The term “epigastric” is an anatomical descriptor used in medicine to refer to a specific area of the human abdomen. The word itself is derived from the Greek prefix epi, meaning “upon” or “over,” and gaster, meaning “stomach.” Therefore, the epigastrium literally translates to the region “over the stomach.” This designation helps healthcare providers accurately communicate and localize symptoms, particularly pain or discomfort, to a specific anatomical zone.
Defining the Epigastric Region
The epigastric region is situated centrally in the upper abdomen, forming one of the nine standard abdominal regions used for clinical reference. To locate it externally, the area is directly below the point where the ribs meet, known as the xiphoid process of the sternum. This region extends downward to the level just above the umbilicus, or belly button.
The epigastrium is flanked on either side by the right and left hypochondriac regions, which sit beneath the lower rib cage. Anatomists use imaginary vertical and horizontal lines to define this space precisely, helping to correlate surface symptoms with underlying internal structures. Understanding this anatomical boundary allows for a focused medical assessment.
Key Organs Found in the Epigastrium
Beneath the surface of the epigastric region lie several organs that are fundamental to digestion and metabolism. The most prominent organ is the stomach, particularly its lower part, the pylorus, where food exits into the small intestine. Conditions affecting the stomach’s lining or function often manifest pain in this area.
The pancreas, a gland responsible for producing digestive enzymes and the hormone insulin, is positioned deep within the epigastrium. Additionally, the left lobe of the liver extends into this central area, performing its metabolic and filtering functions. The duodenum, the first segment of the small intestine, also begins its path within this upper region after leaving the stomach.
Common Reasons for Epigastric Discomfort
Discomfort in this central upper abdominal area is frequently associated with issues involving the digestive organs. One very common cause is gastroesophageal reflux disease (GERD), where stomach acid flows backward into the esophagus, causing a burning sensation often called heartburn. Gastritis, the inflammation of the stomach lining, also typically causes persistent pain or a dull ache directly in the epigastrium.
Peptic ulcers, open sores in the lining of the stomach (gastric ulcers) or the duodenum (duodenal ulcers), are another primary source of pain. The pain from these ulcers is often described as a gnawing or burning sensation that can be worse when the stomach is empty. Referred pain from issues like acute pancreatitis or gallbladder attacks can also be felt in this region.
In rare and serious cases, pain originating from the heart, such as during a myocardial infarction, can be “referred” to the epigastric area instead of the chest. This overlap in sensation makes persistent or severe epigastric pain a symptom that should always prompt a consultation with a healthcare provider. Any sudden, intense, or associated pain, especially with shortness of breath or radiating to the back, requires immediate medical attention.