Abdominal pain in the upper abdomen

introduction

stomach pain are among the am most common symptoms felt and affect almost everyone. The reasons for the development of abdominal pain diverse his and in some cases it is not possible to assign an exact cause to the complaints. Depending on localization abdominal pain experienced by the patient Basic diseases of various organ systems to be responsible.

In addition, upper abdominal pain can also occur at night. This can have different causes.

Abdominal pain is particularly common in the area of ​​the upper abdomen. The “upper abdomen” is the part of the abdomen that is located immediately below the two costal arches. For this reason, pain phenomena that are perceived below the costal arches are called "abdominal pain of the upper abdomen" (upper abdominal pain). Numerous organ systems that are located within the upper sections of the abdomen can be responsible for the development of abdominal pain in the upper abdomen.

In addition, diseases of the organs of the chest can lead to abdominal pain in the upper abdomen. In addition, the patient concerned should try to assign the pain he perceived to an exact location in the upper abdomen.

In everyday clinical practice, a distinction is made between complaints in the upper right abdomen, the middle upper abdomen and the upper left abdomen. A comprehensive and as precise as possible diagnosis is therefore essential in the case of frequent or very severe complaints within this region.

For more information, see: Flank pain on the right

diagnosis

Of the most important step in the diagnosis of abdominal pain in the upper abdomen is the doctor-patient conversation (anamnese). Especially the exact one localization and the Description of the pain (stabbing, dull, colicky) can give the attending physician an initial indication of the cause. Also play other symptoms (for example diarrhea and or Vomit) and the exact temporal connection between Meals and the appearance of complaints, a crucial role. For this reason, the patient should be able to give as precise a description of the symptoms as possible, despite the pain.

You might also be interested in: Bloated upper abdomen

In most cases, the doctor-patient interview is followed by one Blood draw to determine various parameters. Especially the liver- and Pancreas values, the Inflammation parameters and the Bilirubin should be determined as soon as possible.

The Imaging is done in the case of abdominal pain in the upper abdomen by performing a Ultrasound examination. The attending physician can use this method without any radiation exposure of the patient quick overview procured via the organ systems of the abdominal cavity. In most cases, the cause of the abdominal pain in the upper abdomen can be determined within a very short time. If these first diagnostic steps do not lead to a clear result, further measures must be initiated.

causes

Abdominal pain in the right upper abdomen

Gallbladder disease is one of the most common causes of abdominal pain in the right upper abdomen. Particularly in older patients, if symptoms occur in this region, a possible impairment of the gallbladder or the draining biliary tract should be considered.

An inflammatory change in the gallbladder (cholecystitis) or the obstruction of the bile ducts by a stone (choledocholithiasis) usually manifests itself in the affected patient as a sudden development of pulling or stabbing abdominal pain in the upper abdomen. Most of those affected describe the intensity of these complaints as hardly bearable. Furthermore, it can be observed that abdominal pain in the right upper abdomen caused by impairment of the gallbladder often occurs immediately after meals. This fact can be explained by the fact that the gallbladder sends a signal to empty when eating.

If the draining bile ducts are blocked by a small stone, the bile cannot be transported into the duodenum, or only insufficiently. The stones in the bile ducts or in the gall bladder come into close contact with the mucous membranes and trigger pain in the upper abdomen.

Other causes of right-sided upper abdominal pain can be diseases of the liver. In most cases, however, the typical liver diseases (hepatitis, liver cirrhosis, tumors of the liver) lead to pain phenomena much less often. Abdominal pain in the area of ​​the right upper abdomen caused by the liver usually occurs as a result of swelling of the organ. Since the liver is surrounded by a rather tough capsule, it cannot expand. The pain perceived by the patient therefore originates less from the liver itself than from the liver capsule, which is under strong tension.

You might also be interested in the topic: Enlarged liver

Abdominal pain in the middle upper abdomen

Abdominal pain in the middle part is comparatively rare. Nevertheless, its cause should be determined urgently and, if necessary, suitable treatment initiated quickly. If a patient feels abdominal pain in the middle upper abdomen, in most cases this is due to a problem in the stomach area. The pain is often caused by irritation or inflammatory processes of the gastric mucosa (gastric mucosal inflammation = gastritis).

In addition, diseases of the pancreas are considered to be possible causes of abdominal pain in the middle upper abdomen. Inflammatory changes in the pancreas (pancreatitis) in particular often lead to upper abdominal pain that radiates in a belt-like manner to the back. Patients who suffer from acute inflammation of the pancreas usually show other symptoms (fever, deterioration in their general condition). In addition, a dark color of the urine and a lightening of the stool (acholic stool) can be observed in those affected.

Another cause of upper middle abdominal pain can be an acute heart attack. With this clinical picture, the affected patients feel much more frequent complaints in the area of ​​the chest, the left shoulder or arm, the neck and the jaw, but corresponding abdominal pain can also arise.

