancer. The syndrome of minor signs, which includes a number of general and local symptoms, the identification of which gives reason to suspect gastric cancer in the patient. These include:
1) a change in the patient’s well-being, detected several weeks or even months before visiting a doctor and expressed in the appearance of causeless general weakness, decreased ability to work, and fatigue;
2) unmotivated persistent decrease in appetite or its complete loss, up to aversion to food;
3) the phenomenon of “stomach discomfort”: loss of physiological feeling of satisfaction from eating, a feeling of fullness in the stomach, even after a small amount of food, as well as a feeling of heaviness, distension, sometimes pain in the epigastric region and above the navel, occasionally nausea and vomiting;
4) causeless progressive weight loss, accompanied by pallor of the skin, not explained by other diseases;
5) mental depression - loss of joy in life, interest in the environment, in work, apathy, alienation.

The duodenum is the first section of the small intestine, about 25 cm long, into which food from the stomach enters. Ulcers occur here more often than in the stomach, but pain in the duodenum is indistinguishable from gastric pain.

Duodenitis is characterized by pain in the epigastric region and above the navel - constant, dull or ulcer-like, a feeling of fullness or distension in the upper abdomen after eating, loss of appetite, nausea, and sometimes vomiting. Palpation reveals pain deep in the epigastric region.

Gastroduodenitis in the acute phase is manifested by aching, cramping pain in the epigastric region and above the navel, occurring 1-2 hours after eating and often radiating to the hypochondrium (usually the right) and the navel area. Taking food or antacids reduces or stops pain. The pain syndrome may be accompanied by a feeling of heaviness, fullness in the epigastric region, nausea, and hypersalivation.

Pancreatitis. The main manifestation of pancreatitis is pain: in the right upper half of the abdomen - when the head of the pancreas is affected; in the pit of the stomach and above the navel - with primary damage to the body of the pancreas, in the left hypochondrium - with damage to the tail of the pancreas; the girdle nature of the pain is associated with damage to the entire pancreas.
The stool becomes liquefied. The stool is mushy and contains particles of undigested food. The volume of stool increases. The stool has an unpleasant odor. Possibly - a foamy consistency, difficult to wash off from the walls of the toilet.

Which doctors should I contact if there is pain above the navel?

Gastroenterologist

Pain in the gallbladder is most often caused by spastic contraction of the smooth muscles in its walls. The mucous membrane that lines it from the inside is also sensitive. The sharp edges of the stones damage it, causing pain. Chronic inflammation in this case, it can cause cancerous degeneration of cells.

Pancreas

The pancreas is located behind the stomach. Most of this organ is located to the left relative to the midline of the abdomen, and the smaller part is to the right. The gland lies horizontally at the level of 1 - 2 lumbar vertebrae and reaches a length of 15 - 19 cm. It is located retroperitoneally ( behind the peritoneum), that is, the peritoneum is adjacent only to its anterior wall.

The structure of the pancreas includes the following parts:

  • Tail. The tail is located on the left and reaches the spleen, left adrenal gland and kidney.
  • Body. The body is the longest part of the gland, located between the tail and the head. In front of the body lies the omentum and stomach, behind - the spine, abdominal aorta, inferior vena cava and celiac ( sunny) plexus. Perhaps this explains sharp pain, which occurs during an acute inflammatory process in the gland.
  • Head. The head of the gland is located to the right of the midline of the abdomen. It is surrounded by the duodenum. The transverse colon is also adjacent to the head in front, and the inferior vena cava is located behind. Pathological processes in the head ( tumors) can compress the excretory duct and nearby vessels, causing a wide range of different symptoms.
  • Excretory duct. The external duct of the gland emerges between the body and the head and unites with the common bile duct. When the common duct is blocked below the junction, bile may flow into the internal duct of the gland.
Internal structure glands is quite simple. Most of its mass is the alveoli ( round cavities), in which a number of digestive enzymes are produced. Hence the enzymes in the composition gastric juice enter the internal duct of the gland and leave the organ through the excretory duct. Pancreatic enzymes are activated by bile. Therefore, when bile enters the internal duct of the gland and especially the alveoli, the process of destruction of the organ by its own enzymes may begin. Then they talk about pancreatic necrosis.

Spleen

The spleen is located in the left upper abdomen, under the costal arch. This is the organ of immune control of the blood. The spleen takes part in the accumulation of blood reserves, the destruction of some of its cells, and the formation of the body's immune defense. It has an elongated and flattened shape. In adulthood, its size may vary. On average, the length is 11 - 12 cm, and the width is 6 - 8 cm.

The structure of the spleen consists of the following parts:

  • Diaphragmatic surface. This is the upper part of the organ, adjacent to the diaphragm below.
  • Visceral surface. This surface faces the abdominal organs. The loops of the small intestine, the left kidney, the stomach when full, the adrenal gland, the colon, and sometimes left lobe liver.
  • Posterior pole. This is the name given to the posterior end of the organ, directed backward and upward.
  • Anterior pole. This is the name given to the anterior, sharper end of the organ, directed slightly forward.
  • Gates. The hilum of the spleen is a small section of the anterior edge to which the splenic artery, splenic vein and nerves approach.
The spleen is covered on all sides by peritoneum. The leaves of the peritoneum grow tightly together with the outer capsule of the organ on its entire surface, except for the gate. Pain and discomfort most often appear when the organ becomes enlarged or blood circulation in it becomes difficult.

Peritoneum

The peritoneum is a special tissue lining the abdominal cavity from the inside. It consists of a plate connective tissue and one row of flat cells. The peritoneum covers the walls of the abdominal cavity and passes from them to the organs. This occurs through the formation of a mesentery - the fusion of two leaves. The mesentery, along with the ligaments, secures many organs in the abdominal cavity. The peritoneum is a very sensitive tissue, so pain in any part of the abdomen is often associated with its irritation. In particular, it is of great importance which peritoneum is affected by the pathological process.

The entire surface of the peritoneum can be divided into two parts:

  • Visceral peritoneum. Visceral is the part of the peritoneum that covers the internal organs. Irritation of this peritoneum leads to the appearance of diffuse abdominal pain, and the patient cannot say exactly where the epicenter of the pain is.
  • Parietal peritoneum. The parietal peritoneum covers the walls of the abdominal cavity. Its irritation or involvement in the pathological process causes localized pain. The patient can quite accurately tell where exactly it hurts.
Normally, the cells of the peritoneum secrete a certain amount of fluid. It wets the surface of the internal organs and ensures their good sliding relative to each other. All organs of the abdominal cavity are in some way in contact with the peritoneum.

The following options for the position of organs relative to the peritoneum are distinguished:

  • intraperitoneal– if the organ is covered with peritoneum on all sides ( spleen, stomach);
  • retroperitoneal ( extraperitoneal) – if the organ lies outside the abdominal cavity, behind it, and only a small part of it is in contact with the peritoneum ( kidneys, pancreas);
  • mesoperitoneal– if the organ is covered with peritoneum on both sides ( for example, loops of intestine “suspended” on the mesentery).
The peritoneum is affected in almost any pathological process. In the upper abdomen, this most often occurs with perforation of a stomach ulcer, duodenal ulcer, or rupture of the gallbladder. Inflammation of the peritoneum is called peritonitis and is accompanied by very intense pain.

Diaphragm

The diaphragm is a flat muscle that separates the chest cavity from the abdominal cavity. It is dome-shaped and consists of many muscle fibers intertwined. The convexity of the dome faces the chest cavity. The main function of the diaphragm is breathing. When the fibers are tensed and contracted, the diaphragm flattens, the lungs stretch, and inhalation occurs. When relaxed, the muscle regains its dome shape and the lungs collapse.

The diaphragm plays a significant role in the distribution of pain in the upper abdomen. A large number of nerve fibers pass on both the lower and upper surfaces of the muscle. Therefore, irritation from the chest cavity may be felt as pain in the upper abdomen. On the side of the chest cavity, the pleura is adjacent to the muscle ( superficial lining of the lungs) and pericardium ( heart bag). They are very sensitive anatomical structures. Adjacent to the lower surface of the muscle are the liver, stomach, spleen, and partly the pancreas.

The muscle itself is rarely affected by any pathological processes. Large vessels pass through the holes in it ( aorta, inferior vena cava) and esophagus. Almost immediately after leaving the opening of the diaphragm, the esophagus passes into the stomach.

Sternum and ribs

The sternum and ribs, along with the spine, are the bony frame that forms the thoracic cavity. Lower ribs and xiphoid process of the sternum ( its lowest point) also partly form the upper abdominal wall. At this level, the attachment of the muscles of the anterior abdominal wall (rectus abdominis and oblique muscles).

Along the lower edge of each rib there is a small groove in which an artery, vein and nerve are located. The corresponding areas of the skin and intercostal muscles are supplied with blood and innervated by these bundles. Intercostal nerves originate at the level of the thoracic region spinal cord. That is, pathological processes at the level of the spine and chest wall may spread to the upper abdominal cavity. Most often we are talking about hypersensitivity of the skin in the area of ​​the costal arches.

Abdominal vessels

The abdominal cavity contains a large number of vessels that are responsible for supplying the organs with arterial blood and ensuring the outflow of venous blood. The main vessels are the abdominal aorta ( continuation thoracic aorta ) and the inferior vena cava. These vessels pass along the posterior wall of the abdominal cavity, giving off branches to various organs. Problems with blood supply ( when it comes to arteries) and with blood outflow ( in case of veins) can lead to various pathologies of internal organs, and, accordingly, to abdominal pain.

The abdominal aorta gives off the following branches to the abdominal organs:

  • diaphragmatic branches– diaphragm power supply from below;
  • lumbar arteries– nutrition of the lower back muscles;
  • celiac trunk– partly nourishes the stomach, liver, spleen;
  • top and bottom mesenteric arteries – nourish the intestines, branches and other organs;
  • adrenal and renal arteries – paired, located on both sides of the aorta, nourish the adrenal glands and kidneys, respectively;
  • testicular or ovarian arteries(depending on gender) – nourish the gonads.
Arterial blood flowing through the branches of the abdominal aorta carries oxygen and nutrients to the tissues that support the vital activity of cells. Stopping this diet ( for example, when an artery is blocked or ruptured) leads to cell death in a specific organ or muscle, which can also cause pain.

The veins of the abdominal cavity are divided into two large pools. The first is the basin of the inferior vena cava. The veins that flow directly into this vessel carry blood that is not first filtered by the liver. The second pool is portal ( gate) vein passing through the liver. Blood flows here from the digestive organs and spleen. In some liver diseases, the filtration process becomes difficult, and blood stagnates in the portal vein. This can lead to overflow of blood vessels inside other internal organs and the development of various pathological processes.

Both the arteries and veins of the abdominal cavity widely anastomose with each other ( form compounds) through smaller vessels. Therefore, blockage of one vessel does not lead to immediate disaster. The area will be partially supplied with blood from other sources. However, this mechanism is not universal, and if normal blood flow is not restored in a short time, cell death ( or even an entire organ) still happens.

What structures can become inflamed in the upper abdomen?

Often the cause of pain in the upper abdomen is the inflammatory process. Inflammation in general is a universal response of the body to a wide variety of irritations or disturbances. For example, cell death, problems with the blood supply, or the entry of a foreign body usually cause inflammation. Pain is one of the characteristic components. Its intensity depends on which organ or tissue the inflammatory process is localized in.

In the upper abdomen, inflammation can develop in the following organs:

  • stomach– most often we are talking about gastritis;
  • duodenum– duodenitis;
  • liver– hepatitis;
  • gallbladder – cholecystitis;
  • intestines– colitis;
  • esophagus– esophagitis;
  • pancreas– pancreatitis;
  • biliary proto k – cholangitis;
  • peritoneum– peritonitis.

