What causes epigastric pain?

Epigastric pain has many possible causes. Most commonly, epigastric pain is the result of overeating, drinking alcohol while eating, or consuming greasy or spicy foods. Epigastric pain can be caused by digestive conditions such as acid reflux or lactose intolerance. Gastroesophageal reflux disease (GERD) is another possible cause of epigastric pain. Inflammatory diseases or cancers affecting the gallbladder, pancreas or stomach may result in epigastric pain. Pain in the epigastric region can also be a sign of a cardiovascular problem such as a heart attack or angina (chest pain due to the heart not getting enough oxygen).

Common causes of epigastric pain

Epigastric pain can be due to common causes including:

  • Dyspepsia (indigestion)
  • Gastritis (inflammation of the stomach lining)
  • Gastroesophageal reflux disease (GERD), a condition in which acidic stomach contents flow back into the esophagus
  • Heartburn
  • Lactose intolerance
  • Pregnancy
  • Side effects to medications, such as aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs)

Other causes of epigastric pain

Epigastric pain may have other causes including:

  • Barrett’s esophagus (cellular changes in the esophagus that may lead to esophageal cancer)
  • Esophagitis (inflammation of the esophagus)
  • Gallstones or gallbladder disease
  • Hiatal hernia (protrusion of the stomach into the chest through a hole in the diaphragm)
  • Pancreatic cancer
  • Pancreatitis (inflammation of the pancreas)
  • Peptic ulcer or perforated peptic ulcer, resulting in stomach bleeding or an intestinal ulcer
  • Stomach or esophageal cancer

Serious or life-threatening causes of epigastric pain

In some cases, epigastric pain may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

  • Angina (chest pain due to the heart not getting enough oxygen)
  • Heart attack (myocardial infarction)

Questions for diagnosing the cause of epigastric pain

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your epigastric pain including:

  • How long have you felt epigastric pain?
  • Are there certain times your epigastric pain is more severe?
  • Are you lactose intolerant?
  • Do you have angina or any other heart problems?
  • Do you have any other symptoms?
  • What medications are you taking?
  • Where precisely do you feel the pain?

What are the potential complications of epigastric pain?

  • Typically, epigastric pain on its own does not lead to serious complications. However, it can affect your quality of life by causing distress and discomfort when you eat. This may change your eating patterns and result in unintentional weight loss. Further, epigastric pain can mimic serious heart symptoms. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of epigastric pain include:
  • Cancer of the esophagus, stomach, or other organs
  • Esophageal scarring and narrowing
  • Myocardial infarction (heart attack), if the pain is due to angina
  • Poor nutrition due to a decreased desire to eat
  • Poor quality of life
  • Spread of cancer
  • Spread of infection


  1. Indigestion. National Digestive Diseases Information Clearinghouse (NDDIC). http://digestive.niddk.nih.gov/ddiseases/pubs/indigestion/.
  2. Gastroesophageal Reflux (GER), and Gastroesophageal Reflux Disease (GERD) in Adults. National Digestive Diseases Information Clearinghouse (NDDIC). http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/.

What is epigastric pain?

Epigastric pain is pain that is localized to the region of the upper abdomen immediately below the ribs. Often, those who experience this type of pain feel it during or right after eating or if they lie down too soon after eating. It is a common symptom of gastroesophageal reflux disease (GERD) or heartburn. It may be associated with the gastric contents moving upward into the back of the throa... Read more about epigastric painintroduction


What other symptoms might occur with epigastric pain?

Epigastric pain may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Frequently, symptoms that affect the digestive tract may also involve other body systems.

Gastrointestinal symptoms that may occur along with epigastric pain

Epigastric pain may accompany other symptoms affecting the digestive system such as:

... Read more about epigastric painsymptoms

Medical Reviewer: Cynthia Haines, MD Last Annual Review Date: Aug 1, 2013 Copyright: © Copyright 2014 Health Grades, Inc. All rights reserved. May not be reproduced or reprinted without permission from Health Grades, Inc. Use of this information is governed by the HealthGrades User Agreement.

This Article is Filed Under: Digestive System

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