Burning in the upper abdomen
What is a burning sensation in the upper abdomen?
Burning in the upper abdomen is an uncomfortable feeling that can recur or be permanent. It can be accompanied by other symptoms and have various causes. Burning in the upper abdomen is a relatively common symptom.
causes
The most common cause of a burning sensation in the upper abdomen is reflux disease, also known as reflux oesophagitis or simply Reflux designated. The esophagus, which opens into the stomach, has a sphincter muscle at its lower opening. This ensures that food from the esophagus can get into the stomach without any problems, but at the same time normally no stomach contents flow back into the esophagus. In some people, this sphincter muscle is impaired in its function or there is too much stomach acid in the stomach so that the sphincter muscle cannot hold it back sufficiently. Causes for this are, for example, obesity and the consumption of alcohol or cigarettes.
Too much acid in the stomach or incomplete occlusion of the lower esophageal sphincter causes stomach acid to flow back into the esophagus. Heartburn is popularly referred to as heartburn. The mucous membrane in the stomach is very robust and is therefore designed to come into contact with stomach acid. The mucous membrane of the esophagus, on the other hand, is less robust and is sensitive to contact with gastric acid. Symptoms are acid regurgitation accompanied by an uncomfortable burning sensation behind the breastbone and in the upper abdomen.
Read more about this under heartburn
An inflammation of the stomach lining can also lead to a burning sensation in the upper abdomen. Causes of gastric mucosal inflammation are, for example, bacterial colonization with the germ Helicobacter pylori or excessive use of certain pain relievers such as ibuprofen.
Read more about this under
- Inflammation of the stomach lining
- Side effects of ibuprofen
- Symptoms of Helicobacter pylori
However, a cause for the burning sensation in the upper abdomen cannot always be found. We are then talking about an irritable stomach (functional dyspepsia). This means that there are complaints in the stomach area, but no organic cause can be found for these complaints. Very rarely an isolated burning sensation in the upper abdomen can also be an indication of a cardiac event. Around 10-20% of the population in the western industrialized nations suffer from such an irritable stomach. It is therefore - in addition to irritable bowel syndrome - one of the most common diseases in the gastrointestinal tract.
Read about this too Irritable stomach
Concomitant symptoms
Depending on what is causing the discomfort, the accompanying symptoms also vary.
In the case of reflux esophagitis, in addition to the burning sensation in the upper abdomen and behind the breastbone, acid regurgitation and heartburn occur. It can also lead to increased coughing. It is often uncomfortable for those affected to sleep with a flat headboard.
In the case of gastritis as the cause of the burning sensation in the upper abdomen, pain in the upper abdomen is usually added, which is partly dependent on food intake. Loss of appetite and nausea can also occur.
A stomach ulcer can also develop from an inflammation of the lining of the stomach. Here, too, there is severe pain that is dependent on food intake. In the advanced stages, the ulcer may bleed. Blood may then vomit or the stool may turn black from blood (Tarry stool) come.
In the case of an irritable stomach, in addition to burning in the upper abdomen, abdominal pain, a feeling of fullness, loss of appetite, nausea, vomiting and heartburn can occur.
Feeling of pressure
An accompanying feeling of pressure in the upper abdomen can occur both in reflux oesophagitis and in inflammation of the gastric mucosa. An irritable stomach can also cause a feeling of pressure in the stomach.
Flatulence
The symptom combination of flatulence and a burning sensation in the upper abdomen occurs mainly in the context of an irritable stomach. However, this disease is a diagnosis of exclusion. This means that other possible diseases must be ruled out by means of examinations such as a gastroscopy before one can speak of an irritable stomach.
Read about this A gastroscopy procedure
Back pain
The combination of a burning sensation in the upper abdomen and back pain is rather unusual. There are probably two different causes in this case. If a sudden, very strong burning sensation occurs in the upper abdomen, but also if sudden, severe back pain occurs, a doctor should be consulted in order to rule out serious causes of a cardiac nature or acute vascular diseases.
Burning stomach
A burning sensation in the stomach area is - as already described above - usually a symptom of inflammation of the gastric mucosa (gastritis). This can have various causes and is usually treated with medication.