The spleen rarely becomes inflamed. More often it increases in size due to disturbances in the cellular composition of the blood, immune reactions or stagnation of venous blood. In other organs, inflammation has its own characteristics. For example, in the stomach the inflammatory process is localized mainly at the level of the mucous membrane. With hepatitis, there is a diffuse ( common) inflammation of the entire liver tissue with an increase in its size.

The intensity of pain during inflammation depends on the type of inflammatory process and its location. The better the area where the inflammatory process is innervated, the stronger the pain will be ( for example, with pancreatitis or peritonitis, the pain is very severe, and with hepatitis it may manifest itself as only minor discomfort). There are also several types of inflammation. For example, when pus forms ( with the participation of pyogenic microbes) the pain is stronger than with simple inflammation. Also, the pain is stronger during the necrotic process, which is accompanied by tissue death.

Causes of pain in the upper abdomen

As mentioned above, there can be many reasons that cause pain in the upper abdomen. They are not always associated with diseases of organs located precisely in this anatomical region. Often pain in various parts of the abdomen appears due to blood diseases, metabolic disorders, and hormonal disorders. The immediate cause of such a disorder may be located far from the place where the pain appears.

The most common causes of pain in the upper abdomen are the following diseases:

  • spasm or stenosis of the pylorus;
  • cholecystitis;
  • pancreatitis;
  • spleen diseases;
  • diseases of the spine;
  • eating disorders;
  • diaphragmatic hernia;
  • oncological diseases;
  • abdominal injuries;
  • other reasons.

Stomach ulcer

Peptic ulcers are perhaps the most common disease that causes pain in the upper abdomen. This pathology usually develops in cases where the acidity of the stomach is increased ( more hydrochloric acid is produced), and the protective mechanisms of the organ for one reason or another do not protect the walls. This pathological process has several stages, each of which is often classified as a separate group of diseases.

The first stage can be considered gastritis. With this pathology, damage to the gastric mucosa is already occurring, but the ulcer itself has not yet formed. It should be noted that gastritis can be of various origins and are not always caused only by increased acidity. The inflammatory process can occur with normal and even with low acidity of the stomach.

The following factors are considered possible causes of gastritis:

  • InfectionHelicobacter pylori. Currently, the role of this infection in the development of gastritis and stomach ulcers has already been proven. This microorganism is acid-resistant, therefore it is able to colonize the gastric mucosa, disrupting normal protective mechanisms at the cellular level. Because of this, hydrochloric acid gradually damages the mucous membrane.
  • Poor nutrition. Diet is very important for stomach health. Hot and spicy foods, for example, promote the production of hydrochloric acid and increase acidity. It is also not recommended to eat only dry food ( neglect first courses), as this disrupts the production of protective mucus. You need to eat regularly, without long breaks between meals.
  • Autoimmune mechanisms. Sometimes the cause of gastritis is antibodies produced by the immune system to its own cells. In this case, these are the cells of the gastric mucosa. Their destruction leads to increased acid exposure to the walls of the organ.
  • Lack of vitamins. For the harmonious production of gastric juice and protective factors of the mucous membrane, a wide range of vitamins is required. Their deficiency can lead, among other things, to the appearance of gastritis.
  • Alcoholism. Frequent consumption of alcohol ( especially strong alcoholic drinks) contributes to damage to the mucous membrane and the development of the inflammatory process.
  • Smoking. Smoking in the short term modifies the functioning of peripheral nervous system. This affects the stomach with more intense production of gastric juice.
  • Stress. Numerous studies have shown that people regularly exposed to psycho-emotional stress are significantly more likely to suffer from gastritis and peptic ulcers. This is due to the production of special hormones and biologically active substances. On the one hand, they help the body as a whole adapt to an unfavorable environment, on the other hand, they disrupt normal metabolism at the level of the gastric mucosa.
  • Other diseases. For problems with venous outflow ( most often at the level of the portal vein in the liver) blood stagnates in the veins of the stomach. Metabolism is disrupted, and degenerative processes begin in the mucous membrane. As hydrochloric acid continues to be produced, the inflammatory process begins. Somewhat less common are problems with the arterial blood supply to the stomach ( for example, with an aneurysm in the upper abdominal aorta).
The above factors lead to an imbalance between the protective mechanisms of the mucous membrane and the aggressive effects of gastric juice. Gastritis develops, which is characterized by prolonged moderate pain in the upper abdomen in the center ( in the pit of my stomach). At increased acidity the pain is often worse on an empty stomach, when the stomach is empty, and subsides somewhat after a light lunch.

The next stage of the same pathological process is gastric ulcer. In this case, we are talking about a formed defect in the mucous membrane of the organ. The ulcer can be localized in various parts of the stomach, as well as in the duodenum. Pain may appear on an empty stomach, but eating often worsens it ( appear 30–60 minutes after eating). These pains are caused by stretching of the walls, contact of food with the surface of the ulcer, increased production of gastric juice. As a rule, the pain is worse when eating hard, poorly chewed food.

Associated symptoms of gastritis and peptic ulcers include lack of appetite, heartburn, a feeling of heaviness in the stomach, weight loss ( patients are afraid to eat a lot so that the pain does not worsen). Vomiting of acidic stomach contents is sometimes noted. Many patients also experience bowel movements ( constipation or diarrhea). This is explained by the fact that normal breakdown of nutrients does not occur at the level of the stomach, and food is digested less well later in the intestines.

If left untreated, gastric ulcers can lead to a number of serious complications. They are characterized by other symptoms and changes in the nature of pain. It is illogical to single out these complications as separate causes of pain in the upper abdomen, since, in fact, they are all a consequence of the same pathological process. Complications of a peptic ulcer can put the patient's life at risk.

The most typical complications of a stomach ulcer are the following pathologies:

  • Perforation ( perforation) ulcers. Perforation is the formation of a through defect in the wall of an organ. As a result, the contents of the stomach begin to enter the abdominal cavity, irritating the peritoneum. The complication is characterized by a sudden exacerbation of pain ( dagger pain). The patient cannot find a place for himself, the abdominal muscles are tense like a board. Some air enters the abdominal cavity from the stomach. Because of this, a sort of bloating is sometimes observed in the upper abdomen. It is a symptom typical of ulcer perforation.
  • Ulcer penetration. During penetration, destruction of the stomach wall also occurs, but its cavity communicates with another organ ( small intestine, large intestine, etc.). Accordingly, the work of the second organ is disrupted.
  • Bleeding. Bleeding from an ulcer occurs when the acid destroys a large blood vessel in the wall of the stomach. There is no obvious increase in pain. However, as the stomach fills with blood, vomiting of blood may occur. The stool turns black ( from clotted blood), semi-liquid or liquid. This symptom is called melena.
  • Stomach cancer. Gastritis and peptic ulcers can disrupt normal cell division. This increases the risk of developing stomach cancer. This disease will be described in more detail below.
Statistically, gastritis and gastric ulcer ( as well as its complications) are the most common cause of epigastric pain. More than 10% of people encounter them throughout their lives. This group of diseases can occur at almost any age ( but less common in young children).

Spasm or stenosis of the pylorus

Some experts believe that spasm or stenosis of the gastric pylorus is also a complication or consequence of peptic ulcer disease. However, this disease may have other causes. With this pathology, the circular muscle, located at the border of the stomach and duodenum, contracts, narrowing the lumen. Because of this, the food bolus lingers in the stomach and cannot enter the intestines.

There are two main types of violations at this level. Firstly, it is a muscle spasm. It can occur as a result of painful irritation of the gastric mucosa due to peptic ulcer disease. However, it is also sometimes observed with prolonged stress, certain nervous disorders, as well as other pathological processes in a given anatomical area. A spasm is a strong and painful contraction of a muscle. This disorder is functional, that is, there are no structural changes in the muscle itself or in other layers of the wall. Under the influence of drugs, the pyloric muscle relaxes, the stomach empties, and the pain goes away.

The second variant of this pathology is pyloric stenosis. In this case there are structural changes in muscle or mucous membrane. For example, stenosis can occur if an ulcer located near the pylorus becomes scarred. The lumen narrows due to the proliferation of connective tissue, and muscle contraction has no direct relation to this.

Pain due to stenosis or spasm of the pylorus has the following distinctive features:

  • worse after eating ( usually within one and a half to two hours);
  • noticeably stronger when eating solid foods;
  • worsen with overeating;
  • they are felt most strongly not in the epigastrium, but slightly lower and to the right ( at the site of projection of the pylorus onto the anterior abdominal wall);
  • pain of moderate intensity, periodic;
  • after a heavy lunch, vomiting with sour contents may occur;
  • patients are often bothered by belching and heartburn.

Cholecystitis

Cholecystitis is an inflammation of the gallbladder. In the vast majority of cases, it develops due to the formation of stones in the organ cavity. This disease is called cholelithiasis or cholelithiasis. The reasons for the formation of gallstones have not been definitively established. There are many different theories that partly explain this pathology. Most often, stones are formed from salts of bilirubin, cholesterol and calcium. They can be of different sizes ( from a few millimeters to several centimeters in diameter).

Pain in gallstone disease is caused by damage to the sensitive mucous membrane of the gallbladder and spasmodic contraction of the smooth muscles in its walls. An attack of pain in this case is called biliary colic. The intensity of biliary colic can be very severe. The epicenter of pain is located in the upper abdomen between the right hypochondrium and epigastrium. The attack lasts from 15 – 20 minutes to 4 – 5 hours.

With absence urgent treatment The following complications of gallstone disease are possible:

  • Bile duct blockage. When the bile duct is blocked by a stone, the pain usually increases. Since bile stops flowing into the duodenum, serious problems with digestion ( First of all – intolerance to fatty foods). The accumulation of bile in the bladder can lead to stretching of its walls and increased pain.
  • Inflammation of the bile duct. Inflammation of the bile duct is called cholangitis. Unlike cholecystitis, it is most often accompanied by high fever, sometimes with profuse sweating and convulsions.
  • Biliary pancreatitis. Since the pancreas and gallbladder have a common excretory duct, blockage at the level of the papilla of Vater can lead to bile entering the internal ducts of the gland. Then the activation of pancreatic juice enzymes occurs and an acute inflammatory process develops ( up to necrosis - irreversible tissue destruction).
  • Empyema of the gallbladder. Empyema is an accumulation of pus in the cavity of the gallbladder. It occurs when pyogenic microflora enters ( usually intestinal bacteria) on the injured mucous membrane. In this case, the nature of the pain can be different. Typically a stable increase in temperature ( up to 39 degrees or more).
  • Peritonitis. Without proper treatment, the gallbladder wall may rupture ( with the participation of microbes, gangrene develops). Then bile enters the free abdominal cavity, irritates the peritoneum, and peritonitis develops. The pain begins to spread to other areas of the abdomen, the muscles of the abdominal wall tense, and the temperature rises sharply. Without surgical intervention, this can lead to the death of the patient.
In more rare cases, cholecystitis may develop without the background of cholelithiasis. Then there is only inflammation of the gallbladder, without stones. The pain is usually not so intense, and the temperature can remain low-grade for a long time ( 37 – 37.5 degrees).

Pancreatitis

Pancreatitis is inflammation of the pancreas. It can be caused by various reasons ( most often - excessive alcohol consumption, less often - cholelithiasis, hereditary factors, injuries, etc.). There are acute and chronic pancreatitis, which cause various pains and differ greatly in symptoms.

