What causes pain in the epigastric region and what needs to be done. Classifications of epigastric pain

Patient complaints of pain in epigastric region can baffle even the most qualified and experienced doctor. It can be very difficult to accurately determine the diagnosis, since many diseases have similar symptoms, some of which are not even associated with digestive organs. What ailments cause epigastric pain and how to get rid of the symptoms we will tell you in this article.

What is the epigastric region?

To determine that pain that has arisen somewhere in the abdomen is localized precisely in the epigastric region, you need to know where it is located. Mentally draw a triangle on your body, the base of which will pass in a straight line under the ribs through the navel, and the apex will close in the area of the ribs (the height depends on individual characteristics physique). The resulting geometric figure outlines the epigastrium.

Why does epigastric pain occur?

Pain in the epigastric region may be caused by all kinds of diseases, covering various internal organs. Let's look at the most common causes of epigastric pain:

Disease of the esophagus, duodenum, diaphragm and other organs of the gastrointestinal tract, right-sided pyelonephritis, heart disease, damage to the pleura and pericardium.
Chronic gastritis, hiatal epigastric hernia, pancreatitis, left-sided pyelonephritis, spleen damage.
Acute appendicitis, accompanied by pain first in the navel or epigastric area, which gradually turns into right side body into the iliac region.
Myocardial infarction is in some cases accompanied by epigastric pain. The symptoms resemble perforation of an ulcer and the pain is quite acute. The pulse quickens, arrhythmia occurs and blood pressure drops.
Pleurisy and pneumonia, in which pain in the epigastric region intensifies with deep breaths and coughing. Breathing becomes shallow, noises and wheezing occur.
The sensitivity of the epigastric zone may increase and some pain may occur in acute duodenitis. TO additional symptoms illnesses include vomiting and nausea.
Pyloroduodenal stenosis, in which pain appears after eating, as well as heartburn and vomiting.
Pain in the epigastric region can occur with various infectious diseases. Sudden pain in the abdomen, nausea, vomiting, indigestion - all these are signs of food poisoning.
The epigastrium may hurt in anticipation of hemorrhagic syndrome(the disease can be diagnosed by additional symptoms, such as vomiting and mild chills).
Typhus affects solar plexus and also causes pain in the epigastric region.

If pain appears in the epigastrium, which causes discomfort and does not disappear even after taking painkillers, you should consult a doctor. Only a specialist can establish a diagnosis and prescribe the correct treatment.

Nature of pain

Pain in the epigastric region can be different, depending on the cause that caused it:

Hunger pain in the epigastrium can be nagging and quite severe. They disappear immediately after eating, even in small quantities. Sometimes they subside even after a sip of tea.
Constant pain in the epigastrium are associated with irritation of nerve elements in the mucous membranes and submucosal layers. Chronic pain often begin during inflammatory processes.
Periodic aching pain in the epigastrium may be caused by pyloric spasms and secretion of too much large quantity juice in the stomach.
Cramping severe pain in the epigastrium occurs with spastic contractions of the muscle tissue of the hollow organs.

Seasonal pressing pain in the eptigastric region is rare and occurs in certain time of the year, for example in spring or autumn.

Diagnosis of pain in the epigastric region

Physicians, surgeons, neurologists, gastroenterologists, gynecologists, nephrologists and pulmonologists can diagnose the disease that causes epigastric pain. When visiting a doctor with complaints of discomfort in the epigastric region, the patient is referred to full examination to find out the root causes.

Experts must prescribe biochemical and clinical analysis urine and feces, culture, stool analysis. Instrumental examinations are also used, including:

Ultrasound of the abdominal area;
esophagogastroduodenoscopy;
Helicobacter tests;
X-ray examination etc.

Based on the results obtained during the examination, doctors confirm or refute diseases of the gastrointestinal tract. If necessary, examinations are continued to identify real reason pain in the epigastric region.

Treatment of epigastric pain

For pain or discomfort in the epigastric region, treatment should be comprehensive. Important role Adjusting your diet and eating habits plays a role. Doctors also prescribe psychotherapeutic procedures and medications. if necessary, it is necessary to exclude physical and emotional stress, which adversely affect the functioning of the gastrointestinal tract. Not acceptable long breaks between meals, eating fatty, fried, smoked, spicy foods. If you have pain in the epigastrium, you should stop drinking alcohol, soda and smoking.

