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    Epigastric Pain PDF

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    MAHIN

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    Epigastric Pain PDF

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    MAHIN
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    epigastric pain.pdf

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    314 views2 pages

    Epigastric Pain PDF

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    MAHIN

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    © All Rights Reserved
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    Page 1 of 2

    View this article online at: patient.info/doctor/epigastric-pain

    Epigastric Pain
    The epigastrium is the area of central abdomen lying below the sternum and above the umbilicus.

    Aetiology
    Irritable bowel syndrome - by definition the pain has been present for at least six months and is associated with
    bloating and alteration in stool frequency or consistency. Examination is usually normal or there may be mild
    tenderness/distension.
    Peptic ulcer - acute or chronic gnawing or burning pain. This may be improved by food if a duodenal ulcer, and
    worsened if a gastric ulcer. Typically the pain is worse at night.
    Pancreatitis - acute pain which radiates to the back. It is usually accompanied by vomiting. The pain may be
    relieved by sitting forward. Signs vary, but include jaundice, tachycardia, abdominal rigidity, tenderness, and
    discolouration around the umbilicus or flanks.
    Peritonitis - acute pain with signs of shock and tenderness (possibly rebound). This may be exacerbated by
    coughing. The abdomen may feel 'rigid'.
    Pre-eclampsia - epigastric pain is very significant, especially if severe or associated with vomiting.
    Gastrointestinal obstruction - acute colicky pain. Vomiting brings relief. Accompanied by distension and 'tinkling
    bowel sounds'.
    Gallbladder disease - acute constant pain with vomiting, fever, local tenderness and rigidity. It may be possible to
    palpate a gallbladder mass.
    Ruptured aortic aneurysm - acute pain which radiates to the back or groin. The patient may be in cardiovascular
    collapse. A mass is felt swelling and contracting with the pulse.
    Gastric carcinoma - be suspicious in male patients who are over 55 years old and who smoke. Advanced cases
    may also have weight loss, vomiting, palpable mass/nodes, hepatomegaly, vomiting and dysphagia.
    Referred pain - this may be from the heart in myocardial infarction; also from pleural disease or spinal nerves.

    NB: epigastric pain may also be of psychosomatic origin.

    Further reading & references


    Khoury G et al; Emergent Management of Pancreatitis, Medscape, Jun 2011
    Anand BS et al, Peptic Ulcer Disease, Medscape, Jun 2011
    Irritable bowel syndrome, Prodigy (August 2008)

    Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical
    conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its
    accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.
    For details see our conditions.

    Page 2 of 2
    Original Author:
    Dr Hayley Willacy

    Current Version:
    Dr Hayley Willacy

    Peer Reviewer:
    Dr Colin Tidy

    Document ID:
    2105 (v22)

    Last Checked:
    25/01/2013

    Next Review:
    24/01/2018

    View this article online at: patient.info/doctor/epigastric-pain


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