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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Pain And Pressure Around The Upper Abdomen?

I am having severe pain around my middle top section and runs around my sides (some times it will be the left side and then next time it might be the right side). It sometime starts with a burning but not always, I have a lot of pressure and all I want to do is try to move around to get comfortable then it radiates to my back . This has been going on for a couple of days sporadically. However, it starts usually around 1:30 - 2:00 am and last until around 5:30. Once the pain hits it will last sometimes a couple of hours and then it just goes away.
Mon, 29 Apr 2019
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Internal Medicine Specialist,  's  Response
Hello,

Early morning pain (sometimes burning in character) in epigastric region(middle top as you said) with radiation to both hypochondriac region could be due to peptic ulcer pain(present in both duodeal ulcer / DU and gastric ulcer/GU.and radiation to back might be due to penetration to posterior wall.Pain that awakes the patient from sleep (between midnight and 3 a.m.) is the most discriminating symptom, with two-thirds of DU patients describing this complaint. However this symptom is also present in one-third of patients with NUD (Non-ulcer dyspepsia).

Go for USG (Ultrasonograaphy abdomen ) to rule out any gall bladder (gall stone) or panreatic pathology (chronic pancreatitis)and upper Gastro-intestinal endoscopy. Meanwhile antacid like PPI (Proton Pump Inhibitor e.g. Pantoprazole) orally before food can be started.

Hope I have answered your query. Let me know if I can assist you further.

Thank you.

Regards,
Dr. Tushar Kanti Biswas
Internal Medicine Specialist
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What Causes Pain And Pressure Around The Upper Abdomen?

Hello, Early morning pain (sometimes burning in character) in epigastric region(middle top as you said) with radiation to both hypochondriac region could be due to peptic ulcer pain(present in both duodeal ulcer / DU and gastric ulcer/GU.and radiation to back might be due to penetration to posterior wall.Pain that awakes the patient from sleep (between midnight and 3 a.m.) is the most discriminating symptom, with two-thirds of DU patients describing this complaint. However this symptom is also present in one-third of patients with NUD (Non-ulcer dyspepsia). Go for USG (Ultrasonograaphy abdomen ) to rule out any gall bladder (gall stone) or panreatic pathology (chronic pancreatitis)and upper Gastro-intestinal endoscopy. Meanwhile antacid like PPI (Proton Pump Inhibitor e.g. Pantoprazole) orally before food can be started. Hope I have answered your query. Let me know if I can assist you further. Thank you. Regards, Dr. Tushar Kanti Biswas Internal Medicine Specialist