The most effective medications that help with pain in the epigastric region include medications of the prokinetic group. They increase the frequency of contractions of the esophagus, stimulate gastric emptying and tone the lower esophageal sphincter, increasing duodenal motility.

The work of prokinetics is based on the ability to block dopamine receptors that affect the functioning of the gastrointestinal tract. Sometimes restoration of gastrointestinal motility requires the mandatory use of anti-Helicobacter therapy.

The use of antacid drugs rich in aluminum and magnesium hydroxide can relieve the patient of flatulence and neutralize the acidic contents in the stomach.

An excellent result in the fight against epigastric pain is obtained by using acid suppressants. medicines. Histamine H-2 receptor antagonists can quickly relieve symptoms of bloating, heaviness and burning in the abdomen.

Stomach pain is the most common symptom developing pathology digestive system. Pain varies in nature, duration, extent and location. Most stomach diseases begin with a dull, aching pain. The nature of the symptom depends on the cause that caused the unpleasant syndrome.

Pain in the stomach can be a manifestation of diseases such as:

Gastritis.
Ulcer of the stomach and duodenum.
Neurological disorders.
Mucosal polyps.
Diverticula.
Menetrier's disease.
Stenosis.
Transferred foodborne toxic infections.
Severe chemical poisoning.

What causes pain?

1. The causes of dull pain in the stomach are often dietary errors, overeating, depression, excessive physical activity, long-term treatment chemotherapy drugs.

2. Gastritis or inflammation of the mucous membrane is the most common lesion digestive tract. It manifests itself as dull pain in the epigastric region, belching, and loss of appetite. The pain is constant and may intensify after eating. During the acute period this symptomatology even accompanied by nausea and vomiting.

3. When peptic ulcer, on initial stages, the dull pain is constant. Depending on the localization of the erosive process, pain syndrome maybe on empty stomach, so-called “hunger pains”; and after meals, when the production of gastric juice increases. Gradually, the patient begins to lose weight, his appetite completely disappears, and belching air appears after eating. Lack of treatment causes quite intense pain. With the addition of complications in the form of bleeding, nausea and vomiting of “coffee grounds” occur, and the stool is almost black.

4. Stress, neurological disorders, stroke, myocardial infarction contribute to the appearance of Curling and Cushing ulcers. The surge of hormones has a destructive effect on the walls, which leads to dyspeptic disorders with pain in the stomach.

5. Pain radiates to the back if pathological changes also affect the pancreas. In this case, patients have abnormal stools, flatulence, nausea, and sometimes the skin may acquire a jaundiced tint.

6. Cancer quite often causes severe, dull pain in the stomach. In the initial stages, it is short in duration and is accompanied by loss of appetite, weakness, weight loss, and low-grade fever. In cancer patients, skin color changes significantly due to increasing anemia. Gradually the skin becomes pale, with a grayish tint. Cancer can be suspected if there is a combination of dull pain in the abdomen and the appearance of a perverted taste in the mouth. Often such patients cease to tolerate meat and fish, even to the smell. They feel full after eating a small amount of food. Then comes belching with an unpleasant sulfuric odor, nausea and vomiting of stagnant contents.

7. The cause of epigastric pain is sometimes a rare disease such as Ménétrier's disease, or chronic, hypertrophic polyadenomatous gastritis. Usually, the pathology begins gradually, with dull pain in the epigastric region. Then vomiting, diarrhea, flatulence, belching, frequent stomach bleeding And great loss body weight. In advanced cases, as a result of protein malabsorption, swelling and serious metabolic changes occur.

8. Pain and belching after eating are a sign of food retention in the stomach. Stagnation may be due to a developmental abnormality - stenosis. This pathology comes out to suspect childhood or in young people. Typically, patients with this disease are asthenic and pale. They often experience dull pain and heaviness in the abdomen, and belching of sour contents. As the disease progresses, vomiting of food taken the day before occurs.

9. Diverticulosis and polyposis occur with pain and belching after eating, decreased appetite, regurgitation of acidic contents, and bloating.

10. Poisoning disrupts the motor activity of the digestive tube, causing pain in the stomach with aerophagia, flatulence, severe weakness and headaches.

Features of therapy

It is possible to cure pain only by knowing the cause that caused it. To do this, you need to undergo a series of examinations prescribed by your doctor. For correct setting Diagnosis is carried out: endoscopy, radiography and general tests.

Treatment for inflammation of the mucous membrane includes:

Diet therapy.
Taking chemotherapy drugs.
Vitamin therapy.
Physiotherapy.
Surgery.
Symptomatic therapy.

