Whether occasional or persistent, epigastric pain – localized in the stomach region – is a frequent reason for medical consultation. One in four people suffer from it, according to the University Hospitals of Geneva. The stomach is often the cause, but other organs located nearby are also likely to generate unpleasant symptoms: the esophagus, the pancreas, the gallbladder or the upper part of the intestine. Do not take these disorders lightly: although they are often benign (stomach cramp), abdominal pain sometimes reveals a severe illness.
Stomach pain: when it happens suddenly
“A pain unusual should lead to consultation, especially if it is accompanied by a change in general condition: fatigue, weight loss, difficulty eating or malaise.indicates Professor Francisca Joly, gastroenterologist at Beaujon hospital (Hauts-de-Seine).
Stomach pain: acute gastritis
Gastritis, this inflammation of the stomach lining, is indicated by soreness, a feeling of heaviness or burning behind the sternum, the bone to which the ribs are attached. It is sometimes caused by taking medications, particularly anti-inflammatories such as ibuprofen or aspirin. But the consumption of tobacco, alcohol or irritating foods (spices, vinegar, etc.) also weakens the stomach wall.
What to do ? Gastric dressings and alkaline foods (bananas, dairy products, etc.) calm the burns. If the pain does not disappear within a few days, the attending physician prescribes a fibroscopy. This examination consists of visualizing the inside of the stomach using a small camera attached to the end of a flexible tube that the gastroenterologist inserts through the mouth. A sample is often taken to determine the cause of the inflammation.
Stomach pain: hepatic colic
It is recognized by the sudden onset of intense pain in the pit of the stomach or right under the ribs, which can radiate to the shoulder. The harm comes from obstruction of the bile ducts by stones composed of cholesterol or bile pigments. Women are three times more affected than men, especially after the age of 60 because their gallbladder becomes sluggish.
What to do ? A quick consultation is required. The pain is controlled using analgesics and antispasmodics prescribed by the doctor. Even if the crisis has passed, an ultrasound remains essential to check the condition of the gallbladder and bile ducts. If the risk of recurrence seems significant, removal of the gallbladder is often suggested.
Stomach pain: pancreatitis
Inflammation of the pancreas, located just behind the stomach, causes ” a sharp pain at the top of the abdomen: a bar sensation that occurs suddenly and reaches its maximum within half an hour “, explains Professor Joly. In 90% of cases, it also radiates to the back. Vomiting is often associated, as well as a stoppage of intestinal transit. The torment eases in the gun dog position, but returns immediately after. Alcohol abuse or a blocked gallstone in the cystic duct are the cause of most pancreatitis.
What to do ? Acute pancreatitis requires going to the emergency room. The diagnosis is established using a blood test and medical imaging (ultrasound or scanner). To prevent the pancreas from deteriorating, it is often necessary to rest: stop eating for 2 or 3 days.
When this has been going on for several weeks: “Pain that persists or recurs regularly should be reported to the general practitioner and investigated. “, estimates Professor Francisca Joly.
Stomach pain: gastroesophageal reflux
Acid reflux from the stomach causes burning in the esophagus, hoarseness and sometimes a dry cough when going to bed. The causes are multiple: insufficient chewing, hiatal hernia (an anatomical anomaly causing part of the stomach to rise above the diaphragm), taking medications (corticosteroids, benzodiazepines, etc.)… The simple act of leaning forward can be enough to trigger symptoms.
What to do ? A drop of tarragon essential oil on a ball of bread after each meal provides effective relief. Alternatively try proton pump inhibitors (PPIs), tablets which stop the stomach from making too much acid. For prevention, limit alcohol, fatty meals and naps after eating. Wait at least 3 hours after dinner to go to bed.
Stomach pain: what if it was a peptic ulcer
Cramps above the navel relieved by eating food, but which return one to two hours later, are a sign of a peptic ulcer. This lesion of the digestive mucosa can result from frequent taking of aspirin or anti-inflammatory drugs. But in 70% of cases, a bacteria is responsible: Helicobacter pylori. Present in one in two people over the age of 50, it causes an ulcer one in ten. The infection must be treated to avoid perforation or the occurrence of stomach cancer.
What to do ? A blood test can detect the infection. Once confirmed by fibroscopy, antibiotic treatment eradicates it in 90% of cases.
Stomach pain: functional dyspepsia
Heaviness at the top of the stomach, accompanied by belching, nausea or epigastric pain just after a meal, indicates a dysfunction of the digestive system: hypersensitivity of the organs or poor contraction of the walls of the esophagus and stomach. When the doctor does not diagnose any organic lesion, we speak of functional dyspepsia.
What to do ? Changing your eating habits can help: limit large and fast meals, as well as fatty foods, coffee and alcohol. If problems persist, talk to your doctor.
Symptoms that should alert
Professor Francesca Joly, gastroenterologist at Beaujon hospital and co-author of Nourish our intestine well (ed. Marabout): “ Intense epigastric pain that occurs suddenly and quickly becomes unbearable should not be neglected. It can reveal intestinal ischemia, that is to say the obstruction by a blood clot of the main artery which irrigates the intestine. This is a medical emergency: too late diagnosis can be life-threatening. A abdominal pain which is accompanied by digested blood in the stools, black and pasty like tar, can signal the perforation of a ulcer gastric or rupture of a vessel in the wall of the esophagus. It’s an absolute emergency “.
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