I have gastric pain. What could it be?

Upper abdominal discomfort is sometimes referred to by patients as “gastric pain”. The medical term is dyspepsia, which means pain or discomfort centred in the upper abdomen.

There can be associated symptoms such as bloating, nausea and fullness after eating. These are very common symptoms and usually caused by disorders of the digestive tract.

Is it serious?

It depends on whether there are “alarm symptoms”. Severity is important. Dyspepsia is not generally excruciating. Severe abdominal pain is an alarm symptom, could be caused by very acute, sometimes emergency conditions such as inflammation of the gall bladder (acute cholecystitis), inflammation of the pancreas (pancreatitis) or perforation of the stomach or small intestine due to a very deep ulcer. Other alarm symptoms include persistent vomiting, loss of appetite or weight, vomiting blood or passing blood with stool or anaemia (low haemoglobin). Such symptoms might be due to cancer, so it is important to have these symptoms checked out.

What causes gastric pain / abdominal pain?

Upper abdominal discomfort is only sometimes associated with structural diseases. Half of the time, it is due to the way the digestive tract functions or behaves in response to food or other stimuli (functional problems).

In the other half of cases, it could be due to ulcers in the stomach or first part of the small intestine (duodenum), gallstone disease, oesophageal disease or more rarely, a cancer.

Should I see a specialist or a GP? 

Patients who are referred for specialist care are a selected group. In the community, General Practitioners would see a greater proportion of patients with functional problems. GPs would make an assessment of the patient and perhaps try some empirical therapy. If the symptoms recur, they might then refer the patient to a Gastroenterologist.

How would a Gastroenterologist diagnose my gastric pain?

In assessing a patient with dyspepsia, a Gastroenterologist would take a detailed history, as an analysis of the pattern of symptoms often give strong clues as to what could be the matter.

A physical examinat