Diet plays a very important role in treatment. Food should be taken up to 5-6 times a day, in small portions, warm.

Not allowed:

Spicy, salty, fried.
Canned food.
Spices.
Strong broths.
Smoked meats and sausages.
Onions, garlic, herbs.
Sour fruits and vegetables.
Fresh bakery.
Rye bread.
Coffee, chocolate, strong tea.
Alcohol.
Bananas, pineapples.

What you can do:

Boiled fish, poultry, lean young meat.
Porridge with water, pasta, rice.
Stewed vegetables, puree, soufflé.
Puréed soups.
Compote jelly.
Stale White bread with a little oil.
Steamed cutlets and meatballs.
Fruit jelly, cocoa.
Cottage cheese.

Diet principles should take into account the phase of the disease and concomitant pathology.

Pharmacy products

Drug treatment of aching pain in the stomach involves the use of drugs such as:

1. Antacids. These substances reduce the secretion of gastric juice and have enveloping effect. These products include: Almagel, Phosphalugel, Gastal. They are prescribed 40 minutes before meals, or 120 after.

2. Drugs that block excessive cell activity: Omeprazole, Rabeloc, Ulsepan.

3. When increased peristalsis and hypersecretion, which becomes the cause frequent pain, use the drug atropine subcutaneously, platiphylline, metacin. These medicinal substances are prescribed and administered only under the supervision of a doctor, as they have a lot of side effects.

4. Gastroprotectors - to treat damaged endothelial cells and prevent the proliferation of the Helikobakter pylori bacterium. This group includes: Solcoseryl, Sucralfate, De-Nol, Actovegin.

5. Antibiotics are used if the presence of Helikobakter pylori is confirmed. Amikacin, Amoxicillin, Metrogil will help destroy the bacteria and eliminate the damaging factor.

6. Auxiliary treatment necessary to relieve flatulence, pain, cramps, vomiting and nausea. No-shpa, Motilium, Smecta, Cerucal are used. These medications will also relieve the feeling of heaviness and fullness. Enzyme deficiency is corrected with Hilak-Forte, Festal, Panzinorm, Creon.

7. Aloe extract has a stimulating effect on gastric trophism. It must be administered 1 ml subcutaneously.

8. Vitamin therapy is needed to restore the overall strength of the body and stimulate the processes of regeneration of epithelial cells. Vitamins of group E, B1, B6, B12 are mainly used for stomach diseases.

9. K surgical treatment resorted to in severe and complicated cases of gastric ulcer. The Billroth resection technique or the intersection of certain branches of nerves that stimulate the production of gastric juice is used.

10. To eliminate pain and inflammation, ultrasound, galvanization and electrophoresis with No-shpa and papaverine are used. The use of physiotherapy allows achieving stable remission.

11. Physiotherapy is indicated at stages sanatorium treatment or in the period after the elimination of the acute inflammatory process. In case of oncology, physiotherapy is strictly contraindicated.

12. Stomach cancer is treated surgical method followed by long-term chemotherapy.

When to see a doctor?

What to do if the pain does not go away? All cases of persistent, intractable abdominal pain should be thoroughly investigated. IN last years frequency oncological lesions has reached very high numbers even among young people, this must be taken into account.

You should also consult a doctor if your diet and use basic means treatments do not bring their results. The prognosis for gastritis and peptic ulcers is usually favorable. It is important to remember that exacerbation of chronic diseases occurs in the autumn-spring period.

Vomit is a complex reflex act associated with excitation of the vomiting center of the brain, which occurs when various changes external environment(motion sickness, unpleasant odor) or internal environment body (infections, intoxications, diseases of the gastrointestinal tract, etc.).

Causes:

Highlight following reasons vomiting.
1. Infectious:
bacterial intoxication (salmonella, clostridia, staphylococcus, etc.);
viral infections(viral hepatitis, rotavirus, calicivirus).
2. Diseases of the central nervous system(infections, increased intracranial pressure, vestibular disorders).
3. Pathology endocrine system(hyperthyroidism, diabetes mellitus, adrenal insufficiency).
4.
Pregnancy.
5. The influence of drugs (aminophylline, opiates, cardiac glycosides, cytostatics, etc.).
6. Intestinal obstruction (intussusception, adhesions, strangulated hernia, volvulus, foreign body, Crohn's disease).
7. Visceral pain(peritonitis, pancreatitis, myocardial infarction, cholecystitis).
8. Neurogenic factors.
9. Other factors (poisoning, burns, acute radiation sickness).