Read more on the topic: Symptoms of a heart attack

Abdominal pain in the left upper abdomen

Due to the fact that the spleen is located immediately in the left upper abdomen, it is often responsible for pain in this area. Inflammatory processes in the spleen are medical rarities and hardly ever occur in everyday clinical practice. Left-sided upper abdominal pain that originates from the spleen is usually caused by other diseases. In most cases, these trigger severe swelling of the organ and the associated tension in the spleen capsule. The pain in the left upper abdomen is therefore caused by the capsular apparatus and not by the spleen itself.

Blood diseases such as leukemia and infections such as Pfeiffer's glandular fever are among the most common diseases that lead to an enlarged spleen (splenomegaly).

Abdominal pain in this area that occurs immediately after trauma (accident or kick) can be the first indication of a rupture of the spleen.

If pain in the left upper abdomen occurs immediately after intense physical exertion or sport, one can generally assume that it is a harmless stitch.

Furthermore, left-sided upper abdominal pain can be caused by the kidneys and / or the urinary tract. Kidney stones in particular, which are flushed out of the calyx system of the kidneys and block the ureters (ureters), can lead to severe, colic-like pain symptoms.

Another possible cause of pain in the left upper abdomen is an ascending infection from the urinary bladder. The spread of this urinary tract infection can ultimately even lead to inflammation of the renal pelvis (pyelonephritis). Both kidney stones and the ascending urinary tract infection can potentially provoke pain in the right and left upper abdomen.

Read more on the topic: Causes of Upper Abdominal Pain

therapy

The treatment from abdominal pain in the upper abdomen is directed according to the underlying disease.

Infections are in most cases by the gift of a Antibiotic treated.

Upper abdominal pain caused by Irritation or Inflammation of the stomach can often be caused by ingestion of so-called Proton pump inhibitors (Acid blockers).

Upper abdominal pain during pregnancy

As Pain in the upper abdomen stabbing, pressing or pulling pains in the upper abdomen between Costal arch and Navel line is localized, designated.
It can have various causes. Special attention is paid to the pregnancy occurring pain too. The question of whether the pain in the upper abdomen is short or long-lasting and whether it gets worse is of great importance.
Position-dependent pain in the upper abdomen, i.e. pain that changes from lying down to standing, can also occur. Most of the time, even during pregnancy, there is a harmless cause behind it without any significant disease value.
For example, the baby can press on organs or briefly squeeze structures. Also heartburn, in which increased Stomach acid is formed and the esophagus ascending is not a rare cause of epigastric pain in pregnancy. However, if the pain persists longer, caution is advised.

Please also read the topics: Heartburn during pregnancy and Stomach pain in pregnancy

For extreme pain with cramps, especially on the right the suspicion arises Gallstones in the foreground. Also one Appendicitis can be associated with upper abdominal pain radiating to the right.Then a doctor should be consulted quickly.
There is also a certain disease that rarely but specifically causes upper abdominal pain during pregnancy and requires immediate treatment: that HELLP syndrome.
The abbreviation stands for hemolysis (anemia due to perishing red blood cells), increased liver enzymes and low platelet count (low blood platelets).
It emerges as the most serious complication of preeclampsia (syndrome high blood pressure and proteins in urine during pregnancy), which can complicate pregnancy in 5-7% of cases.
The HELLP syndrome occurs with an occurrence of 1-2 cases in 300 pregnancies. One of the typical characteristics is a stabbing pain in the upper abdomen that radiates particularly to the right. This is indicated by an enlarged or swollen liver causing tension in the capsule surrounding the liver.
Overall, therefore, during the pregnancy a doctor should be consulted immediately if the upper abdominal pain persists. Usually the cause is relatively harmless, but due to the dreaded complication of the HELLP syndrome, which is expressed by upper abdominal pain during pregnancy and for the mother, especially but the child can be fatal, the cause must be determined.

You can get further information under our topic: Upper abdominal pain during pregnancy

prophylaxis

Abdominal pain in the area of ​​the upper abdomen can occur not always preventive. In general, the Gastrointestinal tract, liver, spleen and pancreas but by a balanced nutrition and sufficient exercise Be kept “fit”.

In addition, the regular consumption from Tobacco products and or alcohol a significant one Risk factor for various diseases that can lead to the development of abdominal pain in the upper abdomen.

Patient the regular pain medication or others drug take in, should consider the additional application of Proton pump inhibitors Think about (acid blockers). In this way, the Gastric mucosa effectively against possible drug side effects protected and abdominal pain in the upper abdomen can be prevented.

forecast

The forecast from abdominal pain in the upper abdomen dependent of their more precisely root cause. In the most cases However, the diseases underlying the symptoms can handled well become.