In acute pancreatitis, pain occurs suddenly and immediately becomes very intense. It is localized in the epigastrium and around umbilical region, but often radiates to the hypochondrium and back. The pain intensifies with deep breaths and movements. The abdominal muscles in the upper section are noticeably tense. Many patients complain of nausea and repeated vomiting. This condition is extremely life-threatening and requires immediate hospitalization.

With chronic pancreatitis, the pain is usually not so intense. They can also radiate to the hypochondrium or back, and worsen after eating. The duration of an attack of pain can vary from several hours to several days. A decrease in pain is observed when following a special diet. With long-term follow-up, a decrease in the patient's body weight can be noticed. Associated symptoms include jaundice, nausea and vomiting ( during exacerbation).

Spleen diseases

In diseases affecting the spleen, pain is usually localized in the left hypochondrium. Acute pain in this organ occurs quite rarely. More often there is discomfort associated with an increase in the size of the spleen ( splenomegaly). However, there are a number of diseases that also cause acute pain. The spleen tissue itself rarely becomes inflamed, but pathological processes in it can cause inflammation around the organ ( perisplenitis).

Tangible pain in the left upper abdomen can be observed with the following diseases and syndromes:

  • Splenomegaly. An enlarged spleen is not accompanied by severe pain in the left hypochondrium. As a rule, this is discomfort that increases with movement. Splenomegaly can be caused by infectious diseases, portal hypertension (high blood pressure in the portal vein at the level of the liver), autoimmune processes, hematological diseases. In rare cases, the spleen may enlarge so much that its lower edge reaches the level of the navel.
  • Hematological diseases. Diseases of the hematopoietic system are often accompanied by changes in the composition of the blood. An enlarged spleen is a very common manifestation of such pathologies, since this organ is directly involved in regulating the composition of the blood.
  • Splenic rupture. When the spleen ruptures, the pain occurs suddenly and can be very severe. Most often, the gap is a consequence blunt trauma stomach, blow to left hypochondrium. However, rupture is also possible in severe cases of certain infectious diseases ( mononucleosis, hemorrhagic fevers, etc.). The spleen sometimes ruptures in acute autoimmune processes, due to its strong increase. A ruptured spleen is an extremely life-threatening condition due to massive internal bleeding.
  • Splenic infarction. Splenic infarction is an acute cessation of blood supply to the organ. It is caused by the entry or formation of a blood clot in the splenic artery. A blocked artery cuts off the supply of oxygen and nutrients to the spleen. Under such conditions, organ tissue quickly dies, causing acute pain. Treatment involves immediate surgery, often removing the entire organ.
  • Spleen abscess. It is a rare disease in which pus accumulates under the capsule of the organ. The cause of an abscess is the entry of pyogenic microorganisms into the organ. As a rule, this happens in the bloodstream. Microbes enter the blood from other purulent foci. Thus, a splenic abscess is in a sense a secondary process caused by the spread of infection throughout the body. The pain is sharp and intensifies when pressed. An abscess is almost always accompanied by fever, headaches and muscle pain ( due to toxins entering the blood).
When the infectious process spreads to neighboring organs or the spleen ruptures, peritonitis may occur. In this case, the pain will intensify, and the patient’s condition as a whole will become more severe.

There are also physiological causes of pain in the right hypochondrium that are not associated with any pathology. Rapid acceleration of blood flow and increase in blood pressure can cause stabbing pain. They are due to the fact that the ducts in the spleen do not have time to expand, and the throughput of the organ does not keep pace with the increased blood flow. The walls stretch, causing pain. Most often, such pain occurs during prolonged physical activity ( running, endurance swimming).

Spinal diseases

All parts of the abdomen and organs located in the abdominal cavity are partially provided with innervation from the spinal cord. In particular, we are talking about sensory innervation and pain perception. Thus, any diseases at the spinal level that affect the sensory roots can be perceived by the body as pain in the upper abdomen. In this case, it is not at all necessary that there be any pathological changes in the abdominal organs.

Pain in the upper abdomen due to diseases of the spine rarely has a pronounced intensity. More often these are long-lasting, dull pains that may be associated with body position. That is, in a certain position the pain is stronger ( if the roots are pinched), and in another position they weaken or disappear completely.

The following spinal pathologies can lead to such pain in the upper abdomen:

  • back injuries;
  • spondyloarthrosis;
  • arachnoiditis;
  • spinal tumors ( primary or metastases).
An inflammatory process or tissue destruction in the spinal area is also possible due to certain infections. There are, for example, cases of destruction of the vertebrae or their joints due to the systemic spread of tuberculosis infection ( rare, in unvaccinated children). Also a rare option these days is tabes dorsalis with advanced syphilis.

Eating disorders

Pain in the upper abdomen is often associated with poor nutrition. In particular, everyone knows the feeling nagging pain under the spoon ( under the xiphoid process of the sternum), which appears during severe hunger. It is associated with the secretion of gastric juice and the activity of muscle fibers in the walls of the stomach. Also, moderate pain or discomfort in the epigastrium may appear after eating certain foods. This is due to different digestive habits in different people.

Moderate pain may occur after consuming the following foods:

  • hard food ( radish, raw carrots, turnips, cabbage, etc.) contain coarse plant fibers that are difficult to pass through the stomach;
  • alcohol can irritate the mucous membrane of the esophagus and stomach;
  • beer, kvass, carbonated drinks contribute to the accumulation of gases in the intestines, which cause some discomfort;
  • black bran bread, stale food can enhance fermentation processes in the intestines, which also contribute to gas formation;
  • milk and dairy products may cause abdominal discomfort in people who do not digest lactose well ( milk sugar);
  • food that is too hot or too cold.
In children, pain in the upper abdomen may be associated with the introduction of new foods into their diet. This is explained by the fact that the enzymes of the digestive system in childhood do not work as well as in adults.

Myocardial infarction

Myocardial infarction is the death of a certain area of ​​the heart muscle due to a temporary or permanent stop in its blood supply. Clearance coronary vessels, which nourish the heart muscle, can narrow for various reasons. This is atherosclerosis ( cholesterol deposits in the form of plaques), spasm, blockage with blood clots that got here with the blood flow.

In the vast majority of cases, pain during myocardial infarction is localized behind the sternum, in the chest. However, a heart attack back wall adjacent to the diaphragm is often characterized by an atypical pain syndrome. In this case, the pain appears not in the chest, but in the abdomen ( most often just in the upper part). This is explained by the fact that the diaphragm is irritated, and a false sensation is formed due to the characteristics of its innervation. The intensity of pain in these cases can vary, from aching and dull pain to sharp and unbearable ( in rare cases).

Of the accompanying symptoms, a single reflex vomiting, but more often there are still no symptoms from the gastrointestinal tract, and apart from the localization of pain, nothing speaks in favor of pathologies in the abdominal cavity. At the same time, with a thorough examination, increased sweating, paleness, pulse irregularities, shortness of breath, and changes in blood pressure can be noted.

Appendicitis

Despite the fact that the appendix is ​​located in the right iliac fossa, its inflammation sometimes causes pain in the upper abdomen. In this case, we are talking about the onset of pain typical for appendicitis. It appears in the epigastrium and only after half an hour or an hour descends to the right lower abdomen. This development of pain syndrome occurs, according to various sources, in 20–50% of patients and greatly complicates the early diagnosis of the disease. As a rule, pain in the epigastrium is moderate. It becomes more intense only after moving to the right iliac fossa.

The hernia itself may not cause any pain, since there is no tissue trauma. The patient may only experience some discomfort in the upper abdomen or behind the sternum. Moderate pain may occur after eating. They are explained by pathological narrowing at the level of the diaphragm ( because the stomach turns out to be pinched). Contractions of smooth muscles in the walls of the stomach stretch muscle fibers diaphragm. Without treatment in the future, there is a risk of strangulation of such a hernia when the muscle fibers become pinched blood vessels. Then acute pain appears and immediate help is required ( most often – surgical intervention).

With a diaphragmatic hernia, the following accompanying symptoms may be observed:

  • heartburn;
  • belching;
  • vomiting of undigested food;
  • lack of appetite ( and as a result – gradual weight loss);
  • inability to swallow hard foods;
  • sometimes - discomfort behind the sternum with a deep breath, shortness of breath, disturbances heart rate (due to mechanical compression of the heart sac and lung by the stomach).

Oncological diseases

Tumors are a rare but very serious source of pain in the upper abdomen. Basically cancer cells can appear in almost any tissue or organ human body, however, certain tissues still undergo such degeneration more often than others. Painful sensations are more typical for malignant neoplasms. The growth of such tumors is accompanied by the destruction of surrounding organs. Pain appears more often on late stages when treatment is no longer effective. The nature of the pain can be different, and the intensity can be very strong.

Most often, pain in the upper abdomen is caused by malignant tumors the following bodies and fabrics:

  • Esophageal carcinoma. Malignant neoplasms of the esophagus in the lower third usually cause pain in the chest cavity, but can also radiate to the upper abdomen ( when the diaphragm is involved). The first symptom, usually long before the onset of pain, is dysphagia - difficulty swallowing. Often the patient feels that the swallowed food is stuck. Possible vomiting ( 10 – 15 minutes after eating), belching. At later stages, pain occurs, and liver metastases may be detected.
  • Stomach cancer. Stomach cancer on early stages practically does not cause any visible disturbances. In the later stages, an early feeling of satiety and dull pain appear ( as tissues are destroyed, it becomes stronger). Depending on the location and size of the tumor, there may be problems with gastric emptying, as with pyloric stenosis, or dysphagia ( when localized in the cardiac part). Men aged about 60 years or patients suffering from one of the following diseases are more at risk of developing stomach cancer: atrophic gastritis, Helicobacter pylori infection, gastric polyps, Barrett's esophagus, Gardner's syndrome, etc.
  • Liver cancer. Most often, liver cancer is understood as the so-called hepatocellular carcinoma ( tumor of liver cells - hepatocytes), however, the tumor can also develop from other cells in the liver. The disease most often develops against the background of progressive cirrhosis, chronic viral hepatitis B and C. The pain is localized in the right hypochondrium and is caused by stretching of the organ capsule. It is not a necessary symptom in the early stages. More typical and often preceding pain symptoms are liver enlargement ( hepatomegaly), ascites ( accumulation of fluid in the abdominal cavity), jaundice, and sometimes increased body temperature.
  • Gallbladder cancer. Most often, tumors develop against the background of many years of gallstone disease or chronic cholecystitis. Malignant cell mutation is associated with a long-term inflammatory process and a number of substances contained in bile. Symptoms are often similar to those of tumors of the head of the pancreas. Pain appears in the later stages and is preceded by stool disturbances ( especially after eating fatty foods), jaundice.
  • Pancreas cancer. This disease is more common among men, and among the predisposing factors, the role of smoking, alcohol consumption and fatty foods, and hereditary form has been proven chronic pancreatitis. The pain is localized in the epigastrium, often radiating to the back at the level of the lower ribs. Another feature is the reduction of pain in the fetal position ( torso bent forward). Pain appears in the later stages, when, as a rule, there are already metastases to the lymph nodes or other organs. Associated symptoms often include weight loss, bloating, jaundice ( due to compression of the bile duct by a tumor). In some cases, blood glucose levels may increase, causing symptoms of diabetes mellitus ( due to disruption of insulin production by the pancreas).
In rare cases, metastatic lesions of the peritoneum may also be detected ( so-called peritoneal carcinomatosis). Then a large number of small tumors immediately appear on its surface. The localization of pain will depend on where in the peritoneum the metastases grow. The pain can be very intense.

