Gastroesophageal Reflux Disease (GERD) is a common digestive condition where stomach acid frequently flows back into the esophagus, the tube connecting your mouth to your stomach. Many with GERD wonder if upper abdominal pain is a symptom. Upper abdominal discomfort can be a symptom of GERD, though its presentation can sometimes be confusing.
How GERD Causes Upper Abdominal Pain
Upper abdominal pain from GERD is caused by irritation and inflammation of the lower esophagus. When the lower esophageal sphincter (LES), a muscular ring that closes after food passes, relaxes inappropriately or weakens, stomach acid can reflux upwards. This acid irritates the esophageal lining.
This esophageal irritation is often perceived as upper abdominal pain due to referred pain. Nerve pathways from the esophagus share connections with nerves supplying the upper abdomen. The brain interprets signals from the irritated esophagus as pain from the stomach region, even though the issue is higher up. Pain intensity can vary with the frequency and acidity of reflux episodes.
Accompanying Symptoms of GERD
GERD often presents with a range of symptoms beyond upper abdominal discomfort. A common symptom is heartburn, a burning sensation behind the breastbone, often occurring after eating or when lying down. Acid regurgitation is the sensation of stomach acid or bitter liquid rising into the throat or mouth.
Some individuals may experience non-cardiac chest pain, which can be mistaken for heart problems due to its location. Difficulty swallowing (dysphagia) might also occur, giving the sensation that food is sticking in the throat or chest. Chronic cough or hoarseness can develop as refluxed acid irritates the vocal cords and airways, causing persistent throat clearing or a raspy voice.
Other Causes of Upper Abdominal Pain
Upper abdominal pain can stem from various conditions beyond GERD. Gastritis, an inflammation of the stomach lining, causes a gnawing or burning pain in the upper abdomen, which may worsen or improve with eating. Peptic ulcers, open sores in the stomach or duodenum, can also manifest as a burning or aching pain, often relieved temporarily by food or antacids but returning later.
Gallstones can lead to sudden, intense pain in the upper right abdomen, sometimes occurring after fatty meals. This pain may radiate to the back or right shoulder. Pancreatitis, an inflammation of the pancreas, presents with severe upper abdominal pain that can radiate to the back, accompanied by nausea and vomiting. Irritable bowel syndrome (IBS) can cause generalized abdominal pain, bloating, and changes in bowel habits. Even cardiac issues, such as angina or a heart attack, can sometimes cause chest pain that radiates to the upper abdomen, requiring consideration of all possibilities.
When to See a Doctor
Consult a healthcare professional if upper abdominal pain is persistent, worsening, or significantly impacts daily life. Certain symptoms warrant immediate medical attention. These include severe, sudden pain, difficulty breathing, or pain radiating to the arm, jaw, or neck.
Other red flag symptoms include black, tarry stools, unexplained weight loss, persistent vomiting, or difficulty swallowing that progressively worsens. Seek medical advice if over-the-counter remedies provide no relief or if you are concerned about your symptoms. A doctor can accurately diagnose the cause of your pain and recommend appropriate treatment.