Vomiting is not specific symptom damage to the gastrointestinal tract. Vomiting reflex caused by many factors.

Vomiting of nervous origin is associated with organic diseases brain and its membranes, cerebrovascular accident.
In addition, it can occur due to irritation or damage vestibular apparatus, eye diseases, feverish conditions. Psychogenic vomiting develops when psychosomatic diseases or acute emotional disorders.

Vomiting may be a manifestation of irritation of the mucous membranes internal organs- stomach, intestines, liver, gall bladder, peritoneum, internal genital organs in women, kidney damage, as well as irritation of the root of the tongue, pharynx, pharynx. In addition, the vomiting center may be affected by various infections and intoxication (bacterial toxins and own toxic substances, accumulating in severe pathology of the kidneys, liver or deep metabolic disorders at endocrine diseases). Vomiting is characteristic of toxicosis in the first half of pregnancy (vomiting of pregnancy).

It may appear as a symptom of overdose medicines or hypersensitivity the body to them, as well as when taking incompatible medications.

Symptoms of vomiting:

In most cases, vomiting is preceded by nausea, increased salivation, fast, deep breathing.
Consistently, the diaphragm descends, the glottis closes, the pyloric part of the stomach contracts sharply, the body of the stomach and the lower esophageal sphincter relax, and antiperistalsis occurs.

Spastic contraction of the diaphragm and abdominal muscles leads to an increase in intra-abdominal and intragastric pressure, which is accompanied by the rapid release of gastric contents through the esophagus and mouth to the outside. Vomiting, as a rule, occurs against the background of paleness skin, increased sweating, severe weakness, rapid heartbeat, decreased blood pressure.

Differential diagnosis:

Vomiting often accompanies many infectious diseases. Moreover, it can be one-time during the manifestation of the disease, as, for example, with erysipelas, typhus, scarlet fever, or more prolonged and persistent ( intestinal infections, food poisoning). Moreover, it is accompanied by other common infectious manifestations: fever, weakness, headache. It is usually preceded by nausea.

Vomiting with meningitis has a special place - it has a central genesis. Vomit central genesis occurs when the brain and its membranes are damaged, is not associated with food intake, is not accompanied by previous nausea, and does not alleviate the patient’s condition. As a rule, there are other signs of pathology of the central nervous system.

At meningococcal meningitis There is a known triad of symptoms: headache, meningeal signs(rigidity occipital muscles) and hyperthermia. An important sign is the occurrence of vomiting without previous nausea against the background of severe headache and general hyperesthesia.

When the vestibular apparatus is damaged, systemic dizziness occurs in combination with vomiting. With Meniere's disease, there may be both nausea and vomiting with concomitant hearing loss and frequent dizziness. With the syndrome intracranial hypertension vomiting often occurs in the morning, against the background of a sharp headache, and is provoked by turning the head, changing the location of the patient’s body in space.

Vomiting during migraine also occurs against the background of headache, but at its peak, it somewhat alleviates the patient’s condition, and can be one or two times. Vomiting during a hypertensive crisis is combined with headache and occurs with a significant increase in blood pressure. On the background hypertensive crisis with a significant increase in headache, repeated vomiting may occur without previous nausea, which is threatening symptom developing hemorrhagic stroke.

Vomiting when endocrine diseases- enough common symptom. At diabetic coma vomiting can be repeated, does not bring relief to the patient, can be combined with acute pain in the abdomen, which is the reason for hospitalization of the patient in a surgical hospital.

Vomiting that is persistent and causes severe dehydration may be the first and most characteristic symptom hypercalcemic crisis in hyperparathyroidism.

Chronic adrenal insufficiency in the decompensation stage can occur in the presence of nausea, vomiting, and abdominal pain. Usually, in addition to these symptoms, muscle asthenia and fever are noted, and later cardiovascular disorders are added.

Poisoning various substances most often initially manifested by vomiting. Suspicion of poisoning requires urgent measures, as well as studies of vomit and gastric lavage.

For acute surgical pathology organs abdominal cavity vomiting is usually preceded by severe abdominal pain and nausea. In case of intestinal obstruction, the composition of the vomit depends on the level of obstruction: high intestinal obstruction characterized by the presence of stomach contents and a large amount of bile in the vomit; obstruction of the middle and distal intestines is accompanied by the appearance of a brownish tint in the vomit and fecal odor. In addition to vomiting, there is abdominal bloating, sometimes asymmetrical, cramping pain, lack of stool, as well as signs of intoxication and dehydration.

