What Causes Upper Abdominal Pain?

Upper abdominal pain can have a wide range of causes, from indigestion and heartburn to gallstones or a liver abscess. Much of the time, the pain is temporary and resolves on its own. Sometimes, however, upper abdominal pain is caused by something that requires immediate medical attention, like a heart attack. 

The upper abdomen contains the lungs, heart, liver, gallbladder, and upper GI tract. Knowing which organ or part of the body is affected can help you and your doctor determine the cause and type of treatment you need.

Organs in the Upper Abdomen

Your upper abdomen contains a number of organs. These include:

• Heart
• Lungs
• Liver
• Gallbladder
• Upper GI tract

Many conditions, such indigestion and heartburn, are minor and go away on their own. Persistent pain, however (pain that lasts longer than two days), could be a sign of something more serious. If your pain doesn't resolve on its own, see your healthcare provider.

Severe pain may also be a sign of a serious condition. If you have severe pain in your upper abdomen, seek medical attention right away. 

Gastrointestinal Causes of Upper Abdominal Pain

Your gastrointestinal tract travels from your mouth down to the anus and houses the organs that make up the digestive system. Many different issues that occur in the gastrointestinal tract can cause upper abdominal pain.

Indigestion

Indigestion, also known as dyspepsia, is a common condition. It causes symptoms like:

• Stomach pain or bloating
• Heartburn
• Nausea
• Vomiting
• Feeling full early on during a meal
• Feeling excessively full after eating
• Burning in the esophagus or stomach
• Excessive gas

The cause of indigestion is typically overeating, eating too fast, or eating spicy, greasy, and fatty foods. It can also occur if you lie down shortly after eating because this can make digestion more difficult.

Treatment for indigestion ranges from lifestyle changes, such as avoiding food triggers and reducing caffeine or alcohol intake, to over-the-counter (OTC) or prescription medications such as antacids and stomach acid reduction medicine.

GERD (Gastroesophageal Reflux Disease)

GERD is a condition that occurs when the acid in your stomach flows back into the esophagus. This causes irritation to the lining of the esophagus and can lead to symptoms such as:

• Heartburn
• Nausea
• Chest pain
• Difficulty swallowing
• Vomiting
• A feeling that there's a lump in your throat
• Coughing
• Wheezing
• Worsened asthma

Treatment options for GERD include:

• Lifestyle changes: Losing weight, avoiding food triggers, avoiding large meals, and quitting smoking
• Medications: OTC antacids or medications to block or suppress stomach acid production
• Surgery: A procedure known as a Nissen fundoplication to strengthen the antireflux barrier in the body

Heartburn

Heartburn isn't a condition on its own but rather a symptom of another disorder. Health issues such as acid reflux and GERD are thought to be the main culprits behind heartburn.

Heartburn presents with burning in the chest, typically felt behind the breastbone. The pain can also radiate to the throat and neck, and you can also have a bitter, sour taste in the back of the throat.

Heartburn can be triggered by certain habits such as:

• Eating large meals
• Eating before bed
• Experiencing high levels of stress
• Being overweight
• Smoking
• Wearing tight clothes
• Eating certain citrus and tomato-based foods
• Drinking alcoholic, caffeinated, or carbonated beverages

Heartburn is rarely serious and most often treated at home using OTC medications and lifestyle changes. If someone suffers from heartburn chronically, it is most likely caused by a condition that requires a different form of treatment.

Blind Loop Syndrome

Blind loop syndrome occurs when the food you eat doesn't follow the normal digestive route. It is caused by an overgrowth of bacteria in the intestines that is so large, food is forced to go around it.

The cause of blind loop syndrome is typically complications following abdominal surgery such as weight loss surgery. It can also be caused by a peptic ulcer, Crohn's disease, or diverticulitis.

Besides pain in the abdomen, some common symptoms of blind loop syndrome include:

• Fever
• Joint pain
• A skin rash
• Weight loss

In some cases, the body will not get all the nutrients it needs. The standard treatments for blind loop syndrome include antibiotics, corticosteroids to help reduce inflammation, and corrective surgery.

Gallbladder Pain

The gallbladder is an organ that is located on the right side of the abdomen beneath the liver. It is small and shaped like a pear. It houses digestive fluids known as bile. There are a few types of gallbladder issues that can cause upper abdominal pain.

Gallstones

When the digestive fluid in the gallbladder hardens, it forms gallstones. These gallstones can be as large as a golf ball or as small as a grain of sand and are made of mostly cholesterol, calcium salts, bilirubin, and small amounts of proteins.

Many people with gallstones will have no symptoms, and the body will expel them on its own. If symptoms occur while the person has gallstones, it is likely they will require surgery to have them removed.

