Upper Abdomen Pain: 17 Causes

Upper abdomen pain is one of those symptoms that can be totally harmless (hello, leftover pizza at midnight)
or a big neon sign that says “please don’t Google this at 2 a.m.go get checked out.” The tricky part?
Your upper belly is prime real estate for multiple organs, shared nerves and referred pain from places that
aren’t even in your abdomen. So “upper stomach pain” can feel vague, dramatic, or annoyingly on-and-off.

This guide breaks down 17 common causes of upper abdominal pain in plain American English,
with practical clues about where it hurts (right, left, middle), what symptoms often tag along, and
when it’s time to call a clinician instead of calling it “just indigestion.”

Where exactly is “upper abdomen”?

Picture your abdomen like a 3-part balcony under your ribs:
upper right, upper middle (epigastric), and upper left.
The location can offer hints about which organ is complaining.

Upper right (RUQ) often involves:

• Liver and bile ducts
• Gallbladder
• Part of the pancreas

Upper middle (epigastric) often involves:

• Stomach and duodenum (the first part of the small intestine)
• Pancreas
• Esophagus (reflux can feel “upper belly”)

Upper left (LUQ) often involves:

• Stomach
• Spleen
• Pancreas (tail end)
• Sometimes kidney/ureter pain wrapping around from the back

When upper abdomen pain is an emergency

Some conditions can masquerade as a “stomach problem” but aren’t. If any of these show up, don’t tough it out:
get urgent care (or call emergency services).

• Chest pressure, shortness of breath, sweating, or nausea (possible heart-related pain)
• Sudden, severe “ripping/tearing” belly or back pain (possible aortic emergency)
• Fainting, confusion, severe weakness, or very low blood pressure symptoms
• Vomiting blood or black, tarry stools
• High fever, shaking chills, or worsening pain with a stiff/rigid abdomen
• Yellowing of skin/eyes (jaundice) with pain and fever
• Severe upper-left pain after an injury (possible spleen injury)

Upper Abdomen Pain: 17 Causes (with telltale clues)

Below are 17 causes that show up frequently in real clinics. Several overlap (because the human body loves
teamworkespecially when causing confusion), but the patterns can still be useful.

1. Indigestion (dyspepsia)

   Think of indigestion as your stomach’s way of filing a complaint after a heavy meal, alcohol, stress,
   or eating too fast. It often feels like burning or discomfort in the upper middle abdomen,
   plus fullness, burping, or nausea.

   • Clues: discomfort after eating; bloating; belching; no fever
   • Often helps: smaller meals, avoiding trigger foods, antacids (short-term)

2. Gas, bloating, or constipation

   Gas can stretch your intestines like an overfilled balloon animal. Constipation can also create pressure
   that you feel higher up than you’d expect. Pain may be crampy, move around, and improve
   after passing gas or having a bowel movement.

   • Clues: pressure-like pain, bloating, fewer bowel movements, relief after passing stool/gas
   • Often helps: fluids, fiber, gentle movement, and (sometimes) an OTC stool softener

3. GERD (acid reflux)

   GERD happens when stomach acid flows upward and irritates the esophagus. It’s famous for heartburn, but it
   can also feel like upper belly pain, especially after meals or when lying down.

   • Clues: burning chest/upper belly; sour taste; worse when lying down
   • Often helps: avoiding late meals, elevating head of bed, acid reducers (as directed)

4. Hiatal hernia

   A hiatal hernia is when part of the stomach pushes up through the diaphragm. It can go unnoticed or act like
   reflux on steroids: heartburn, regurgitation, and sometimes upper abdominal or chest discomfort.

   • Clues: reflux symptoms + upper belly/chest discomfort; worse after large meals
   • Often helps: reflux-friendly habits; medical treatment if symptoms persist

5. Gastritis (stomach lining inflammation)

   Gastritis is inflammation of the stomach lining. It can cause a gnawing or burning pain
   in the upper middle abdomen, sometimes better or worse with food. Common triggers include NSAIDs
   (like ibuprofen), alcohol, infection, and severe stress on the body.

   • Clues: burning/gnawing epigastric pain, nausea, upper fullness
   • Watch for: vomiting blood or black stools (possible bleeding)

6. Peptic ulcer disease (stomach or duodenal ulcer)

   An ulcer is an open sore in the stomach or duodenum. Pain is often described as burning
   and may come and go. It might wake you at night or flare when the stomach is empty. Major culprits include
   H. pylori infection and chronic NSAID use.

   • Clues: burning epigastric pain; nausea; symptoms that cycle
   • Red flags: black/tarry stool, vomiting blood, dizziness

7. Functional dyspepsia (the “tests look normal” stomachache)

   Functional dyspepsia can feel like indigestion that overstays its welcome: upper stomach burning,
   early fullness, and discomfort after meals. The key feature is that standard testing doesn’t reveal
   a structural problemyet the symptoms are very real.