Abdominal injuries

Blunt abdominal injuries do not cut or puncture the skin, but such injuries can damage internal organs located in the abdominal cavity. Such injuries can be caused not only in the case of targeted blows, but also during a strong shock or sudden stop of the body, as a result of a fall from a height, etc. The consequences of such injuries are different and depend on which organ is damaged.

Possible consequences of blunt trauma to the upper abdomen include the following:

  • Fractured ribs. With fractures or cracks in the ribs in the front, pain may well be felt in the area of ​​the xiphoid process of the sternum. It appears immediately after injury and can be quite strong. The pain is constant and intensifies with movement and deep breaths.
  • Splenic rupture. When the spleen ruptures ( consequence of blows to the left hypochondrium) massive bleeding is observed, since this organ is well supplied with blood. The pain is very severe and occurs immediately after the injury. The patient may quickly lose consciousness due to massive blood loss. Without urgent surgery, the risk of death is high.
  • Liver rupture. When the liver ruptures, hemorrhage most often occurs directly inside the organ. A pathological cavity filled with blood is formed. Since there is a rapid and strong stretching of the liver capsule, the pain is very severe. There is also a high risk to the patient's life and urgent surgical intervention is required.
  • Hematoma formation. Hematomas are pathological cavities filled with blood. In this case, we are talking about a hematoma in the soft tissues of the anterior abdominal wall. The pain appears immediately after the blow and gradually decreases ( as the blood dissolves). On the skin of the abdomen at the site of the impact, the damaged area is clearly visible, usually bruising and swelling. There is no immediate threat to life.

Other reasons

This section will list more rare causes of pain in the upper abdomen. Due to their low prevalence, they are more difficult to diagnose ( this requires additional equipment or lab tests ). This also includes referred pain, when the source or cause is located in another part of the abdominal or chest cavity.

Other possible causes of pain in the upper abdomen may include the following pathologies:

  • Hepatitis. For hepatitis of various origins ( viral, toxic, autoimmune) pain is usually moderate. Many patients describe it more like a feeling of discomfort in the right hypochondrium. Sharp, stabbing pain appears at the moment of a sharp turn, tilt, or during physical activity. For chronic infectious hepatitis ( especially B and C) pain may appear periodically over time ( years).
  • Peritonitis. Peritonitis is inflammation of the peritoneum itself. It usually develops as a consequence of other abdominal diseases. For example, when the intestinal wall is perforated, the appendix or gallbladder ruptures, various fluids enter the peritoneum, causing irritation. In the epigastric region, peritonitis can occur against the background of perforation of the ulcer. Sometimes a rupture of the stomach wall can be a complication during some diagnostic procedures ( for example, fibrogastroduodenoscopy). With peritonitis, severe pain, plank-like tension in the abdominal muscles, stool disturbances, and possible vomiting are observed. The patient's condition is usually severe and requires surgical intervention.
  • Crohn's disease. This disease is congenital and can appear at almost any age. Most often, Crohn's disease affects the intestines, but cases of damage to the stomach are also known. The disease is characterized by an inflammatory process at the level of the mucous membrane. This inflammation is associated with dysfunction of the immune system. Often, a certain area of ​​the intestine is also affected at the same time as the stomach.
  • Poisoning. In case of food poisoning, microorganisms or their toxins enter the body that appeared in food due to improper storage or poor preparation. The pain can be localized in any part of the abdomen, including the upper part. Most often, nausea, vomiting, diarrhea and other gastrointestinal symptoms are simultaneously observed.
  • Porphyria. This disease is caused by genetic disorders. It debuts more often in adulthood ( in women also during pregnancy). The disease is characterized by the presence in the blood of an excess of porphyrins - special substances formed in the hematopoietic system. Stomach ache ( including in its upper part) occur in the form of attacks lasting several hours.

Diagnosis of the causes of pain in the upper abdomen

With pain in the upper abdomen, it is quite difficult to quickly make a correct diagnosis, since there are many different diseases that cause a similar pain syndrome. The initial examination of the patient and analysis of complaints usually does not provide enough information to confirm the diagnosis. To do this, you have to resort to additional laboratory or instrumental research methods. They are straight ( as an image) or indirectly ( as an analysis result) will indicate an existing problem.

The following methods can be used to diagnose pain in the upper abdomen:

  • physical examination of the patient;
  • radiography;
  • CT scan ( CT) and magnetic resonance imaging ( MRI) ;
  • ultrasonography ( Ultrasound);
  • fibroesophagogastroduodenoscopy ( FEGDS);
  • microbiological research methods;
  • general blood test and biochemical blood test;
  • general and biochemical urine analysis.

Physical examination of the patient

A physical examination of a patient means an initial examination, which is carried out by a doctor when the patient first visits. The specialist is looking for a set of specific signs and symptoms of the disease that would help to suspect the correct diagnosis and suggest in which direction to conduct further research. The simplest manipulations are used as research methods.

Standard research methods during the initial examination are:

  • General visual inspection. When examining a patient with abdominal pain, you can detect signs such as bloating, changes in skin color, and the presence of a rash. The sclera is also examined, yellowing of which will indicate problems with the liver or gall bladder. With many gastrointestinal diseases, there will be a coating on the tongue, which is also detected at this stage.
  • Palpation. For abdominal pain, palpation is the most important method. With its help, you can evaluate the consistency of the liver, palpate the spleen, determine whether the pain intensifies with pressure and where the epicenter of the pain is located. All this is very important for understanding the pathological process.
  • Percussion. Percussion is the act of tapping the front wall of the abdomen with your fingers. Changes in sound help determine tissue density. This method is important for determining the size of the liver and spleen. Their increase will indicate problems with these organs. Also, percussion can sometimes detect large tumors in the upper abdomen.
  • Auscultation. Listening to noises using a stethoscope ( listener) is necessary to study the functioning of the heart and lungs. This will help eliminate the possibility of referred pain due to a heart attack or pneumonia.

Also at this stage, elementary instrumental studies. For example, blood pressure and body temperature are measured. Blood pressure may be low due to heart problems or internal bleeding. The temperature usually rises during an inflammatory or infectious process.

Radiography

Radiography is one of the most common instrumental research methods. The method involves passing x-rays through body tissue. Depending on the density of the tissue, an image is obtained in which a specialist can distinguish the contours of various organs and anatomical formations.

Nowadays, radiography is quite affordable financially. The study lasts only 5–10 minutes, and after the same period of time you can view its results. The dose of radiation that a patient receives at a time is very small, so modern devices can even examine children and, if necessary, pregnant women ( although in these cases, whenever possible, they try to resort to other research methods).

X-rays can help identify following reasons pain in the upper abdomen:

  • abdominal neoplasms;
  • stomach ulcer ( especially clearly visible with contrast radiography, when the patient drinks a special mass to identify the boundaries of the stomach and esophagus);
  • abscesses in the liver and abdominal cavity;
  • kidney and gallstones;
  • diaphragmatic hernia;
  • pathological changes in the spine.

Computed tomography and magnetic resonance imaging

CT and MRI are also aimed at obtaining images of internal organs and visually detecting pathology. CT scans, like radiography, use x-rays. However, the images are taken layer by layer, in the form of slices. Thus, the doctor receives a whole series of high-quality images. Their comparison gives the specialist a more complete understanding of the pathology. In the case of MRI, the patient is placed in a special machine that creates a very strong electromagnetic field. Sensors record the excitation of hydrogen ions, the concentration of which varies depending on the tissue. This results in an even clearer image.

With CT and MRI, you can see the same pathologies as with radiography, but smaller defects will also be noticeable ( for example, blood clots in blood vessels, small stones forming). MRI can also evaluate the state of blood flow in various organs. This makes it possible to detect, for example, an increase in pressure in the portal vein. Thus, the range of structural abnormalities that can be detected using CT and MRI is very wide. Currently these are the most accurate ( but also the most expensive) methods of visualization of abdominal organs.

Ultrasonography

Ultrasound is also a very common diagnostic method for pain in the upper abdomen. The principle of the method is to pass ultrasonic waves through tissue and record their reflection. The picture is formed depending on the density of the tissue. The good thing about this method is that it has no contraindications ( safe for all patients) and gives results immediately after carrying out ( in 10 – 15 minutes). The doctor himself directs the waves using a special sensor, which allows him to examine the formations or organs of interest from different angles.

Ultrasound can detect the following pathological changes in the abdominal cavity:

  • kidney and gallstones;
  • pyloric stenosis;
  • abscesses;
  • neoplasms;
  • fluid in the abdominal cavity;
  • change in organ size ( including vessel diameter) and their densities;
  • measurement of blood flow velocity ( in Doppler mode).

Fibroesophagogastroduodenoscopy

The disadvantage of FEGDS is the complexity of the procedure. Patients have to swallow a special probe equipped with a small video camera and a light source ( device - endoscope). The doctor receives an image of the mucous membrane of the esophagus and stomach, has the opportunity to record a video and take pictures. Also during this procedure, tissue samples can be taken for other tests ( biopsy). This may be necessary if malignant neoplasms are suspected.

FEGDS is usually prescribed if the following diseases are suspected:

  • stomach ulcer;
  • gastritis;
  • neoplasms of the stomach and esophagus;
  • pyloric stenosis;
  • presence of Helicobacter pylori infection.

Microbiological research methods

Microbiological methods are not used very often when diagnosing pain in the upper abdomen. They are necessary, for example, to detect Helicobacter pylori infection in gastric ulcers. The presence or absence of this microorganism determines the tactics in treating the patient. Microbiological research methods are also necessary for food poisoning in order to establish which microbe caused the intoxication. In this case, vomit, feces, and uneaten food that the patient was poisoned with are examined.

The most commonly used microbiological methods are:

  • microscopy;
  • culture method ( microbial culture);
  • detection of antigens and antibodies ( serological reactions for infectious diseases);
  • polymerase chain reaction ( an expensive method for detecting the DNA of the desired microorganism).

General and biochemical blood test

Blood test is mandatory research, which is prescribed to all patients who consult a doctor with pain in the upper abdomen. The cellular composition of the blood and the concentration of various substances in the blood can vary greatly. By analyzing these changes, you can obtain valuable information about the functioning of various organs and systems of the body. Often it is a blood test that helps confirm a particular diagnosis.

The most characteristic changes in various pathologies are:

  • an increase in the number of leukocytes and an increase in the erythrocyte sedimentation rate ( ESR) – they talk about the inflammatory process, often about acute surgical pathology;
  • a strong increase or decrease in red blood cells, white blood cells or platelets is characteristic of hematological diseases that cause problems with the spleen;
  • decrease in the concentration of red blood cells and hemoglobin ( anemia) characteristic of internal bleeding with a stomach ulcer;
  • the enzyme amylase increases with pancreatitis;
  • an increase in alkaline phosphatase is characteristic of cholelithiasis;
  • increase in alanine aminotransferase ( ALAT), aspartate aminotransferase ( ASAT) and bilirubin indicates liver pathology.
There are other indicators, the study of which is carried out at the direction of the attending physician if a specific pathology is suspected ( for example, the level of porphyrins if porphyria is suspected, etc.).

General and biochemical urine analysis

Urinalysis is of secondary importance for pain in the upper abdomen, since it usually does not provide direct information about the pathology of the organs located in this area. Sometimes the growth of certain substances ( for example, porphyrin proteins) indicates the presence of specific violations. In general, the analysis is carried out to exclude urolithiasis, in which the pain sometimes radiates to the stomach and back. Also, by the concentration of various substances in the urine, one can indirectly judge the normal functioning of the liver and other organs.

In addition to those listed above, there are other methods used in diagnosing diseases of the upper abdominal organs. It is mandatory, for example, to take an electrocardiogram ( ECG) to exclude referred pain during a heart attack. For gastric sphincter stenosis, there are devices that measure the force of muscle contraction. However, these studies are prescribed after a preliminary diagnosis has been made to collect more complete information about the pathology.

