What’s Causing My Epigastric Pain and How Can I Find Relief

What’s Causing My Epigastric Pain and How Can I Find Relief?

Epigastric pain is one of the most common complaints among patients with gastroesophageal reflux disease (GERD). However, it may not always be obvious what causes it. Many times the cause is unknown or misdiagnosed. For example, many patients have a history of GERD but do not experience any symptoms until they are already experiencing severe symptoms from their surgery. Other times the cause is known but the patient does not respond well to standard treatments.

The following section discusses what causes myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and fibromyalgia (FM), two other common conditions commonly referred to as “myalgic” disorders. These diseases share some similar features, such as chronic fatigue, muscle pain, sleep disturbances, and cognitive dysfunction.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)

Symptoms: Fatigue, cognitive problems, mood changes, joint pain, headaches, difficulty concentrating.

Causes: ME/CFS is believed to result from damage to the central nervous system caused by viral infections or chemical exposures. There is no cure for either condition. Treatment involves rest and anti-inflammatory medications.

Fibromyalgia (FM)

Symptoms: Generalized pain throughout the body, especially in the muscles, tendons, and ligaments. Other symptoms may include headaches, cognitive complaints, irritable bowels, and sleep disturbances.

Causes: Many experts believe that fibromyalgia is caused by a malfunction in the way the central nervous system processes pain and discomfort signals. This results in an increased sensitivity to pain. FM is also thought to be triggered by physical trauma or emotional stress.

Other causes of epigastric pain may include inflammatory bowel disease, gallstones, liver disease, and pancreatitis.

Diet and nutrition: Certain food may trigger or worsen symptoms of epigastric pain. Common food culprits include alcohol, caffeine, chocolate, mint flavored products, onions, and garlic.

Natural pain relief: While lifestyle changes can help to manage symptoms, there is no cure for these conditions. In some cases, lifestyle changes may be enough to manage symptoms and improve quality of life.

Cognitive Behavioral Therapy: This helps people with these conditions learn to better cope with the condition and maintain a positive outlook.

Pranayama: This helps people control their functions of mind and body.

Acupuncture: This can help relieve pain and promote peacefulness.

Aromatherapy: Using essential oils that are believed to have healing powers.

Traditional Chinese medicine: This involves using herbs, acupuncture, and other techniques.

Relaxation techniques such as yoga and meditation.

Common epigastric pain drugs: Ranitidine, cimetidine, famotidine, nizatidine, and other drugs in this class interfere with the production of stomach acid. These drugs are effective for treating GERD but they do not help relieve the pain caused by epigastric disease.

What are the complications of epigastric pain?

In addition to the symptoms mentioned above, complications may include:

Depression or other mental health issues.

Digestive problems such as dysphagia (swallowing difficulties), heartburn, nausea, vomiting, diarrhea, or constipation.


Peritonitis (infection or inflammation of the peritoneum)

Severe cases can lead to shock and death.

What is the treatment for epigastric pain?

The treatment for epigastric pain will depend on the cause. Conditions that cause severe and persistent pain may require hospitalization. If the cause is an ulcer, acid-reducing drugs such as famotidine (Pepcid) or ranitidine (Zantac) may be prescribed.

Dietary changes can also help to relieve symptoms. If the cause is stress, treatment should be aimed at the stress. If it’s caused by poor eating habits, dietary changes should be made.

Eating smaller, more frequent meals rather than three large meals a day may help. A diet high in fiber and low in fat may help to reduce symptoms.

If you have an infection, antibiotics may be necessary. If an ulcer is causing the pain, a combination of drugs that reduce stomach acid along with an antibiotic and maybe an antacid are typically prescribed.

In some cases, surgery may be necessary. Endoscopic treatments to burn off patches of mucous membrane or remove parts of the stomach can help alleviate symptoms in some cases.

Sources & references used in this article:

Prevalence and symptom pattern of pathologic esophageal acid reflux in patients with functional dyspepsia based on the Rome III criteria by YL Xiao, S Peng, J Tao, AJ Wang, JK Lin… – American Journal of …, 2010 – journals.lww.com

by Keystone Radiology| Mar 3, 2020| Health Understanding Epigastric ‘stomach’pain by KSM Vision – ks-med.co.za

The trigger point therapy workbook: Your self-treatment guide for pain relief by C Davies, A Davies – 2013 – books.google.com

The hormonal causes of premenstrual tension by RT Frank – Archives of Neurology & Psychiatry, 1931 – jamanetwork.com

Abdominal symptoms: do they disappear after cholecystectomy? by MY Berger, TC Olde Hartman, AM Bohnen – Surgical Endoscopy And …, 2003 – Springer

Functional dyspepsia, delayed gastric emptying, and impaired quality of life by NJ Talley, GR Locke, BD Lahr, AR Zinsmeister… – Gut, 2006 – gut.bmj.com

A 35-year-old man with epigastric pain by R Glickman – JAMA, 1995 – jamanetwork.com

What is behind dyspepsia? by AG Klauser, WA Voderholzer, PA Knesewitsch… – Digestive Diseases and …, 1993 – Springer

Punctate midline myelotomy for the relief of visceral cancer pain by HJW Nauta, VM Soukup, RH Fabian, JT Lin… – … of Neurosurgery: Spine, 2000 – thejns.org