Anatomically medical scholars have divided human abdomen into nine regions. Epigastrium is one of the nine quadrants. The upper central region just below the breastbone and above the umbilicus is called epigastrium. Pain can be present in one particular area of abdomen as in epigastric region. The intensity of pain can be mild or severe and it may be associated with many other symptoms.
Since stomach, pancreas, duodenum, left half of liver, abdominal muscles and peritoneum underlie peritoneum, pain arising in this area of abdomen is often due to problems related to these organs. However, sometimes pain can radiate to epigastrium from other sites as well.
Severe epigastric pain can occur after meal, before meal or during meal. It may be mild discomfort or severe burning pain depending on the underlying etiology. While in majority of cases epigastric pain is not serious, sometimes severe pain can be an indication of life threatening condition such as acute pancreatitis or perforated peptic ulcer.
Often mild cases can be treated with conservative home remedies and change in life style.
Causes And Symptoms Of Severe Epigastric Pain
There are several causes of epigastric pain. Below are given all the possible etiologies with severe pain in epigastrium.
- Peptic ulcer: Ulcer in stomach or duodenum is called peptic ulcer. Duodenum is first part of small intestine. It is attached to the inferior end of stomach. Peptic ulcer causes severe gnawing pain in epigastrium. If it is a duodenal ulcer patient feels better after eating food. Whereas in gastric ulcer the pain aggravates few hours after meal.
- Pancreatitis and pancreatic cancer: Pancreas is a gland located in the right epigastirum deep below the stomach. It is in fact sandwiched between stomach and spine. Pancreas is a flat long gland playing a major role in secretion of certain digestive juices as well as insulin. Diseases of pancreas such as acute pancreatitis, pancreatic cancer or obstruction of stone in pancreatic duct can cause severe unbearable pain in epigastric region.
- Gastritis: Gastritis is inflammation of stomach. Most common cause of gastritis is H. pylori infection. If the condition is not treated on time it may lead to peptic ulcer. Gastritis can also occur due to anti inflammatory medicines and intake of too much alcohol. Along with pain the other accompanying symptoms are vomiting, nausea and loss of appetite.
- Acid reflux: Also known as gastroesophageal reflux disease (GERD), it occurs when the stomach acid flows backwards into the esophagus due to its weak lower sphincter. It leads to severe discomforting burning pain in epigastric region. Mostly the pain occurs when the patient is lying or at nighttime during sleep.
- Stomach cancer: Cancer in stomach region causes severe unbearable pain in epigastric region.
- Gall bladder stone: An obstructed gall stone can cause pain in epigastrium as well as in the right upper side of abdomen.
Treatment Options For Severe Epigastric Pain
Treatment of epigastric pain depends on the underlying cause. Sometimes the pain occurs suddenly and relieves within few minutes or hours. Such occasional pain may not need any treatment. But severe pain may necessitate medical attention. Often antacids and H2 receptors are conventional treatment choice of this condition. However, lifestyle change, restriction in oily and spicy food must be strictly followed.
Often stress is determined to be an underlying cause for gastritis, peptic ulcer disease. Controlling long standing stress is thus valuable to alleviate discomforting pain. Yoga and meditation both are beneficial in such case. Eating bland food for few days will help to heal the erosions present in stomach in case of gastritis.