“Fecal” vomiting is more often associated with the presence of communication between the stomach and the transverse colon, or develops in the terminal stage of long-existing intestinal obstruction.

When thrombosis of mesenteric vessels occurs, vomiting is preceded by severe abdominal pain and a collapsing state. There may be blood in the vomit.

Most often, however, bloody vomiting is a symptom of bleeding from the esophagus, stomach or duodenum. Less commonly, the vomit may contain blood swallowed by the patient in the presence of pulmonary or nasal bleeding (for details, see bleeding syndrome).

For acute appendicitis and appendicular infiltrate are characterized by the occurrence of vomiting against the background of diffuse or localized (infiltrate) abdominal pain. Peritonitis in toxic stage accompanied by vomiting in combination with abdominal pain and symptoms of peritoneal irritation.

Vomiting in diseases of the gastrointestinal tract:

The time of onset of vomiting, the presence of previous nausea, the relationship of vomiting with food intake, pain during vomiting, the amount and nature of vomit are important for correct diagnosis.

Most often, in diseases of the gastrointestinal tract, nausea precedes vomiting. However, this does not always happen. For example, esophageal vomiting is not accompanied by nausea. Vomiting occurs with various diseases of the esophagus, usually associated with a violation of its patency and the accumulation of food masses.

Esophageal stenosis can be caused by tumor process, peptic or post-burn stricture. In addition, esophageal vomiting can lead to achalasia cardia, diverticulum, esophageal dyskinesia, as well as gastroesophageal reflux due to insufficiency of the cardiac sphincter (lower esophageal sphincter).

Esophageal vomiting can be divided into early and late. Early vomiting develops during food intake, often with the first pieces swallowed, and is associated with dysphagia, discomfort and pain in the chest. Such vomiting may be a symptom of organic damage to the esophagus (tumor, ulcer, scar deformity), and neurotic disorders.

In the first case, pain, vomiting, chest discomfort, and dysphagia directly depend on the density of food swallowed. The denser and coarser the food, the more pronounced the esophageal disorders. For neuroses with functional disorders When swallowing food, no such dependence is observed; on the contrary, denser foods often do not cause any problems with swallowing, and liquids lead to vomiting.

Late esophageal vomiting develops 3-4 hours after eating, which indicates a significant expansion of the esophagus. It appears when the patient assumes a horizontal position or leans forward (the so-called lace symptom). Typically, this sign is characteristic of achalasia cardia.

In addition to late esophageal vomiting of food eaten mixed with mucus and saliva, more often when bending forward (for example, when washing floors), patients complain of chest pain. They resemble those of angina pectoris and also disappear when taking nitroglycerin, but are never associated with physical activity.

Late vomiting can also develop in the presence of a large esophageal diverticulum. However, the amount of vomit is much less than that with achalasia cardia. The composition of vomit in esophageal vomiting is undigested food with a small amount of mucus mixed with saliva.

With reflux esophagitis, vomit consists of a large amount of undigested food debris, as well as a large amount of sour or bitter liquid ( gastric juice or its mixture with bile).

Vomiting can occur both during meals and some time after it, in some cases at night when the patient is in a horizontal position, as well as when the body suddenly bends forward, sharp increase intra-abdominal (straining due to constipation, pregnancy, etc.) and intragastric pressure. Vomiting at night during sleep can lead to vomit entering the respiratory tract, and then to the development of chronic, persistently recurrent bronchitis.

In diseases of the stomach and duodenum, vomiting is constant sign. It is closely related to food intake and occurs, as a rule, after meals, with regular intervals between them. With duodenal ulcer, vomiting most often appears 2-4 hours after eating or at night against the background of severe pain in the stomach. upper half belly, it accompanies severe nausea. A characteristic symptom is the subsidence of pain after vomiting; sometimes such patients deliberately induce vomiting in order to make themselves feel better.

With stenosis of the pyloric part of the stomach due to ulcerative scar deformation or cancer, vomiting is frequent and profuse; the vomit contains remnants of food eaten several days ago, which have a putrid odor.

With pylorospasm, which is often caused by functional disorders motor function of the stomach ( reflex influences for peptic ulcer disease, disease biliary tract and gallbladder, neuroses) and in some cases intoxication (lead) or hypoparathyroidism; patients also often complain of frequent vomiting.

