Upper Abdominal Pain: Causes

What causes upper abdominal pain?

Upper abdominal pain often originates in the digestive tract, although it can also be due to disorders of the circulatory system, kidneys, respiratory system, or body wall.

Digestive tract causes of upper abdominal pain

Upper abdominal pain may be caused by conditions of the digestive tract including:

• Bacterial, parasitic or viral infection of the gastrointestinal tract
• Celiac disease (severe sensitivity to gluten from wheat and other grains that causes intestinal damage)
• Diverticulitis (inflammation of an abnormal pocket in the colon)
• Food intolerance such as lactose intolerance (inability to digest lactose, the sugar in dairy products)
• Gallbladder disease or stones
• Gastritis (inflammation of the stomach lining)
• Gastroesophageal reflux disease (GERD)
• Inflammatory bowel disease (includes Crohn’s disease, ulcerative colitis)
• Irritable bowel syndrome (IBS; digestive discomfort that does not cause intestinal damage or serious disease)
• Liver disease, including hepatitis (inflammation of the liver)
• Pancreatitis (inflammation of the pancreas)
• Ulcers of the stomach or duodenum (first section of the small intestine)

Other causes of upper abdominal pain

Upper abdominal pain can also be caused by conditions involving other body systems including:

• Cancer of an abdominal organ
• Hiatal hernia (weakened area of the diaphragm that allows the stomach to protrude into the chest)
• Kidney stones
• Pleurisy (inflammation of the lining around the lungs)
• Pneumonia
• Pyelonephritis (kidney infection)
• Shingles (painful, blistering rash, often forming a stripe, that results from a reactivation of the varicella-zoster, or chickenpox, virus)

Serious or life-threatening causes of upper abdominal pain

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

• Abdominal abscess
• Aneurysm of the abdominal aorta (life-threatening bulging and weakening of the wall of the abdominal aorta that can burst and cause severe hemorrhage)
• Bowel obstruction or perforation
• Chemical or heavy metal poisoning
• Colonic volvulus (twisting of the colon)
• Intestinal ischemia (loss of blood supply to the intestines leading to death of intestinal tissue)
• Intussusception (telescoping of the intestines into themselves, which can cause intestinal ischemia)
• Myocardial infarction (heart attack)
• Pancreatitis (inflammation of the pancreas)
• Peritonitis (infection of the lining that surrounds the abdomen)
• Sickle cell crisis (blockage of small blood vessels by abnormally shaped red blood cells)
• Significant abdominal trauma

Questions for diagnosing the cause of upper abdominal pain

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

• How long have you had upper abdominal pain?
• How would you describe your pain?
• Does anything make it go away or make it worse?
• Have you had pain like this before?
• Have you been injured?
• Do you have any other symptoms?
• What medications are you taking?

What are the potential complications of upper abdominal pain?

Because upper abdominal pain can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

• Bowel infarction (severe injury to an area of the bowel due to decreased blood supply)
• Internal hemorrhage
• Intestinal obstruction and rupture of the intestinal wall
• Organ failure or dysfunction
• Ruptured appendix
• Spread of cancer
• Spread of infection

References:

Abdominal pain. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm. Accessed May 11, 2011.

Abdominal pain. American College of Gastroenterology. http://www.acg.gi.org/patients/gihealth/aps.asp. Accessed May 11, 2011.