Gastric pain: A doctor’s perspective on when to be worried

In medical terms, gastric pain is used to describe upper abdominal pain or pain just right above the belly button and below the ribs. It is often confused with stomach pain. While most pain experienced in the upper abdomen indeed arises from the stomach, some of the pain may originate from other organs like the bile duct, small intestine, gallbladder, pancreas or liver. In such cases, it may signal something more serious, such as kidney stones or the presence of a stomach ulcer. 

How do you tell if your gastric pain is caused by a bigger underlying problem, and when should you consult a doctor? Here’s my take.

Generic symptoms of gastric pain

Gastric pain usually carries symptoms such as: 

  • Gnawing pain in the upper abdomen that comes and goes 
  • Indigestion 
  • Excessive wind which can make you feel bloated 
  • Feeling hungry but not able to eat much 
  • Nausea and/or vomiting

Identifying the types of gastric pain

The above symptoms are generic symptoms associated with gastric pain. However, some patients experience more unique symptoms or experience these symptoms differently. Let me explain these characteristics. 

How does the pain hit?

Gastric pain usually hits at a slow onset and ebbs and flows; meaning the pain comes and goes. As such, those who frequently experience gastric pain would know to curb their symptoms early with remedies like medication before the pain gets worse. If you experience a sudden onset of abdominal pain, it could be due to a blockage of the bile duct caused by a gallstone, or a lack of blood supply to the colon. 

Does the pain affect anywhere else? 

It is not common for gastric pain to be consistent in pain or last for several hours. Prolonged steady pain at one time usually indicates the presence of gallstones or kidney stones. Some patients may experience severe pain that radiates to the upper back; this could mean an inflammation of the pancreas. 

Where is the pain located?

Localised pain in the abdominal region may not necessarily be gastric pain. For example, pain on the lower right side of the abdomen could be appendicitis; pain on the lower left side of the abdomen could be diverticulitis, a condition caused by inflamed pouches in the walls of the colon; and pain in the upper right side of the abdomen may be caused by a gallbladder disorder.

How often does the pain hit?

Patients with irritate bowel syndrome (IBS) may find that they get gastric pain every now and then for a few years. On the other hand, pain caused by gallstones has quite a specific pattern of onset; the patient can usually identify around when and what time the pain comes i.e. in the middle of the night for a few hours.

Issues that result in gastric pain 

In this section, I will explain more on some underlying issues that can result in gastric pain. You will realise that gastric pain is not necessarily always caused by skipping meals. 

Flatulence 

We naturally have gas in our digestive tract due to the digestive processes that occur. But gas buildup can cause bloating, a feeling of fullness and pain. This pain may come in waves and is accompanied by burping and passing of gas. Certain foods such as beans and dairy may increase our chances of getting flatulence. 

Indigestion 

Indigestion is a full, uncomfortable sensation in the upper abdomen after eating. This burning feeling, due to a result of acid buildup in the stomach, may sometimes be felt in the throat or chest too. Indigestion is usually caused by eating too quickly or certain food but recurring indigestion may be a sign of GERD or a stomach ulcer. 

Stomach flu 

Stomach flu, or gastroenteritis in medical terms, often manifests as many symptoms and gastric pain is one of them. Most patients recover within a few days and do not really have anything to worry about. Just ensure to drink lots of water to prevent dehydration. 

Hepatitis or pancreatitis 

Inflammation of the liver or pancreas can result in gastric pain too. In rare cases, it could be due to liver cancer or pancreatic cancer, but I would keep a lookout for jaundice, unusually dark urine and pale and oily stools. 

Gallstones 

Gallstones form in the gallbladder due to a buildup of cholesterol or bilirubin, and when large and several in amount can cause symptoms like abdominal pain and vomiting. If your pain is at the upper right portion of your abdomen, it’s likely a sign of gallstones.

When to visit a specialist

Most gastric cases resolve on their own or with simple treatment, but if you get severe and recurrent gastric pain that doesn’t go away, please see a specialist. The following should also not be ignored: 

  • Gastric pain accompanied by persistent diarrhoea or vomiting for more than 12 hours 
  • Black (dark brown does not count) or bloody stools 
  • Fever 
  • Unexplained weight loss 
  • Injury suffered to the abdomen previously 

The key here is to look out for unusual symptoms and identify where the pain is at and how it onsets. If you suspect your gastric pain is due to an underlying issue, I urge you to get it checked out by a specialist as soon as possible. 

References 

  1. Yamashita, S., Tago, M., Katsuki, N. E., Nishi, T. M., & Yamashita, S. I. (2020). Relationships between sites of abdominal pain and the organs involved: a prospective observational study. BMJ open, 10(6), e034446. https://doi.org/10.1136/bmjopen-2019-034446
  2. al-Musawi, D., & Thompson, J. (2000). The important signs in acute abdominal pain. The Practitioner, 244(1609), .