The symptoms associated with gallstones include:

• Sudden and intense pain in the upper right section of the abdomen or in the center of the abdomen below the breastbone
• Pain in the back between the shoulder blades or the right shoulder
• Nausea or vomiting

If the body doesn't expel the gallstones, the only available treatments are medications designed to dissolve gallstones or surgery to have them removed.

Cholecystitis

Cholecystitis is a condition that is characterized by inflammation of the gallbladder. It occurs when bile becomes trapped in the gallbladder. It can be caused by gallstones, a bacterial infection, tumors in the pancreas or the liver, or a buildup of thick material in the gallbladder known as gallbladder sludge.

Symptoms of cholecystitis can include:

• Sudden and intense pain in the upper abdomen on the right side
• Pain that radiates to the back or below the shoulder blade on the right side and is worsened by deep breaths
• Nausea and vomiting
• Fever
• Bloating
• Yellowing of the skin and eyes (jaundice)
• Light-colored and loose bowel movements

Treatment typically includes a hospital stay, removal of the gallbladder, IV antibiotics, and pain relievers.

Liver Pain

Issues with the liver such as a liver abscess can also cause upper abdominal pain.

Liver Abscess

A liver abscess is a pus-filled sac in the liver that can be caused by bacteria, blood infection, liver damage, or an infection of the abdomen such as appendicitis.

Symptoms of a liver abscess can include:

• Fever or chills
• Nausea or vomiting
• Weakness
• Jaundice
• Weight loss

To treat a liver abscess, drainage of the abscess, along with antibiotic treatment, is needed. If the abscess is severe, surgery may have to be performed to remove it.

Heart-Related Pain

Heart conditions can also lead to upper abdominal pain in some cases.

Heart Attack

A heart attack, also called a myocardial infarction, is the result of a blocked artery. Immediate medical attention is required.

Symptoms of a heart attack include:

• Tightness and pain in the chest
• Shortness of breath
• Cold sweats
• Feeling lightheaded
• Pain that spreads into the left arm

Treatment for a heart attack is done in the hospital and can include medications such as aspirin, antiplatelet agents, blood-thinning medications, nitroglycerin to help improve blood flow, and ACE inhibitors to reduce blood pressure.

Surgery may also be required. The two surgeries that can be done include coronary angioplasty and stenting and coronary artery bypass.

Lung-Related Pain

The lungs are tasked with getting oxygen into red blood cells where they can be transferred to other cells that require oxygen to function. They also help to rid the body of carbon dioxide. Some conditions that affect the lungs can lead to upper abdominal pain.

Pneumonia

Pneumonia is an infection that causes inflammation of the air sacs in the lungs. The air sacs could fill up with liquid or pus, which leads to difficulty breathing and other symptoms.

Pneumonia often presents with sharp or stabbing chest pain that can worsen when someone coughs or breathes deeply. Other symptoms include:

• Shallow breathing
• Loss of appetite
• Fatigue
• Nausea and vomiting
• Fever
• Chills
• Excessive sweating
• Coughs with green, yellow, or bloody mucus
• Confusion

The most common form of pneumonia is caused by bacteria, but it can also develop because of a viral infection. Pneumonia will be treated depending on the cause. Treatment can include:

• Antibiotics
• Fever-reducing medications
• Rest and fluids
• Oxygen therapy in severe cases

Pulmonary Embolism

A pulmonary embolism is a blood clot in the lungs. The condition can be life-threatening and cause damage to the lungs because of restricted blood flow and a decrease in oxygen levels. As many as 30% of people who suffer from pulmonary embolism will die from the condition.

Symptoms of a pulmonary embolism can include:

• Shortness of breath
• A bloody cough
• Fever
• Leg pain
• Abdominal pain

Pulmonary embolism is usually treated in a hospital, and treatment can involve blood-thinning medication, compression stockings, and sometimes surgery to improve blood flow and reduce the risk of blood clots in the future.

Trauma

Bodily trauma can also lead to upper abdominal pain. Trauma to the abdomen can damage several of the internal organs including the bowel, liver, intestines, and spleen.

Blunt trauma to the upper body can cause upper abdominal pain. Common causes of blunt trauma and injury to the abdomen include car accidents, assaults, falls, or various types of recreational accidents.

The other symptoms that are associated with trauma will depend on the type of injury and other parts of the body that are affected. It is thought that trauma to the abdomen is one of the leading causes of death in young people worldwide.

If you were involved in an accident or were injured and are now experiencing upper abdominal pain, it is best to see your doctor. Treatment will vary depending on the extent of the damage and the type of injury.

A Word From Verywell

Since there are so many causes of upper abdominal pain, it can be hard to deduce what the actual cause is. When it comes to some of the causes, they are not serious and can be treated with home or OTC remedies. Other conditions, however, will require a trip to the doctor's office. If you are experiencing severe upper abdominal pain or pain that does not go away, book an appointment with your doctor or seek medical attention as soon as possible.