What to do if you have pain in the upper abdomen?

If you have acute pain in the upper abdomen, you should never endure it for long. You should immediately seek qualified help. Most often, in case of severe pain, consultation with a surgeon is necessary, since it is he who diagnoses life-threatening acute diseases and decides whether urgent surgery is necessary. For moderate pain, you can consult a general practitioner or gastroenterologist, who will make a preliminary diagnosis and prescribe further research methods.

Hospitalization is necessary in all cases of acute sudden abdominal pain. The possibility of a life-threatening pathology cannot be ruled out, so the patient is admitted to the hospital until a final diagnosis is made. Until this point, self-administration of painkillers is not recommended ( without consulting a doctor) or warming with a heating pad. The pain may subside somewhat, making diagnosis difficult and putting the patient's life at risk.

Urgent surgical treatment is often necessary for the following pathologies:

  • perforation of a stomach ulcer;
  • bleeding from an ulcer;
  • acute pancreatitis;
  • acute cholecystitis;
  • peritonitis.
In other cases, if the patient’s condition allows, they initially resort to drug treatment. Depending on the results of further examination and effectiveness conservative treatment a decision may be made regarding elective surgery.
  • stomach ulcer;
  • biliary colic;
  • acute and chronic pancreatitis.

Stomach ulcer

Treatment of gastritis and gastric ulcer is quite a difficult task. First of all, it is necessary to find out the possible cause of these pathologies. It is important to know whether they are associated with Helicobacter pylori infection or not. If the microbe is present, a course of antibiotic therapy is added to the main treatment. In general, in the treatment of peptic ulcers, a wide range of drugs that reduce acidity and reduce the secretion of gastric juice are usually used. While taking these medications, the pain goes away. If you can get rid of the infectious agent, this is a guarantee that the disease will most likely not worsen in the future. Diet is also an important component of treatment. Compliance with it most often reduces pain.

Treatment of uncomplicated peptic ulcers can be carried out at home. Hospitalization may be necessary if the pain becomes severe or if there are complications. A family doctor usually treats a patient at home.

Complex treatment of patients with gastric ulcer

Treatment regimen Recommended drugs Reception mode
(daily doses)
Purpose of application
Scheme 1 Lansoprazole 30 mg 2 times
Omeprazole 20 mg 2 times
Pantoprazole 40 mg 2 times
Rabeprazole 20 mg 2 times
Ranitidine bismuth citrate 400 mg 2 times
Clarithromycin 500 mg 2 times Antibiotics against Helicobacter pylori infection.
Amoxicillin 1000 mg 2 times
Scheme 2 Lansoprazole 30 mg 2 times Choose one of the drugs. The goal is to reduce stomach acidity by reducing the production of hydrochloric acid.
Omeprazole 20 mg 2 times
Pantoprazole 40 mg 2 times
Rabeprazole 20 mg 2 times
Ranitidine bismuth citrate 400 mg 2 times Reduces the production of gastric juice and the activity of the enzyme pepsin.
Clarithromycin 500 mg 2 times Choose either metronidazole or tinidazole in combination with clarithromycin. The goal is to destroy the bacterium H. pylori, if the analysis detected it after treatment according to scheme 1.
Metronidazole 500 mg 2 times
Tinidazole 500 mg 2 times
Scheme 3 Lansoprazole 30 mg 2 times Choose one of the drugs. The goal is to reduce stomach acidity by reducing the production of hydrochloric acid.
Omeprazole 20 mg 2 times
Pantoprazole 40 mg 2 times
Rabeprazole 20 mg 2 times
Bismuth subcitrate colloidal 120 mg 4 times Decreased production of gastric juice.
Metronidazole 500 mg 3 times At the same time, both drugs to get rid of H. pylori.
Tetracycline 500 mg 4 times

In these treatment regimens, it is repetitive drugs that are aimed at eliminating pain. These are inhibitors proton pump, blocking the production of hydrochloric acid in cells. The effect of their use will be noticeable within a few days. For gastritis ( including those not related to infectionH. pylori) one of these drugs is prescribed at the discretion of the attending physician. Also, for severe pain, special gels can be prescribed ( almagel, phosphalugel, etc.), protecting the gastric mucosa.

The diet for gastritis and peptic ulcers is based on the following principles:

  • Fractional meals. Food should be taken 5-6 times a day in small portions to avoid stomach overfilling. Then the pain after eating will be less, and the food will be digested better.
  • Elimination of seasonings. Most seasonings ( including salt in large quantities) is added to food not only to improve taste, but also to increase the secretion of gastric juice. With gastritis or an ulcer, this will only worsen the patient’s condition and the pain will intensify.
  • Avoiding solid foods. Solid foods can mechanically irritate the intestinal mucosa, causing pain. Therefore, it is recommended to eat mainly soups, cereals and other soft foods during an exacerbation.
  • Optimal food temperature. The temperature of food served to the patient should vary from 15 to 55 degrees ( including tea, milk or other drinks). Otherwise, not only will the abdominal pain intensify, but the healing process will also slow down and the treatment process will be delayed.
  • Eliminating hard-to-digest foods. Such foods include most raw vegetables and fruits, fresh White bread, beef ( especially fried). It is recommended to serve the meat well boiled or steamed in thin pieces so that it is as soft as possible. You can cook cutlets, meatballs and other dishes from minced meat. However, in general, the amount of meat on the menu should be limited.
  • Elimination of factors that increase the secretion of gastric juice. Among food products, coffee and some varieties of black teas have this effect. Eating them, especially on an empty stomach, can provoke a severe attack of pain.
  • Alcohol exclusion. Alcohol has a direct inhibitory effect on the process of cell regeneration in the mucous membrane. In addition, it burns the area of ​​the ulcer where the mucous membrane is destroyed. Contrary to popular belief, it does not disinfect the ulcer ( Microbes cannot survive in the acidic environment of the stomach), but simply unreasonably irritates the mucous membrane and causes pain.
  • Balanced diet. A peptic ulcer is not a reason to reduce the total number of calories consumed per day. You just have to divide the food into large quantity servings. The diet must include meat, cereals, vegetables ( in the form of soups), dairy products. This will ensure that the body receives the vitamins necessary for the speedy scarring of the ulcer.
Treatment with this regimen can last several weeks ( less often - several months). After this, scarring of the ulcer usually occurs, and the pain goes away. However, no treatment regimen can guarantee that the ulcer will not open again in the future. It depends largely on the patient himself and his lifestyle ( diet, quitting alcohol and smoking). If drug treatment is ineffective or complications develop, it is possible surgical treatment. Its type and options for performing the operation are determined by the location of the ulcer. However, even after part of the stomach is removed, new ulcers may appear in the future at the suture sites if the cause of the disease has not been determined and eliminated.

Biliary colic

Biliary colic, which occurs due to cholelithiasis or, less commonly, due to other diseases of the gallbladder, is temporary. However, the pain can be very intense, so the primary task is to eliminate the pain syndrome. Since the pain in this case occurs due to spasm of smooth muscles, antispasmodics are used as first aid ( mainly M-anticholinergics). They relax muscles and quickly relieve pain.

The most effective antispasmodics in this case will be the following drugs:

  • atropine sulfate;
  • scopolamine hydrobromide;
  • aeron;
  • Homatropine hydrobromide.
Conventional anti-inflammatory or painkillers will not be as effective in this case. They will somewhat reduce the perception of pain, while its source will remain. Dullness of pain can lead to the fact that the patient does not acutely feel the rupture of the gallbladder. Peritonitis, which will develop after this, is a much more serious problem. Relaxation of smooth muscles practically eliminates such a complication.

In the long term, it is necessary to treat the underlying disease that caused biliary colic. Most often, ursodeoxycholic and chenodeoxycholic acid preparations are used for medicinal dissolution of gallstones. They have the property of dissolving stones when long-term use (usually months). However, this treatment method is not suitable for all patients. With a large number of stones, large sizes, and also depending on their chemical composition your doctor may recommend surgical treatment. Most often it involves removal of the entire gallbladder. Then the risk of recurrence of colic is eliminated completely and forever. Cholecystectomy ( gallbladder removal) is also necessary for any complications of gallstone disease.

In recent years, instrumental crushing of stones using ultrasonic waves has also been practiced. However, this method is also not ideal. It is not always possible to completely get rid of stones. In addition, there is a risk of their reoccurrence in the future.

Acute and chronic pancreatitis

Treatment of chronic pancreatitis is usually carried out at home. In case of exacerbation or sudden attack of acute pancreatitis, urgent hospitalization is necessary. Drug treatment has limited effectiveness in acute pancreatitis. Surgery is often necessary. Drug treatment is aimed at reducing the production of enzymes by the pancreas, pain relief ( usually a combination of narcotic and non-narcotic drugs), intravenous infusion of maintenance solutions.

Most often, the following medications are used for acute pancreatitis:

  • meperidine intramuscularly 50–100 mg every 4 hours to eliminate pain;
  • sandostatin ( octreotide) 100 mcg subcutaneously three times a day to reduce the production of digestive enzymes in the gland;
  • pancreatin 0.5 g orally - before meals for normal digestion and absorption of food.
It is also necessary to hospitalize the patient, aspiration ( exhaustion) stomach contents and careful monitoring of its condition. IN severe cases may be needed artificial ventilation lungs and other resuscitation measures.

For chronic pancreatitis, an important component of treatment is diet. In case of exacerbation of the disease, fasting for several days is recommended ( minimum amount of food). Then gradually add those foods that are most easily digestible. In acute pancreatitis, the patient returns to a normal diet only after a few weeks. To prevent exacerbations, take pancreatin or other drugs containing pancreatic enzymes before eating large amounts of heavy food.

Features of pain in the upper abdomen

As mentioned above, pain in the upper abdomen is not a specific symptom. It is much easier to discover the cause of the disease if it is considered in combination with other symptoms. Then the range of possible pathologies is greatly narrowed. Sometimes such features of the pain syndrome make it possible to suspect the correct diagnosis only after analyzing the patient’s complaints. Next, we will consider the most common combinations of pain in the upper abdomen with other symptoms and complaints.

Why does my upper abdomen hurt and feel nauseous?

Nausea is a very common symptom of gastrointestinal diseases. In combination with pain in the upper abdomen, it most likely indicates a pathology of the stomach, intestines, pancreas or liver. It is these organs, as noted above, that are usually associated with pain. In some cases, nausea also appears with pathologies of the nervous system, but with them, as a rule, there is no abdominal pain. Nausea may also be associated with intoxication ( food poisoning).

A combination of pain in the upper abdomen and nausea can occur with the following pathologies:

  • gastritis;
  • pancreatitis;
  • hepatitis;
  • peptic ulcer;
  • cholecystitis;
  • food poisoning.
As a rule, symptoms in these cases appear after eating. This puts a strain on the affected organ, and disturbances in its functioning become more noticeable.

Why did there be acute pain in the upper abdomen?

The appearance of sudden acute abdominal pain is almost always associated with acute surgical pathology. As a rule, this is a complication or sudden exacerbation of a chronic disease. The most acute pain occurs when the peritoneum is irritated or when there is noticeable massive tissue damage. Also, very acute pain occurs with rapid expansion of the liver capsule.