   • Clues: epigastric pain/burning + early satiety; symptoms persist for weeks/months
   • Often helps: targeted diet changes, stress management, clinician-guided treatment

8. Gallstones (biliary colic)

   Gallstones are like tiny rocks that can block bile flow and trigger intense pain. Classic gallstone pain is
   right upper abdomen (sometimes center upper abdomen), often after a heavy or fatty meal,
   and can radiate to the back or right shoulder.

   • Clues: RUQ pain after meals; episodes that build to a peak then ease
   • Next steps: medical evaluationultrasound is commonly used

9. Cholecystitis (inflamed gallbladder)

   If gallstones are the party crashers, cholecystitis is when the party becomes an emergency. Pain is typically
   severe in the upper right or upper center, often with nausea, vomiting, fever, and tenderness.
   It commonly follows eating and doesn’t politely go away on its own.

   • Clues: RUQ pain + fever and persistent tenderness
   • Act fast: needs prompt medical care

10. Pancreatitis

    Pancreatitis is inflammation of the pancreas and often causes upper abdominal pain that can spread to the back.
    It may worsen after eating and come with nausea, vomiting, fever, or a fast heartbeat. Causes include gallstones,
    heavy alcohol use, certain medications, and other conditions.

    • Clues: upper belly pain radiating to back; significant nausea/vomiting
    • Urgency: can be seriousseek care for severe or worsening pain

11. Hepatitis (liver inflammation)

    Hepatitis can be viral, toxic, medication-related, or alcohol-related. Liver-related pain is often felt in the
    upper right abdomen. Jaundice (yellow skin/eyes), dark urine, or pale stools can appear,
    along with fatigue and nausea.

    • Clues: RUQ discomfort + jaundice, dark urine, fatigue
    • Don’t guess: needs lab testing and clinician evaluation

12. Bile duct blockage or infection (choledocholithiasis / cholangitis)

    Sometimes a stone slips into the common bile duct, blocking bile drainage. This can cause severe pain and jaundice,
    and if infection develops, fever and chills can join the chaos. This is not a “wait and see” situation.

    • Clues: RUQ/epigastric pain + jaundice; fever suggests infection
    • Urgency: prompt evaluation is important

13. Kidney stones (pain that wraps around)

    Kidney stone pain is usually intense, sharp, and can start in the back or side below the ribsthen wrap around
    toward the front. Some people feel it as upper abdominal pain, especially if it’s higher in the urinary tract.
    Nausea and urinary symptoms may tag along.

    • Clues: waves of severe pain; blood in urine; urinary burning/urgency
    • Tip: fever with urinary symptoms = urgent evaluation

14. Kidney infection (pyelonephritis)

    A kidney infection can cause pain in the flank or back and sometimes a wrapping pain that feels abdominal.
    It often comes with fever, chills, and urinary symptoms. Unlike “basic” indigestion,
    this one tends to make people feel genuinely unwell.

    • Clues: fever/chills, back or side pain, urinary burning or frequency
    • Urgency: needs medical treatment

15. Pneumonia or other chest infection (referred pain)

    Yes, lungs can cause belly pain. Lower-lobe pneumonia can irritate the diaphragm and create pain that lands in the
    upper abdomen. If you also have cough, fever, shortness of breath, or chest discomfort, consider that
    your “stomachache” might actually be your lungs.

    • Clues: cough + fever + breathing symptoms with upper abdominal discomfort
    • Next steps: medical evaluation; may require chest imaging

16. Heart attack or angina (yes, sometimes it feels like indigestion)

    Heart-related pain can be referred to the upper abdomen and feel like pressure, discomfort, nausea,
    or “bad heartburn.” This is especially important if symptoms occur with exertion or are paired with
    sweating, shortness of breath, or pain radiating to the jaw/arm/back.

    • Clues: upper belly discomfort + shortness of breath, sweating, chest pressure
    • Urgency: treat as emergency if suspected

17. Abdominal aortic aneurysm (AAA)

    An AAA is a bulge in the aorta (major artery) in the abdomen. Many people have no symptoms until it becomes large
    or ruptures. A rupture can cause sudden, severe belly or back pain and signs of shock.
    This is a medical emergency.

    • Clues: sudden severe belly/back pain; dizziness; low blood pressure symptoms
    • Urgency: emergency care immediately

18. Enlarged spleen (splenomegaly)

    An enlarged spleen can cause pain or fullness in the upper left abdomen and sometimes a feeling of
    fullness after eating a small amount (because it presses on the stomach). Causes vary widely, including infections
    and liver disease.

    • Clues: LUQ fullness/pain; early fullness with meals
    • Next steps: medical evaluation to identify the cause

19. Shingles (herpes zoster)

    Shingles can start with pain, tingling, or burning in a strip-like areaoften before the rash appears.
    If the affected nerves run around the upper abdomen or ribcage, it can feel like deep internal pain at first.
    A few days later, the rash typically shows up on one side.