However, vomiting with pylorospasm is not as profuse as with organic pyloric stenosis; moderate amount Gastric contents eaten recently do not have a specific smell of rotting. Fluctuations in the frequency of vomiting are associated with the severity of the underlying disease and the mental instability of the patient.

Vomiting in acute gastritis is repeated; the vomit has an acidic reaction. Vomiting is accompanied by sharp, sometimes excruciating pain in the epigastric region. It occurs during or immediately after eating and brings temporary relief to the patient.

For chronic gastritis, vomiting is not the most characteristic feature, except for gastritis with normal or increased secretion. In addition to severe pain ( sharp pains in the epigastric region after eating), heartburn, sour belching, a tendency to constipation are noted, the tongue is covered with a copious white coating. Vomiting in this form of the disease can appear in the morning on an empty stomach, sometimes without the characteristic pain and nausea.

Vomiting in chronic diseases of the liver and biliary tract:

Vomiting when chronic diseases liver, biliary tract and pancreas is recurrent; bile in the vomit is typical, coloring it yellow-green. Chronic calculous cholecystitis is characterized by pain in the right hypochondrium, sometimes even short-term icteric discoloration of the skin and sclera. These phenomena are provoked by the intake of fatty, spicy and fried foods.

In biliary colic, vomiting is characteristic as one of the typical symptoms diseases. Biliary colic occurs with cholelithiasis, acute and chronic cholecystitis, dyskinesias and strictures of the biliary tract, stenosis of the major duodenal papilla. Vomiting bile always accompanies a painful attack along with other typical signs: bloating, nausea, fever, etc. Vomiting brings temporary relief.

Vomiting with bile occurs at altitude pain attack in acute or exacerbation of chronic pancreatitis. It does not bring relief and can be indomitable.

Treatment:

There is no specific treatment for vomiting; it is associated only with the treatment of the underlying disease.

Pain in the epigastric region is one of the most common symptoms, which often accompanies a wide range of gastrointestinal disorders, but can also occur with some ailments of other internal organs. The localization of pain and the place of its strongest intensity often indicates problems with the organ that is located in this projection.

Since there are many diseases that can cause the manifestation of such a symptom, if it occurs, it is necessary to seek help from specialists as soon as possible. The basis diagnostic measures consists of instrumental examinations, in particular ultrasound, FEGDS and radiography.

Elimination of pain in the epigastric region depends on the causes of its occurrence. Often it is enough to take medications and follow a gentle diet.

Etiology

Pain in the epigastric region is caused by various ailments, which cover many internal organs. Among the ailments, the most common causes of this symptom are:

a wide range of diseases of the stomach, duodenum, esophagus and other gastrointestinal organs. In particular, chronic course gastritis, of different nature occurrence, pancreatitis and pyelonephritis;
acute course of appendicitis. At the beginning of development, aching pain is noted in the navel area, then in the epigastrium, after which it spreads to the entire right side of the abdomen;
myocardial infarction - can often be accompanied by painful spasms in this place. The pain is expressed quite acutely, and is also accompanied by a decrease in blood pressure and an increase in heart rate;
pleurisy and pneumonia - with such disorders, pain in the upper abdomen increases sharply with severe cough and inhale, pain can often radiate to the back;
acute duodenitis – a slight pain syndrome appears, the sensitivity of this area increases, and signs of intoxication of the body are also observed;
pyloroduodenal stenosis - characterized by the fact that pain is expressed after eating, accompanied by heartburn and frequent vomiting;
various infectious disorders, in which sudden abdominal pain is expressed;
hemorrhagic syndrome;
typhus – differs in that it involves pathological process solar plexus, thereby causing intense pain in this area.

But not only diseases can become a factor in the manifestation of unpleasant sensations in the epigastric region. Often the source of pain can be damage to other internal organs, in particular:

stomach – there are strong and paroxysmal pain, often accompanied by other symptoms. Can occur both after meals and on an empty stomach;
hearts - in addition to the appearance painful spasms in the epigastric region, pain spreads into right shoulder And lower jaw;
lungs - the intensity of pain varies depending on the breathing rate;
pancreas - provokes constant and colicky pain, which can radiate to the back or left shoulder;
intestines - almost always causes pain in the epigastrium, which is accompanied by many other symptoms;
spleen – causes intense pain, often spreading along the left side of the body and neck;
gallbladder - diseases associated with this organ often cause unbearable pain in the epigastric region, pain is often observed, radiating to the back;
kidney - sharp pain, spreading to the perineum and lower back;
diaphragm - spasms in this area are greatly intensified during food consumption or deep breaths.