Acute, sometimes unbearable pain in the upper abdomen is characteristic of the following pathologies:

  • perforation of gastric ulcer– pain occurs due to acidic stomach contents entering the peritoneum;
  • acute pancreatitis– due to the inflammatory process in the pancreas, enzymes that break down proteins enter the abdominal cavity ( proteolytic enzymes);
  • biliary colic– due to spasm of the smooth muscles of the gallbladder ( usually when a stone gets stuck);
  • intestinal perforation– pain in the upper abdominal cavity may occur due to perforation of the colon ( more often due to a tumor);
  • peritonitis– with massive inflammation of the peritoneum;
  • liver rupture– due to the rapid formation of a hematoma inside the organ and stretching of the capsule.

Severe pain is also typical for malignant neoplasms, for example, stomach cancer. However, in this case they usually build up rather than appear suddenly. Regardless of where the pain occurs, you should immediately call an ambulance. Transporting a patient to the hospital yourself can be dangerous. Only doctors are able to decide what kind of assistance should be provided to the patient on the spot, as well as how exactly to deal with the pain syndrome.

Why does the upper abdomen hurt and diarrhea?

Both abdominal pain and diarrhea ( diarrhea) is a very common symptom in medical practice. However, disorders of digestion and absorption of food that cause diarrhea most likely indicate problems with the gastrointestinal tract. In other words, the range of reasons is narrowing.

Possible causes of diarrhea and pain in the upper abdomen are the following pathologies:

  • stomach ulcer– disturbances in the digestion of food in the stomach lead to its poor absorption in the intestines, which is why diarrhea occurs;
  • pancreatitis– with inflammation of the pancreas ( usually chronic) the organ does not secrete a sufficient amount of digestive enzymes;
  • cholecystitis– violations of the outflow of bile lead to the fact that fats are not absorbed in the intestines;
  • irritable bowel syndrome– caused by concomitant nervous disorders or poor diet ( sometimes stress), but the pain is spread throughout the abdomen, and episodes of diarrhea alternate with constipation.
The most common cause of diarrhea and associated pain in the stomach are food poisoning. Diarrhea is caused by the direct action of microbes or their toxins. Once in the gastrointestinal tract, they disrupt the process of digestion and absorption of food. The absorption of microbial toxins at the level of the mucous membrane causes painful spasms of the smooth muscles of the intestine. It should be noted that pain in such poisonings can be localized not only in the upper abdomen, but in other areas. Moreover, in severe cases ( depending on the type and number of microbes) patients may complain of vomiting, fever, headaches, muscle pain, and weakness.

Why does the upper abdomen and temperature hurt?

Temperature is a universal reaction of the body to various pathological ( and sometimes physiological) processes. This symptom appears when the thermoregulatory center in the brain is irritated by special substances - pyrogens. Pyrogens are formed as a result of a number of biochemical reactions under the influence of microbial toxins, pro-inflammatory agents, and some hormones. As a result, the brain gives a command for the breakdown of chemical compounds in tissues with the release of energy, and the body temperature rises.

In combination with abdominal pain, a temperature usually indicates an inflammatory process, or, less commonly, food poisoning. However, there are other, more rare causes that cause this combination of symptoms. In all cases, one has to take into account the possibility of an acute inflammatory process, which poses a potential threat to the patient’s life.

The most serious causes of fever and pain in the upper abdomen are the following pathologies:

  • gastritis– the temperature is usually low-grade, rarely higher than 38 degrees;
  • stomach ulcer– the temperature can be different, in case of complications – sometimes more than 38 degrees;
  • acute pancreatitis– temperature varies widely and can change quickly;
  • food poisoning– the temperature can be up to 39 degrees and higher, depending on the type of microorganisms and their quantity entering the body;
  • parotitis ( piggy) – abdominal pain accompanied by fever appears as a complication – viral pancreatitis ( Rarely occurs in unvaccinated children).
If you develop fever and abdominal pain, it is not recommended to take painkillers, as they can distort the typical picture for a particular disease. In case of severe pain, you should immediately consult a doctor or call an ambulance. High temperature ( above 38.5 degrees) can be shot down once. But if it does not subside, you also need to consult a specialist to clarify the cause of these symptoms.

Why does my upper abdomen and back hurt?

The combination of pain in the upper abdomen and back is most often associated with acute pathological processes in the organs of the posterior abdominal cavity. Sometimes the cause is also pathological processes at the level of the spine. In general, there are not many diseases that cause this combination of pain. You should pay attention to the nature and sequence of symptoms. This will help in identifying the causes.

The following pathologies can cause pain in the upper abdomen and back at the same time:

  • Spinal curvature. The innervation of many organs, muscles and skin areas comes through the spinal nerves. Their roots emerge at the junction of the vertebrae. They can be pinched due to various curvatures of the spine ( for example, against the background of osteochondrosis or scoliosis). Then a combination of back and abdominal pain is possible at approximately the same level.
  • Renal colic. More often renal colic caused by the movement of stones during urolithiasis ( nephrolithiasis). Pain with this disease can be very diverse. The most typical pain is in the lower back on the corresponding side. Less commonly, pain may also appear in the upper and side of the abdomen.
  • Perforation of gastric ulcer. If an ulcer located on the back wall of the stomach forms a through hole, irritation of the peritoneum occurs. Suddenly there is severe pain in the upper abdomen, radiating to the back.
  • Acute pancreatitis. Acute pancreatitis is characterized by girdling pain, involving the epigastrium, hypochondrium and radiating to the lumbar region.
  • Biliary colic. With spastic contraction of the smooth muscles of the gallbladder, pain is most often localized in the upper abdomen, closer to the right hypochondrium. However, it can also radiate to the lower abdomen, back or shoulder.
Of the above reasons, in the first case, the pain will not be so intense, and its appearance will most often be associated with turns of the torso, a change in body position. In other cases, we are talking about acute, sometimes unbearable pain, which requires urgent qualified help.


Why does the upper abdomen hurt during pregnancy?

Pregnancy is a physiological state of a woman’s body, not a pathology. However, changes in the body during this period often provoke an exacerbation of various chronic diseases and the emergence of new pathologies. Some of them can cause pain in the upper abdomen.

The prerequisites for the development and exacerbation of various pathologies during pregnancy are the following changes:

  • Hormonal changes. To fix the fertilized egg inside the uterus, the development of the placenta and the normal course of pregnancy, special hormones begin to be produced in the body. They partly affect the functioning of various organs.
  • Changes in the immune system. The growing fetus, of course, is not perceived by the mother's body as foreign tissue, but its presence still requires some adaptation of the immune system. During pregnancy immune defense weakens, which becomes a prerequisite for infection with various infections.
  • Mechanical adjustments. The growth of the fetus in the abdomen in the first trimester does not greatly impede the work of neighboring organs. However, in the second and especially the third trimesters, simply increasing the size of the fetus creates certain problems. In particular, the intestinal loops shift slightly upward, and some vessels may be compressed. All this contributes to the exacerbation of chronic diseases and the occurrence of acute conditions.
  • Intoxication. During pregnancy, the maternal body is like a life support system for the growing fetus. It not only nourishes the child, but also takes in all the products of its vital activity. A very common problem is toxicosis, in which various toxins accumulate in the mother’s blood.
In such conditions, frequent exacerbation various diseases is quite obvious. The pain itself is usually caused by the inflammatory process ( for example, with gastritis or pancreatitis), tissue stretching ( with the accumulation of gases in compressed intestinal loops), muscle spasms ( with biliary or intestinal colic). In case of poisoning, for example, we are also talking about muscle spasm caused by the ingestion of the toxin.

In general, pain in the upper abdomen is most often caused by the following diseases:

  • gastritis– inflammation of the gastric mucosa;
  • toxicosis of pregnant women (but abdominal pain is not a necessary symptom);
  • biliary colic– as a rule, with exacerbation of cholelithiasis ( stones move as the fetus grows);
  • pancreatitis– inflammation of the pancreas, as a rule, there is an exacerbation of chronic pancreatitis;
  • appendicitis– inflammation of the appendix ( due to the mobility of the cecum in the third trimester, the appendix rises upward, and the pain may radiate to the right hypochondrium);
  • intestinal colic – painful contraction of smooth muscles in the intestinal walls ( may be spread throughout the abdomen, and not just at the top).
It has also been noted that during pregnancy, due to disturbances in the functioning of the immune system, some autoimmune diseases may worsen ( for example, Crohn's disease). Some of them directly or indirectly affect the gastrointestinal tract. There are also a number of diseases with a hereditary predisposition, which often first appear in women during pregnancy. These include, for example, porphyria. The pain with this disease can be very severe, but is most often localized around the navel ( upward can only give).

What diseases cause pain in the upper abdomen under the ribs?

The upper part of the abdominal cavity is partly located under the costal arches. This is due to the dome-shaped shape of the diaphragm, the muscle that separates the abdominal and thoracic cavities. Some pathologies of organs in the upper abdominal cavity are characterized by pain in the right or left hypochondrium. Such localization often helps to make a diagnosis, as it narrows the range of possible causes. First of all, you need to figure out what organs are located in the hypochondrium area.

The spleen is located under the left costal arch, which most often causes characteristic pain. Also here is the cardiac part of the stomach, intestinal loops, and a little behind - the tail of the pancreas and the left kidney. Under the right costal arch, almost the entire space is occupied by the liver. On the border of the lower rib in front is the gallbladder ( under the liver), and below and behind – right kidney. In most cases, pain in the right hypochondrium is caused by diseases of the liver and gallbladder.

Pain in the hypochondrium is usually dull and dull, not sharp. This is explained by the fact that the pain is caused by stretching of the organ capsule ( when it comes to the liver) or organ enlargement ( spleen). Acute pain can occur only when the organ suddenly enlarges, when the capsule quickly stretches, or when the organ ruptures.

Most often, pain in the hypochondrium is caused by the following pathologies:

  • Hepatitis. Hepatitis is inflammation of the liver. It can be caused by certain toxins or viruses ( less often - bacteria). In all these cases, there is discomfort or moderate, prolonged pain associated with enlargement of the liver and stretching of its capsule.
  • Liver rupture. Accompanied unbearable pain in the right hypochondrium. The organ capsule usually does not rupture, but the liver tissue itself is damaged and bleeding occurs inside the organ. Because of this, the capsule quickly stretches, causing severe pain. Liver rupture is always the result of blunt trauma ( strong impact, sudden stop of traffic during an accident).
  • Cholelithiasis. The disease is associated with the formation of stones in the gallbladder, which injure the mucous membrane of the organ and cause pain. A blockage of the gallbladder's excretory duct may also occur, causing bile to accumulate in the organ. When smooth muscles contract in the walls, acute pain occurs approximately at the level of the lower rib on the right ( closer to the center line of the abdomen). This pain is called biliary colic.
  • Enlarged spleen. This syndrome not always accompanied by pain. It may be a consequence of a rapid increase in blood circulation ( for example, during exercise without warming up, running, etc.). Also, the spleen can increase in various infectious diseases and simultaneously with liver pathologies ( due to stagnation of blood in the splenic vein, which goes to the liver).
Also, pain in the hypochondrium can be caused by other, rarer causes that are not directly related to the organs located in this area. For example, an enlarged spleen and tenderness in the left hypochondrium may occur with some hematological diseases ( diseases of the hematopoietic system). Also, pain may radiate to the left hypochondrium with atypical pain syndrome accompanying myocardial infarction ( most often the posterior wall of the heart). Sometimes patients confuse pain in the hypochondrium with pain in the intercostal muscles. Such pain occurs with intercostal neuralgia ( for example, with curvature of the spine or herpes zoster).

Why does my child have pain in the upper abdomen?

Most of the reasons causing pain in the upper abdomen in adults, also relevant for children. There are not so many specific causes that are not found in adults. The problem most often is that young children cannot pinpoint where it hurts or communicate the nature of the pain. This makes it much more difficult to make a correct diagnosis.