    • Clues: burning/tingling pain on one side; rash appears later
    • Tip: early treatment can helpsee a clinician promptly

How clinicians narrow down the cause

Upper abdominal pain is a detective story, not a single test. Clinicians usually start with pattern-matching:
location, timing, triggers, and “extra” symptoms. They may ask:

• Where is the pain exactlyright, left, or middle?
• Is it burning, sharp, crampy, or pressure-like?
• Does it occur after meals, with fatty foods, or when lying down?
• Any fever, vomiting, jaundice, chest symptoms, or urinary changes?
• Any recent injury, new medication (especially NSAIDs), or alcohol binge?

Common tests (depending on your symptoms)

• Blood tests (infection, liver enzymes, pancreatic enzymes, anemia)
• Urinalysis (UTI or kidney stone clues)
• Ultrasound (often used first for right upper quadrant pain and gallbladder issues)
• CT scan (helpful for many abdominal causes, including stones and serious emergencies)
• EKG and heart tests if symptoms could be cardiac
• Endoscopy when ulcers, gastritis, or ongoing reflux symptoms need a closer look

What you can try at home (only when it’s mild and you’re otherwise well)

If symptoms are mild, you’re not having red flags, and this feels like a familiar “I overdid it” episode,
these are reasonable first steps:

• Try smaller, bland meals for 24–48 hours (think: toast, rice, bananas, soup)
• Hydrate, especially if nausea is present
• Avoid alcohol while symptoms persist
• Skip NSAIDs (like ibuprofen) if you suspect gastritis/ulcers; they can irritate the stomach
• For reflux: avoid late meals, elevate your head at night, limit trigger foods
• For gas/constipation: gentle walking, fiber (if tolerated), and fluids

If the pain lasts more than a few days, keeps returning, or starts changing character (more severe, more frequent,
or paired with new symptoms), it’s time to get medical advice.

of real-world experiences people commonly report

Let’s talk about what upper abdomen pain feels like in everyday lifebecause symptom descriptions are often
more relatable than organ charts. These examples aren’t diagnoses, but they mirror common patterns clinicians hear.

1) “It’s a burning ache right in the middlelike my stomach is cranky.”

People often describe epigastric pain as a slow burn, especially after coffee, spicy food, alcohol, or stress.
Some say it feels better with a small snack; others say food makes it worse. This is a classic storytelling style
for gastritis, reflux, or ulcersespecially if nausea joins the party. A common twist: folks try to “power through”
with ibuprofen, which may temporarily dull pain but can irritate the stomach lining and make things worse later.

2) “I get a tight, stabbing pain under my right ribs after greasy food.”

This is the gallbladder’s greatest hit. People report an episode building over 15–60 minutes, then lingering for
hours. The pain may radiate to the right shoulder blade like an uninvited back massage. Many notice the pattern:
burgers, fried food, or a heavy meal = predictable regret. Some describe sweating or nausea during attacks.
If fever appears or the pain becomes constant and severe, that’s often when clinicians worry about inflammation
or infection rather than a simple blocked-then-unblocked duct.

3) “It’s a deep pain that goes straight through to my back.”

When pain seems to drill from the upper belly through to the back, clinicians get more cautious. People may curl up,
feel intensely nauseated, or find eating makes symptoms worse. It’s one of the reasons pancreatitis is taken seriously:
the discomfort can be dramatic and persistent. Even if you’re not sure what it is, the “back radiation” detail is
worth mentioning to a healthcare professional.

4) “It comes in waves, and I can’t get comfortable.”

Wave-like, peak-and-fade pain is how many people describe kidney stones. They may pace, shift positions, or feel
restless because lying still doesn’t help. Nausea is common, and urinary symptoms sometimes appear laterburning,
urgency, or blood in urine. People are often surprised that a stone can feel like upper abdominal pain when it sits
higher in the urinary system or the pain wraps around the torso.

5) “This feels like indigestion…but different. I’m sweaty and short of breath.”

This is the scenario nobody should ignore. Some people assume they ate something “off,” especially if nausea is the
main symptom. But when upper belly discomfort shows up with sweating, unusual fatigue, shortness of breath, chest
pressure, or pain radiating to the jaw/arm/back, clinicians think beyond digestion. The experience can be subtle
enough that people delay careso it’s worth repeating: if something feels wrong in a new or alarming way, get checked.

Conclusion

Upper abdominal pain is common, but it isn’t always simple. Many causes are manageable (reflux, indigestion, gas),
while others deserve urgent attention (heart attack symptoms, pancreatitis, gallbladder infection, aortic emergencies).
Your best “next step” is guided by pattern: where it hurts, when it happens,
what triggers it, and which extra symptoms show up.

If you’re unsureor the pain is severe, persistent, or paired with red flagschoose safety and get evaluated.
Bodies rarely send push notifications. Upper abdomen pain is sometimes the closest thing they have to one.