According to location
Burning in the right upper abdomen
The position of the stomach in the abdomen is anatomically slightly different from person to person. Usually the stomach lies in the middle and left upper abdomen. A burning sensation in the right upper abdomen is therefore rather rare when there are complaints in the stomach or esophagus. If pain in the right upper abdomen occurs in addition to the burning sensation, this can indicate a disease of the gallbladder, for example an acute gallbladder inflammation (Cholecystitis) or gallstones (Cholecystolithiasis), be.
Read about this too
- Upper abdominal pain on the right
- Inflammation of the gallbladder
- Symptoms of gallstones
- Burning in the intestines
Burning in the middle upper abdomen
A burning sensation in the middle of the upper abdomen can indicate the presence of reflux disease or an inflammation of the stomach lining. An irritable stomach can also be the cause.
Read more about this under Upper abdominal pain in the middle, symptoms of a heart attack
Burning in the left upper abdomen
Burning in the upper abdomen located on the left side can indicate inflammation of the gastric mucosa. An irritable stomach is also a possible cause.
Read about this too Upper abdominal pain on the left
diagnosis
If a burning sensation occurs repeatedly in the upper abdomen, this should be discussed with the treating doctor. He will first take an anamnesis, i.e. ask various questions. For example, he will want to know in which situations the symptoms occur, whether they are related to food intake, how often and since when they have occurred, what pre-existing conditions exist, what medications are taken regularly and whether alcohol and nicotine consumption is regular. Your family doctor could also inquire about your eating habits.
Depending on the cause of the symptoms, it may be necessary to perform a gastroscopy. The patient is usually given a short anesthetic. A tube with a camera attached to the front is pushed over the mouth into the esophagus, stomach and duodenum. This allows the mucous membrane to be assessed. If necessary, samples are taken which are then examined under a microscope by a pathologist.
A blood test can also be useful, for example to determine blood lipids. If necessary, the attending physician will also write an ECG in order to be able to rule out acute cardiac problems as the cause of the symptoms as far as possible.
Read also on this topic
- Gastroscopy
- Anesthesia during a gastroscopy
therapy
Patients who suffer from repeated burning in the upper abdomen, often accompanied by heartburn, should first try to change their eating habits. As far as possible, you should avoid fatty foods and switch to a balanced diet. Only a light meal should be consumed in the evening.
Weight reduction should be aimed for in overweight patients. In addition, any nicotine or alcohol consumption should be significantly restricted or stopped.
If these measures are not sufficient, there are various drug therapy options. The most effective remedy for the symptoms is usually to take acid-reducing tablets. The group of proton pump inhibitors lowers gastric acid secretion and usually leads to rapid relief of symptoms. Pantozol® is a typical representative of this group of drugs.
Read more about this under
- Proton pump inhibitors
- Pantozol®
The active ingredient magaldrate (Riopan ®) often helps against acute heartburn. It neutralizes the disturbing gastric acid. Treatment of gastric mucosal inflammation depends on the underlying cause.
If there is a colonization with Helicobacter pylori, eradication therapy must be carried out. To do this, several medications have to be taken over 7 days. A triple therapy consisting of 2 antibiotics and a proton pump inhibitor is usually recommended. In addition, proton pump inhibitors such as Pantozol are usually used for non-bacterial gastritis.
Read more about this under Eradication therapy for Helicobacter pylori
For patients who suffer from an irritable stomach, a change in diet and lifestyle often helps: a balanced diet, light meals before going to bed, sufficient physical activity and avoidance of alcohol and nicotine play an essential role in therapy.
Duration and forecast
The duration of the symptoms depends on the triggering cause and the therapy. If it is a question of reflux disease or an inflammation of the gastric mucous membranes, there is usually a significant reduction in symptoms within a few days after taking proton pump inhibitors. However, after stopping the medication, the two diseases can recur. Therefore, in addition to drug therapy, a change in diet and lifestyle is essential.
The irritable stomach is often a chronic disease that is difficult to treat. In addition to changing everyday habits and diet, supportive psychotherapeutic treatment may also improve the prognosis.