Possible causes of pain in the upper abdomen in children are:

  • Gastritis. Gastritis is an inflammation of the stomach lining. In adolescence, this is most often associated with poor nutrition. At an earlier age, hereditary forms of this disease can occur. The pain is localized approximately in the center of the abdomen at the top, “in the pit of the stomach.”
  • Hepatitis. Most often children get sick infectious hepatitis, especially hepatitis A ( Botkin's disease). The infection is transmitted through contaminated food. The virus infects liver cells, causing their inflammation and enlargement of the organ as a whole. This may be accompanied by moderate pain ( and sometimes just discomfort) in the right hypochondrium.
  • Enlarged spleen. The spleen responds to many different processes in the body that involve blood cells or the immune system. In many infectious diseases, an increase in this organ is observed. Pain appears rarely; a feeling of discomfort in the left hypochondrium is more typical.
  • . For children, excessive physical activity is often associated with pain in the right and/or left hypochondrium. This is explained by the fact that the blood begins to circulate faster, nourishing the muscles, and the spleen and liver do not have time to adapt to the new conditions. Pain occurs after prolonged exercise ( long endurance run). In this case, we are not talking about any disease. You just need to give the child a rest and gradually increase the load in the future.
  • Poisoning. Unlike adults, children do not always understand the importance of eating fresh food. Common food poisoning ( staphylococcal toxin, etc.) can cause severe pain in the upper abdomen. At the same time, weakness is observed, sometimes vomiting and diarrhea. Small children left unattended can become poisoned household chemicals. Then the pain will be caused by a chemical burn of the mucous membrane of the esophagus and stomach.
  • Intolerance to certain substances. The digestive system of young children is very different from that of adults. In particular, we are talking about the absence of certain enzymes. Thus, foods that adults digest normally may become problematic for adults. child's body and manifest as abdominal pain. Congenital intolerance to certain substances also occurs ( gluten protein, lactose milk sugar, etc.). One of possible symptoms If the diet is not followed, there will be pain in the upper abdomen.
At the same time, there are a number of diseases that can cause pain in the upper abdomen in adults, but are almost never found in children. Usually these are diseases that appear due to prolonged exposure to unfavorable factors. For example, myocardial infarction or gastric ulcer may be associated with long-term smoking, poor diet, and alcohol abuse. It's about about many years of bad habits, so these diseases do not occur in children. It also usually takes many years for gallstones to form, so gallstone disease is more common in people over 40 years of age.

In newborns and infants, there are many more possible pathologies that can manifest as abdominal pain. Often they are associated with certain congenital characteristics of the body, which appear just in the first months or years of life.

It should be noted that pain in the upper abdomen ( especially abrupt and strong) may indicate very serious illnesses that require immediate medical care. Therefore, when this symptom appears, it is necessary to show the child to a pediatrician ( and in case of acute pain - to the surgeon). For example, very common appendicitis can also cause pain in the first hours not in the lower right, but in the upper abdomen. This migration of pain often confuses parents.

Why does pain appear in the upper abdomen after eating?

The dependence of abdominal pain on food intake is very important feature pain syndrome, which in no case should be ignored. The fact is that such a dependence directly indicates the involvement of the gastrointestinal tract ( Gastrointestinal tract) into a pathological process. This greatly narrows the range of possible causes and makes diagnosis easier.

To determine the cause of pain, you need to pay attention to the following features:

  • Dependence on the type of food. After solid food, for example, pain often appears due to gastritis or stomach ulcer. This is explained by mechanical irritation of the mucous membrane. Pain may also appear, for example, after sour or salty foods. Excessive fat consumption may cause pain in the right hypochondrium. This suggests that the gallbladder is not coping with its functions ( Normally, it is bile that helps digest fatty foods). Epigastric pain ( in the center of the stomach) after drinking alcohol may indicate pancreatitis. Thus, you need to pay attention to what kind of food the pain becomes stronger.
  • Time dependent. Normally, the food bolus, which forms in the oral cavity, passes through all parts of the gastrointestinal tract in a certain time. That is, the esophagus, for example, food passes in 3 – 10 minutes ( slow down when there are problems). Pain, accordingly, will appear behind the sternum around this time. With a stomach ulcer, pain appears after half an hour or an hour. At this time, food irritates the damaged area of ​​the mucous membrane. With a duodenal ulcer, pain in the upper right part of the abdomen appears only an hour or an hour and a half after eating.
  • Dependence on quality. In case of food poisoning, you can almost always associate the appearance of pain in the upper abdomen with the consumption of expired foods.
Thus, we can conclude that pain in the upper abdomen after eating is most often caused by peptic ulcer of the stomach and duodenum, pancreatitis ( inflammation of the pancreas), cholecystitis ( gallbladder inflammation). For gastritis ( inflammation of the gastric mucosa without local defects) pain after eating is not so common. More often, pain, on the contrary, appears on an empty stomach. The ingestion of food reduces the acidity of the stomach and soothes pain. However, there are exceptions depending on the type of disease.

With malignant tumors of the stomach, the nature of the pain can be different. It most often appears after eating, but there is still no clear dependence. The pain may also be constant.

It should be noted that the appearance of pain after eating also excludes a number of different pathologies. Basically, these are diseases that are not associated with the gastrointestinal tract, but also manifest themselves as pain in the upper abdomen.

If pain in the upper abdomen appears only after eating, then the following causes can be excluded:

  • spinal diseases– here pain usually depends on body position and movements;
  • myocardial infarction– pain appears after physical activity;
  • intercostal neuralgia– pain can be triggered by colds;
  • hematological diseases– there is no clear dependence of pain on food or other factors;
  • muscle diseases– more often associated with muscle tension and movements.
In general, the regular appearance of pain after eating most often indicates the presence of certain problems, so leave this symptom it is impossible without attention. You should consult a gastroenterologist or therapist ( general practitioner), to spend necessary examinations and find out the cause of the pain.

What folk remedies are there for upper abdominal pain?

Pain in the upper abdomen is a common symptom that is familiar to every person. The prevalence of this problem may lead to the erroneous idea that there is no serious pathology behind these pains. However, in medicine, abdominal pain is treated with extreme caution. There are a lot various reasons, which can cause this symptom, and some of them pose a serious threat to the patient's health.

That is why the use of folk remedies in the treatment of pain in the upper abdomen is strictly prohibited. Most patients do not attach any importance to even severe pain. They find treatment options with folk remedies and actively use them ( most often unsuccessfully) and waste time that could be used to diagnose the problem and provide qualified assistance.

The use of folk remedies for abdominal pain is not recommended for the following reasons:

  • Most medicinal plants have a very narrow spectrum of action. Some of them can, for example, reduce stomach acidity and reduce pain due to gastritis or peptic ulcers, others can relieve muscle spasms. But there is no universal remedy. For each pathology, pain is caused by a specific mechanism. Therefore, before a diagnosis is made, there is a high probability that the chosen folk remedy will simply be ineffective and will not reduce pain.
  • Many patients take infusions or decoctions and expect visible effects within a few hours or days. At the same time, such acute conditions as perforation of a stomach ulcer or rupture of the gallbladder requires immediate surgical intervention. A delay of even an hour can endanger the patient's life.
  • Also, most medicinal herbs have a relatively slow effect. This is explained by the low concentration of active substances in any decoctions or infusions. For acute severe pain ( for example, when biliary colic ) no folk remedy will eliminate the pain. Pharmacological drugs have a much stronger and faster effect. That is why they should be used to relieve severe pain. Folk remedies can be used for long-term treatment, in combination with pharmaceuticals.
  • Folk remedies are aimed mainly at eliminating functional disorders. Pain can be caused by structural disorders ( pyloric stenosis, gastric ulcer, etc.). In these cases, the main treatment method will be surgery, and traditional methods of treatment cannot dull the pain.
However, a number of traditional medicine recipes can be used to treat certain diseases. However, the patient must know his diagnosis, and treatment must be agreed with a specialist. In this case, traditional medicine will contribute to overall recovery. However, the remedies listed below will not be aimed specifically at eliminating the pain that appears.

Folk remedies for certain diseases that cause pain in the upper abdomen

Disease Folk remedy Cooking method Reception mode
Gastritis Aloe juice with honey For half a glass of warm juice you need 100 g of honey. Stir honey until completely dissolved. 1 teaspoon three times a day 15 minutes before meals for a month.
Motherwort juice Rinse young motherwort well boiled water and squeeze out the juice. Three times a day, 1 teaspoon with a small amount of water.
Peptic ulcer Potato decoction Well-washed unpeeled potatoes are boiled until tender. The water is filtered and drunk after cooling ( do not add salt). Half a glass three times a day on an empty stomach.
Sea buckthorn juice and butter Prepare them yourself or buy them in stores. Juice – 50 ml three times a day, an hour before meals. Oil - after juice, 1 teaspoon.
Cholelithiasis Rowan infusion Take 50 g of berries per liter of boiling water. Infusion lasts 4 hours. Drink 1 glass of infusion three times a day 5 – 10 minutes before meals.
Highlander snake decoction The rhizome of the snakeweed is well washed, finely chopped and thrown into boiling water for 15 minutes. For 1 liter you need 2 tablespoons of rhizome. 10 minutes after preparation, the broth is filtered and cooled. Take 2 tablespoons of decoction half an hour before meals.
Pancreatitis Sprouted oats Sprouted oats are washed and ground into flour. Pour it with cold water and boil for 2 minutes. Then cool without straining. Strain before use. Drink fresh ( store no more than 24 hours) 20 – 30 ml in small portions throughout the day.

Thus, folk remedies play a certain role in the treatment of certain abdominal diseases. However, when abdominal pain appears from above, it should be remembered that this role is secondary, and it is dangerous to resort to alternative medicine before making a correct diagnosis and prescribing the main treatment.

Is a stomach ache in the middle a harbinger of danger or normal? Abdominal pain is a symptomatic manifestation of many diseases of the gastrointestinal tract and intestines. The appearance of pain is often associated with pathology or dysfunction of organs located in the projection of the navel. However, patients do not always clearly identify the location of the source of pain. Discomfort in the central abdomen can be reflected downwards or above the umbilical line with varying intensity.

Complex intestinal anatomy

Given the complexity of the anatomical parts, intestines and stomach, pain can be radiating or radiating. So, the true source of pain can be the genitals, upper digestive sections, vascular components of any localization, and are reflected in the peri-umbilical zone.

To reliably assess the clinical situation, a multi-level differential diagnosis to exclude any diseases with similar symptoms.

Target organs for abdominal pain

Wide localization of pain

The central region of the abdomen is a vast anatomical zone, involved in almost all symptomatic manifestations in diseases of the peritoneal organs and retroperitoneal space, all parts of the intestine, and pelvic organs.

The intensity of the pain syndrome depends entirely on the individual sensitivity of the patient, his clinical history, as well as age and severity of the underlying pathology. The following anatomical sections in the projection of the umbilical space are subject to inflammation:

  • anterior wall tissue;
  • stuffing box;
  • pancreas;
  • large vessels;
  • abdominal section

Pain can be caused by infectious diseases, trauma, intestinal obstruction, thrombosis, hereditary factors, acute and chronic intoxication, and much more. An important aspect of any inflammation is the absence of parenchymal tissue in the abdominal cavity, so the membranes of the internal organs are first affected.

Note! Also, the abdominal cavity contains a small number of sensory nerve endings, so pain due to vascular pathologies may be associated with complications in other organs that involve blood transport through adjacent arteries and capillaries.

Features of pain and localization

The central region of the abdomen is conventionally classified into the upper and lower lines. So, it is important to determine the localization of pain and the location of the pain syndrome.