Another reason why epigastric pain may occur is oncology of one of the gastrointestinal organs or cancer metastasis.

Classification

In gastroenterology, there is a clear division into the expression of pain in the epigastric region, which differs depending on what factor caused the appearance of such an unpleasant sensation. Thus, pain is divided into:

hunger pains– can be aching and strong. It goes away after eating food, and sometimes a few sips of tea are enough;
constant– its occurrence is associated with irritation nerve endings in the mucous and submucosal layer. Chronic pain syndrome is often observed during inflammation;
periodic– is often aching in nature and is caused by the secretion of large amounts of gastric contents;
grip-like cutting.

In addition, pain in the epigastric region can be seasonal and worsen in spring or autumn.

Depending on food consumption, similar symptom divided by:

epigastric pain after eating– often observed after consumption junk food, fast food, fried or salty foods, as well as low-quality food products. In order to get rid of spasms, a person needs to take painkillers;
fasting pain– is eliminated after eating, and for this it is not at all necessary to eat to the full; in some situations it is enough to simply snack on a small amount of food. Quite rarely it can go away after drinking liquid.

Symptoms

Pain in the epigastric region can be the only symptom or be accompanied by other symptoms. It is necessary to seek help from specialists as soon as possible if, in addition to this symptom, the following clinical picture occurs:

violation respiratory function and the process of swallowing food;
discomfort in the heart area;
an increase in temperature above thirty-eight degrees;
detection of blood impurities in feces and vomit;
increase in abdominal size;
increased pain, spreading to the back or right side.

These are the main signs that may accompany hunger pain or the occurrence of cramps on an empty stomach in the epigastric region, and also indicate during diagnosis diseases of the gastrointestinal tract, heart and other internal organs.

Diagnostics

If a person is bothered by pain in the epigastrium, then it is necessary to seek help from specialists such as:

therapist;
surgeon;
neurologist;
gastroenterologist;
gynecologist;
nephrologist;
pulmonologist

After reviewing the medical history and life history, the doctor sends the patient, provided that he has complaints of pain and discomfort in the epigastric region, to instrumental examination. This is necessary to establish the disease that caused such unpleasant symptoms.

IN mandatory doctors prescribe the following:

general and biochemical analysis blood and urine;
microscopic examination of feces;
breath tests to detect the bacteria Helicobacter pylori in the body;
bacterial culture for antibodies;
Ultrasound of the abdominal organs;
FEGDS – endoscopic procedure studying the mucous membrane of the gastrointestinal tract;
radiography - with or without contrast;
biopsy - for histological studies and cancer detection.

Based on the results obtained during diagnosis, specialists confirm the presence of a particular gastrointestinal disease.

Treatment

If there is pain and discomfort in the epigastric region, then the elimination of a particular disease should be comprehensive.

First of all, they appoint drug treatment. Regardless of the illness that caused the pain syndrome, drugs such as prokinetics and antacids are prescribed. They are aimed at relieving pain.

It is important in therapy dietary food. Absolutely all patients are advised to avoid fatty and spicy dishes, as well as smoked meats and carbonated drinks. In addition, long breaks between meals are not allowed, which is why it is necessary to eat small portions every three hours.

Surgical intervention is indicated in individual cases, with acute course the disease that caused pain in the epigastric region.

In addition, diseases can be treated with physiotherapy and the use of folk remedies medicine.

Pain in the epigastric region is a common symptom of many diseases (and not only the digestive tract). It is difficult to immediately determine their origin even an experienced doctor. Making a diagnosis requires more than just thorough examination.

Epigastric pain can be caused by a wide variety of reasons.

Often, focusing on pain, a person does not pay attention to associated symptoms, knowledge of which will enable a specialist to narrow the list possible violations and direct to the necessary diagnostic procedures. Therefore, everyone should know what kind of pain occurs in the epigastric region, as well as what points still need to be paid attention to.

Organ diseases - causes of pain

Pain can be expressed in different ways: have its own duration, acute or hidden onset, and be accompanied by additional sensations and disorders. All these parameters depend on the organ in which the disorders occur. Therefore, the cause of pain in the epigastric region can be any of the organs described below. However, in each specific case the symptoms will vary.

