What causes upper abdominal pain?

It can be difficult to identify the source of pain felt in the upper abdomen, as several vital organs and muscles are located here. Any pain you feel may have many causes.

Some causes of upper abdominal pain are more common than others and can be determined by the type of pain they cause.

If your pain persists, or has been occurring for some time, you should see a doctor.

Burning pain

Acid reflux

Acid reflux can cause burning pain in your upper abdomen. It’s a common condition that occurs when acid from the stomach flows back up into your oesophagus, irritating its lining and producing an unpleasant sensation in your chest and neck.

Acid reflux can also make you feel nauseous, and leave a sour or acidic taste in your mouth. Other symptoms include:

• bloating
• a sore throat
• bad breath
• a hoarse voice

The condition is usually treated with antacid medicines which relieve heartburn.

You may also be able to reduce symptoms by making small changes to your diet and lifestyle. For example, fatty and spicy foods can sometimes cause acid reflux, as well as caffeine and alcohol.

Gastritis

Burning pain in your upper tummy can also be a symptom of gastritis - a common condition that occurs when the lining of your stomach becomes inflamed due to damage.

Gastritis can be caused by a bacterial infection, but it’s also linked to stress, excessive cocaine or alcohol use, or regularly taking non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.

In rare cases, gastritis can be caused by an autoimmune reaction, where the body’s immune system mistakenly attacks the healthy tissue in your stomach.

If you think you may have gastritis, talk to a doctor as soon as possible. They can diagnose the issue and provide medication to tackle the underlying cause.

You may also be advised to manage your symptoms by taking antacids, dealing with any stress and cutting down on alcohol. It may help to avoid anything that irritates the stomach, such as fatty or spicy food, coffee and fruit juice.

Peptic ulcer

Peptic ulcers can also cause a burning pain in the upper abdomen.

These are sores in the lining of your stomach or small intestine caused by the breakdown of the layer that protects your stomach lining from stomach acid. This allows the stomach lining to become damaged.

Peptic ulcers are usually caused by a bacterial infection or taking non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen for a long time.

They are often accompanied by symptoms like nausea, bloating or indigestion.

Most ulcers respond well to treatment, but you should get them checked by a doctor.

Cramping pain

Excess gas

If you experience cramping pain in the upper abdomen, or pain that comes and goes, you could be suffering from excess gas that builds up in your digestive system.

Excess gas affects a lot of people, and it can be harmless.

If you’re struggling to manage the condition, try eating small, regular meals or avoiding foods that are known to make you gassy, such as legumes and pulses (e.g. beans and lentils) or vegetables such as cauliflower or sprouts.

Biliary colic

Severe cramping or pain that comes and goes in the upper abdomen can also occur due to a gallstone getting stuck in the tube that connects your gallbladder to your small intestine, called the bile duct.

This type of pain is known as biliary colic and it may cause you to experience waves of intense pain that come and go for several hours. It typically occurs in your tummy region or under your ribs on your right-hand side.

You may also notice pain after eating a meal of fatty food.

Biliary colic is normally treated with medication and painkillers, but you may need to have surgery if gallstones are causing you a lot of discomfort.

Occasionally, cramping in the upper tummy can be a symptom of irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD).

Sharp or stabbing pain

Pancreatitis

Severe, sharp or stabbing pain in the upper abdomen can be a sign that your pancreas is inflamed (pancreatitis). The pain caused by pancreatitis can start suddenly or come on slowly and last for long periods of time.

Other common symptoms include nausea and vomiting, decreased appetite and weight loss.

The most common causes of pancreatitis are drinking too much alcohol and gallstones, but it can develop for a variety of reasons, such as injury, infection or as a side effect of some medications.

If you think you may have pancreatitis, you should see a doctor straight away.

In rare cases, sharp or stabbing pain above your tummy can be a symptom of pneumonia or angina.

When should I worry?

Sharp or severe pain in your upper abdomen should always be checked by a doctor.

You should go straight to the emergency room if you have abdominal pain and you:

• are pregnant
• are vomiting blood
• have blood in your poo
• have black or sticky poo
• can't pee or poo
• can't breathe
• have chest pain
• are diabetic and vomiting

If you have mild burning or cramping pain in your upper abdomen, you could try taking antacid medicine or a painkiller like paracetamol, but you should still see a doctor if the pain doesn’t go away, or goes away and comes back.

Read more about how to tell if your stomach pain is serious.