Pain above the midline

If there is pain in the middle of the abdomen above the navel, these are typical manifestations of gastric ulcer and inflammation of the duodenum. In the chronic course of a gastric ulcer, pain may appear as the disease worsens. The initial sections of the small intestine can cause pain not only with ulceration, but also with polyps, erosions, perforation of the walls, and internal bleeding. Peptic ulcer disease is accompanied by other symptoms:

  • hungry night pain;
  • pain immediately after eating;
  • sour belching;
  • blackening of the stool or the appearance of blood in the stool.

May be caused by a change in diet, alcohol abuse and tobacco products. Pain often radiates to the abdominal area in diseases of the heart or respiratory system (diaphragm, lungs).

Another disease with pain just above the navel is cancer of the stomach or upper intestines, but cancer rarely spreads to the duodenum. Tumor-like growths, polypous lesions, and cells of the affected mucosa are prone to malignancy, especially with a hereditary predisposition to cancer of any location.

The appearance of pain above the navel in the middle of the abdomen is a serious condition, sometimes requiring emergency hospitalization. It is important to pay attention to the following symptoms:

  • vomiting with bloody spots;
  • darkening of the stool (black feces, blood);
  • feces mixed with pus and copious mucus;
  • increased tone of the abdominal wall (signs of peritonitis);
  • impaired swallowing function (dysphagia);
  • sharp cutting pain in the epigastric region;
  • pale and sweaty skin;
  • sudden loss of body weight.

Important! Cholecystitis, tumors, pancreatitis and dyskinesia - all this can cause pain in the abdominal area, along the upper border of the navel. Some clinical cases require immediate surgical treatment.

Pain along the lower navel line

If the pain is in the middle of the abdomen just below the umbilical line, then the spectrum possible diseases it's much higher here. The symptomatic picture often corresponds to the disease urinary tract, pathologies of the intestinal sections, reproductive organs. The following are the main causes of pain:

  • Umbilical or inguinal hernia. Incarceration of the hernial sac has clear symptoms, manifested by acute pain with a tendency to irradiate throughout the abdominal space. Often the localization of the infringement is not amenable to visual diagnosis and palpation (in the case of inguinal-scrotal hernias).
  • Perforation. If the integrity of the walls is violated sigmoid colon acute pain occurs, reminiscent of an exacerbation. Unlike true appendicitis, with perforation of the walls of the sigmoid colon, the pain is localized at the bottom of the umbilical line.
  • Acute salpiginitis. The condition is typical for inflammation of the pelvic organs. The inflammatory process in the pelvic area is called adnexitis. Pain spreads across the lower abdomen, accompanied by fever.
  • Painful menstruation in women. The pain is associated with rupture of the follicular cells as the eggs are released. It is usually localized closer to the side, but can radiate directly to the navel. The discomfort is short-lived, usually no more than 2-3 days after the start of menstruation.
  • Diseases of the genital organs. Various pathologies reproductive organs in women and men contribute to the development of unpleasant symptoms, including pain in the midline of the peritoneum. So, bacterial prostatitis, sexually transmitted diseases and inflammation genitourinary system in men they are often accompanied by abdominal pain. Women's diseases are uterine fibroids, polyps cervical canal, inflammation of the endocervix, endometriosis, cystic components.
  • Diseases of the kidneys and urinary tract. The most common phenomenon in nephrology is pyelonephritis, affecting both women and men of any age. Inflammation is accompanied by pain and cutting in the back (in the projection of the kidneys), radiating to the sacrum and abdomen. To others inflammatory disease with irradiation of abdominal pain is cystitis - inflammation Bladder. The pain intensifies, mainly at the time of urination.
  • Intestinal obstruction. Symptoms of intestinal obstruction in the thin and thick sections are often combined with pain in the navel area or just below. At the beginning the pain is sharp, but gradually subsides. As the pathological obstruction increases, the pain becomes obsessive and constant. Intestinal obstruction is a clinical situation requiring medical intervention.
  • Urinary retention and kidney pathologies. Any nephrological diseases, including renal failure, can provoke pain in the abdominal area in the middle due to the anatomy. When urinary retention occurs, the bladder becomes stretched, blocking the ureters, which contributes to abdominal pain.

Pain can be caused by the consequences of trauma (including long-term ones), wounds, severe bruises and contusions. An injury is considered to be overstrain of the abdominal muscle structures during intense physical activity.

Pain above the navel, which appears suddenly or has been present for some time, may indicate that symptoms of a certain disease have appeared in the body. It could be the first serious wake-up call.

Pain, if it is severe or constantly aching, gives a person a lot of trouble, he is forced to constantly be distracted by it and cannot calmly work, walk, sit, etc. Therefore, here you need to immediately begin to solve this problem by finding out why the symptom arose.

Causes of pain in the area above the navel

The reasons why a person experiences pain in the navel and slightly above are quite varied. In this area there are two vital important departments Gastrointestinal tract - stomach and upper duodenum.

Painful sensations that arise in this place may indicate the progression of the disease in one of these organs or the beginning of its development. Most often, the source of discomfort that appears in the area just above the center of the abdomen is inflammatory processes organs of the gastrointestinal tract.

Such ailments include:

  • Gastroduodenitis. The pain, throbbing, resembles contractions and is concentrated in the right side of the peritoneum. It may appear above the navel 2-3 hours after eating. Sometimes accompanied by a feeling of nausea and swelling of the upper part of the peritoneum. Painful sensations stop gradually after a person begins to regularly take small portions of the right food and medications prescribed by a doctor. Sometimes eliminating the main cause of the disease (irregular meals, fast food, etc.) already leads to getting rid of the problem;
  • Duodenitis. Seizures occur dull ache, sometimes there are sharp sharp ones (they happen infrequently). There is a state of nausea and a complete lack of appetite, after eating there is a feeling that the stomach is bloated, when the epigastric region is exposed, severe pain appears;
  • Acute gastritis. This disease is characterized by the appearance of dry mouth, a gray coating forms on the tongue, the skin turns pale, frequent diarrhea begins, there may be vomiting, there is often a constant state of nausea and general weakness;
  • Ulcer of the stomach and duodenum. Pain increases when a person is hungry or between meals. In cases where he is full, pain does not occur so often. Side effects such as nausea and vomiting may also be present;
  • Pancreatitis. With this disease, pain is observed in the upper right side of the abdomen. If the head of the pancreas is inflamed, then the pain will appear in the left region, if the back part (tail) is inflamed, then right above the navel. TO additional symptoms include frequent bowel movements with the release of fat and mucus, dizziness, nausea, great weakness of the whole body, frequent urge to vomit. This cause of discomfort can occur not only in adults, but also in children;
  • Stomach cancer. If we consider all the causes of pain above the navel, then this is one of the most dangerous. On initial stage The disease's symptoms are similar to gastritis. Then, as the disease progresses, the patient experiences distension in the left side, complete apathy, lack of appetite and interest in life, and sudden weight loss;
  • Soreness above the navel often signals inflammation of an internal organ. There are many organs in the peritoneum that can provoke such pain - inflammation of the bladder, ovaries, inflammation of the pleura (pleurisy), inflammation of the liver (hepatitis), cholelithiasis, etc.;
  • The appendix can also cause pain above the umbilical opening. Here the pain changes its form "position". At first it is felt slightly above the middle of the abdomen, and then radiates down to the right side. The abdominal muscles are constantly tense; when moving, a person feels increased discomfort;
  • A common cause of pain in the umbilical region in people is ordinary overeating, indigestion, abuse of fatty foods or smoked meats, alcohol poisoning;
  • There are cases when pain just above the navel occurs in pregnant women. This occurs in cases where an umbilical hernia begins to develop in a pregnant woman and the growing fetus stretches the rounded ligament of the liver. The causes of pain above the navel in men, women and children are largely similar. But a child’s digestive system is somewhat different from an adult’s. Therefore, usually complaints of pain in the umbilical area or just above the central part are most often associated with problems in the digestive system. In children, discomfort in the navel area is most often observed for the following reasons:

  • Lack of adult control over the child’s proper nutrition – the diet is unbalanced and food is taken irregularly. Abuse of harmful foods (fast foods, smoked foods, sweets, carbonated drinks, etc.). The child does not eat well and is allergic to certain foods;
  • Some children have problems from birth with lactose and dairy intolerance. And even with a small content of these substances in some products, the baby may experience discomfort;
  • The baby may sometimes experience functional tenderness in the tummy. This is not due to physical problems, but may be due to severe mental disorders and experiences.

Otherwise, the reasons why a child’s stomach hurts at the top are the same as in adults.

Treatment methods

If you experience persistent or recurring painful sensations that do not go away within three hours, you should urgently seek medical help. Before the patient begins treatment, it is very important to find out the cause of the disease and make an appropriate diagnosis.

There are cases when the patient requires urgent hospitalization, in which case surgical intervention cannot be ruled out. If the patient’s health is not seriously threatened, the doctor may limit himself to recommendations - write a prescription and send him home. When the disease occurs due to infection, the patient will undergo a course of rehabilitation, taking antibiotics, sorbents, antispasmodics, painkillers, and proper gentle nutrition will be prescribed.

If pain in the umbilical region arose due to psychological trauma or was provoked by a strong emotional disorder, then such a patient is recommended to take bed rest for a while and take medications that relieve intestinal spasms.

When diagnosed with cancer, the patient undergoes removal of the diseased organ, after which he will have to undergo chemotherapy or radiation therapy. The success of cancer treatment always depends on timely consultation with a doctor. The sooner it is detected, the more favorable the outcome will be.

If there is slight discomfort in the umbilical area caused by overeating, a person is prescribed to take activated charcoal and enzymatic preparations. Self-medication in case of pain above the navel is extremely dangerous, as this can lead to undesirable consequences. After all, pain in this place can be an indicator of various diseases, including very serious ones, sometimes leading to sad consequences.

Therefore, you should not start treatment without consulting a doctor! For example, with advanced gastritis, an ulcer may appear. With an ulcer, internal bleeding may occur, which will become known only after taking stool for analysis or after a post-mortem autopsy. A disease such as volvulus has very serious consequences.

It is necessary to seek help from a doctor as soon as possible. In case of exacerbation of appendicitis, surgical intervention is also indispensable. A timely operation saves a person’s life!

Appearance of signs umbilical hernia requires urgent hospitalization, as necrosis of the strangulated intestine may occur, and then necrosis is possible death. An aneurysm in the abdominal cavity is considered a dangerous disease and its treatment requires only surgical intervention.

For cystitis, a course of antibiotics is prescribed. Inflammation in the pelvic area can have both infectious nature, and tumor. So you can’t do without getting tested. The examination of this part of the human body must be taken seriously. But uterine fibroid large sizes subject to amputation.

When uterine cancer is diagnosed, extirpation is performed (the uterus is removed along with the ovaries and appendages), and a course of chemical radiation therapy is carried out. From all of the above, it is easy to conclude that there is no need to self-medicate, it can be dangerous. After all, you first need to establish the reason why it hurts above the navel, and only then act. This especially applies to children!

Prevention of pain above the umbilical zone

Pain in the abdomen above the navel is, first of all, a signal to a person that he urgently needs to pay attention to his physical health and prevent the situation from reaching a critical state. This is especially true for acute, aching and frequently recurring attacks of pain.

If we analyze all the causes of discomfort that are outlined above, it becomes clear that prevention primarily lies in proper nutrition. The digestive system cannot constantly get dry and junk food. Sooner or later it will malfunction and then there will be pain in the stomach above the navel.

You can’t expect the discomfort to go away on its own. Required in similar cases Seek help from a doctor and strictly follow all his instructions to avoid serious complications!

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