Upper Abdominal Pain

This is an extremely common site of abdominal pain. Indigestion, trapped wind, gastritis, gallbladder diseases, and kidney stones are the common causes of pain in this part of the abdomen.

Other causes of upper abdominal pain include peptic ulcer, pancreatitis, liver disease, spasms of the oesophagus, infection involving the spleen, liver or kidneys, rupture of the aorta as in abdominal aortic aneurysm, ureteric stones, angina, heart attack, herpes infection, and problems with the muscles, bone or skin over this site.

The upper abdomen is a wide area spanning both flanks or loins on the sides, through to the center of the body below the breast bone down to the level of the umbilicus.

Any insult or injury to organs located in this region will thus cause pain, usually in the vicinity of the organ involved. It is therefore imperative that we familiarize our selves with organs and structures located in the upper abdomen, if we must understand the cause of pain in the upper abdomen.

Pain from organs located outside the abdomen could also "refer" pain to the upper abdomen. This is particularly true in heart attack, pulmonary embolism (blood clots to the lungs), pneumonia (chest infection), and the so called Fitz-Hugh-Curtis Syndrome. We shall discuss each of these causes and how to identify which is which.

Let's remind ourselves of the organs found in the upper abdomen that may cause upper abdominal pain. They include:

• The Skin and Muscles over the upper abdomen

• The Right and Left Kidneys

• Right and Left Adrenal Glands just above the kidneys

• Right and Left Ureters from the kidneys

• The Lower part of the Oesophagus or gullet

• The Stomach

• The Liver

• The Gall bladder

• The Duodenum

• Pancreas

• Part of the Small Intestines

• Part of the Large Intestines or Colon

• The Blood vessels - especially the Aorta

• Muscles on the floor of the abdomen

• The lumbar bones of the spine

The heart, lower part of the lungs and its coverings all lie in close approximation to the upper abdomen, thus injuries or pain in these structures too can cause upper abdominal pain.

Also crucial in understanding potential causes of upper abdominal pain is to narrow down the site of the pain into one of the three divisions of the upper abdomen.

So, is your pain on the :

1. Right Upper Abdominal Pain?

2. Central Upper Abdominal Pain?

   or

3. Upper Left Abdominal Pain?

Common causes of pain in the Right Upper Abdomen includes:

• Biliary Colic

• Cholecystitis

• Hepatitis

• Right Sided Kidney Stone

• Constipation

• Trapped Wind

• Right Lower Lobe Pneumonia

• Right Lower Lobe Pulmonary Embolism (Blood Clot)

We have discussed the causes of right upper abdominal pain in more detail here. central upper abdominal pain is even more common than right side abdominal pain.

Common causes of pain in the Central Upper Abdomen includes:

• Trapped Wind

• Gastritis

• Indigestion

• Heartburn

• Cholecystitis

• Biliary Colic

• Pancreatitis

• Stomach Ulcer.

This is a region of the abdomen where there is more difficulties in diagnosing the cause of pain there.

This is due to the fact that organs in that region do not usually cause much problems, and when they do, their symptoms and signs are vague.

Common causes of pain in the Left Upper Abdomen includes:

• Trapped Wind

• Gastritis

• Indigestion

• kidney Stone

• Ureteric Stone

• Ruptured Abdominal Aortic Aneurysm

• Food Poisoning

• Constipation

• Bowel Cancer.

We have discussed more causes of upper left abdominal pain in detail here.

In A Page Signs & Symptoms

By: Scott Kahan (Franklin Square Hospital) and Ellen Smith (Harrisburg Family Practice) Apr 2004 ISBN: 9781405103688.

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