. Issues severe pain, which is often accompanied by vomiting. Abdominal muscles tense.
Lungs. The intensity of pain in diseases of this organ varies depending on breathing. In addition, with pneumonia, for example, body temperature rises, heart rate increases, and breathing becomes shallow.
. If pancreatitis is acute, then the sensations will be constant or in the form of colic. Otherwise .
Liver. Sharp, localized under the right ribs, can occur in the form of attacks.
Heart. In this case, the sensations will radiate to the shoulder, between the shoulder blades, forearm, and lower jaw. Epigastric pain in heart disease can be accompanied by changes in blood pressure, breathing, heart rate, sweating and other disorders. When a heart attack occurs, a person tries not to move and tries to maintain a half-sitting position.
. First appears in the navel area, then spreads along the right bottom side belly. This is the area where the muscles are most tense and painful. Gives to the rectum.
. Accompanied by vomiting and nausea. Strong, spreads across upper section abdominal cavity.
. The pain is sharp, radiates to the perineum and lower back. Added to this is a frequent urge to urinate bladder. If a stone passes, there may be blood in the urine.
Spleen. Appear on the left side of the epigastrium. They radiate to the neck, shoulder, and there is an increase in body temperature.
. Occurs suddenly with right side. Intensifies with any movement abdominal wall, gives it to the back, right hand. It has the nature of contractions, very strong.
Diaphragm. Characterized by intensification with deep breaths. If triggered by a diaphragmatic hernia, it occurs after eating a certain type of food.

What other reasons could there be?

What else can be a factor that provokes pain in the epigastric region? For example, functional on nervous soil. Unpleasant sensations in the epigastrium can occur after experiencing stress and go away on their own, without consequences. In addition, gastrointestinal diseases of an infectious nature, poisoning, and eating disorders can cause pain. Unpleasant feeling Compression may occur if food is absorbed very quickly and the stomach is full.

Often the cause of pain in the epigastric region is increased exercise stress. This phenomenon can be observed in intensively training people with poor physical fitness. Another factor leading to pain is smoking and drinking alcohol in very large quantities. After the spasm is relieved, the sensation goes away.

Smoking and alcohol can also cause pain in the epigastric region

Classifications of epigastric pain

There are several classifications of pain in the epigastric region. They can be based on its nature, intensity, time period, and so on. For example, pain in the epigastrium can be:

(occur on an empty stomach, may disappear even after a piece of food or sips of a drink) or associated with food intake;
permanent (as a rule, they arise against the background inflammatory processes in organs and are caused by constant irritation of nerve endings) or be periodic;
strong or weakly expressed.

In addition, pain in the epigastric region may depend on the time of year, that is, it may be seasonal. Such sensations are also divided by nature: in the form of contractions, pain, colic, etc.

Associated symptoms

Pain in the epigastric region can be expressed in a single form. However, most often (especially upon closer examination) other symptoms are also present. Among them may be the following:

unpleasant or painful sensations in the heart area;
the stomach increases in size;
the pain begins to radiate to the back or is localized on the right side, and at the same time intensifies;
there were breathing problems;
body temperature became above 38;
it became difficult to swallow even water;
Blood appeared in feces, urine and vomit.

Attention! If such symptoms are detected in combination with pain in the epigastric region, you should urgently call an ambulance team!

If you experience pain in the epigastrium, first of all you need to consult a therapist.

Which doctor to contact, diagnostic features

Whenever painful sensations in the epigastric area, you should first consult a therapist. In the future, he can refer you to other specialists: gastroenterologist, nephrologist, cardiologist and others. If the disease is chronic and you already know why the pain occurs, then you need to visit your doctor.

Diagnosis of pain in the epigastric region of unknown origin may include methods such as:

blood, urine, stool tests;
bacterial cultures;
conducting breath tests;
endoscopic examinations;
ultrasonography;
X-ray;
biopsy and others.

Only after receiving the results of the examination will the doctor be able to determine the cause of the disorder and make a diagnosis.

Considering that such a symptom can be caused various factors, the first thing to do when it appears is to contact a specialist. Delay can be fatal.

Attention! Do not try to diagnose yourself! Variety of reasons causing pain in the epigastrium, requires only laboratory and instrumental examination.

In conclusion, we can add that not a single description of symptoms taken from the Internet (including in this article) can replace a full, thorough examination prescribed by a doctor. Be attentive to your feelings and your health. About how pain in the epigastric area is diagnosed specific example, can be seen in a short video