Most of the pains in the pit of the stomach are trivial and improve by leaving the stomach at rest with hydration, a soft diet, analgesia and sometimes antacids, stomach protectors.
Pain in the pit of the stomach, what we call epigastralgia , is a very common type of abdominal pain that can be triggered by different causes. Most of them are trivial and of digestive origin, but sometimes they can be a pain due to potentially serious diseases or whose origin is not digestive.
Stomach pain is characterized by appearing in the center of the upper abdomen , below the ribs, and can remain localized there or radiate to the sides of the abdomen, the back, or ascend into the chest cavity. Depending on the characteristics of the pain, the location and the accompanying symptoms, the cause of the pain and the possible treatment can be oriented.
Pain due to inflammation of an abdominal viscus
Acute gastroenteritis is one of the main causes of stomach pain . It is a pain that is not constant, it is always present, but it varies in intensity. It can be accompanied by nausea, vomiting and diarrhea , as well as fever , since most gastroenteritis is due to a viral infection . In general, they are pains that subside by themselves and once the stomach is empty, the nausea persists and the pain moves to the rest of the abdomen, giving the classic cramps.
The treatment is hydration and an astringent diet and, at most, paracetamol for pain or some antiemetic for vomiting if they are very copious.
The pain of gastritis due to what people commonly call heartburn , is characterized by being burning, like a burning, usually appears after eating and is relieved by eating or taking antacids . Likewise, there may be a feeling of fullness, a certain distortion in the stomach area, feeling full from early menar, belching, nausea and vomiting.
The pain improves with antacids and drugs that modulate gastric acid secretion, and certain foods (coffee, chocolate, alcohol) should be avoided. It is important to go to the gastroenterologist if the symptoms persist to rule out a possible Helicobacter pylori infection or the existence of a gastric ulcer.
Biliary colic is pain caused by obstruction of the bile ducts by a stone or biliary sludge . It is a pain that appears in the upper right part of the abdomen but that can also appear as pain in the pit of the stomach and that can radiate to the back. It is usually accompanied by nausea and vomiting and usually occurs after copious or high-fat meals. If it is also accompanied by fever, an infection of the gallbladder should be suspected , cholecystitis , which is a surgical emergency and requires going to the emergency room.
Biliary colic usually improves with analgesia, spasmolytics, and antiemetics if vomiting is present. After the acute episode, it should be studied in consultation with a gastroenterologist.
Acute pancreatitis is a medical emergency. The main cause is gallstones and involvement due to excessive alcohol consumption. It is characterized by epigastric pain that radiates both to the left upper abdomen and to the back and is relieved by sitting leaning forward. It is accompanied by nausea, vomiting, low-grade fever, and prostration.
When to go to the doctor
In case of suspicion, it is important to go to a hospital emergency service, as admission is required.
An appendicitis is characterized by pain that can begin at the level of the stomach and is accompanied by nausea, vomiting, fever and general malaise . Subsequently, the pain moves from the stomach area to the lower and right area of the abdomen, where the appendix is located . The belly is often distended, may be hard, and is very painful to the touch.
When to go to the doctor
If appendicitis is suspected , you should go immediately to an emergency center without delay, as it is a surgical emergency.
Pain due to peritoneal inflammation
Perforated gastroduodenal ulcer
A perforated gastroduodenal ulcer is characterized by sudden onset, very intense pain, with a hard abdomen and a history of gastroduodenal ulcer. It can be accompanied by serious symptoms and signs, such as dizziness, sweating, tachycardia, low blood pressure and loss of consciousness.
When to go to the doctor
It is a medical emergency that requires going to a hospital immediately.
Aortic aneurysm rupture
It is a dilation of the aortic artery , it is a rare condition and can present as intense stomach pain , of sudden onset, radiating to the back that improves when sitting and worsens when lying down. Likewise, it can be accompanied by the palpation of a pulsatile mass at the abdominal level and signs of severity, such as hypotension, syncope, sweating and dizziness. It is always a surgical emergency .
Pain of extra-abdominal origin
Inflammation and erosion of the epithelium of the esophagus can present as stomach pain or in the sternal area, in the center of the chest, which is usually referred to as a burning sensation. May be accompanied by nausea.
Improves with antacids and stomach protective drugs.
It consists of spontaneous and repeated contractions of the esophagus that are caused by swallowing . It can be due to the ingestion of very cold drinks, a large food bolus, esophagitis, stress, diabetes or other causes. It can be accompanied by difficulty swallowing solids or liquids , as well as nausea and dizziness .
In which cases go to the doctor
You should go to the emergency room to rule out other pathologies that can cause similar symptoms, especially a heart problem, and start treatment with smooth muscle relaxants.
ischemic heart disease
Especially if it affects the underside of the heart, it can present as pain not in the center of the chest but in the pit of the stomach. It is common to occur in diabetic patients . It should be suspected if there is a history of heart disease or cardiovascular risk factors and if the pain is accompanied by symptoms of dizziness, sweating or paleness.
It is an inflammation of the serous layer that covers the heart , it usually presents as central thoracic pain and is usually accompanied by low-grade fever, but it can also appear as radiating pain towards the pit of the stomach and calms down, like pancreatitis, when sitting leaning forward .
It is usually treated with aspirin , but it is advisable, in any case, to go to the emergency room to rule out other pathologies.
It is very common to appear in states of nerves, anxiety or mood swings. Psychiatric pathology manifests itself at an organic level very frequently as digestive symptoms. Psychogenic epigastric pain is aggravated by stress and does not disrupt sleep and is not accompanied by other symptoms.
What you should know…
- Most of the pains in the pit of the stomach are trivial and improve by leaving the stomach at rest with hydration, a soft diet, analgesia and sometimes antacids, stomach protectors, spasmolytics or anti-vomiting drugs.
- In any case, if any of the alarm symptoms described above appear, it is essential to go to the emergency room .
- Likewise, if these pains are repeated, it is advisable to request a visit with a specialist in the digestive system.
- Pain due to inflammation of an abdominal viscus also includes gastroduodenal ulcer and cholecystitis .
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