Question on Epigastric Pain

I always get an epigastric pain and body temperature elevated after taking fruits like a durian and rambutans...why this conditions occur?
(January 4, 2011)

What is epigastric pain?

The epigastrium is the region in central abdominal area, which lies just below the sternum. It is also situated just above the umbilicus. Hence, an ached felt in the upper middle region of the abdomen is referred to as epigastric pain. In most cases, the pain felt in the epigastric region is dull. At times, a person could experience severe epigastrium pain, due to different factors.

What are the causes of epigastric pain?

There are many conditions that could lead to intense pain in the epigastric region. There are different epigastric pain symptoms that are associated with each different condition. Given below are some of the most common epigastric pain causes:

Peritonitis

This is a fungal or a bacterial infection that affects the peritoneum, which is a silk-like membrane, lining the inner abdominal wall covering the organs in the abdomen. Peritonitis calls for immediate medical attention, as it could lead to severe and life-threatening infections in the body. The signs and symptoms that are associated with this condition are epigastric region pain, fever, vomiting, nausea, appetite loss, increased thirst, fatigue and difficulty in passing urine. The treatment of this condition generally includes the use of antibiotics and other medication prescribed by doctors.

Peptic Ulcers

These ulcers can be described as open sores on the inner lining of the esophagus, stomach and the small intestines. Some of the most common causes of peptic ulcers and the subsequent sharp epigastric pain could include smoking, the use of pain relievers on a regular basis, the consumption of alcohol and stress. In order to treat peptic ulcers, there are several dietary and lifestyle changes that need to be made. Moreover, at times medications like antibiotics, acid blockers, antacids, proton pump inhibitors and cyto-protective agents may be required to kill the bacteria that lead to an infection. At times, peptic ulcers may not heal properly even after the use of medication. In such cases doctors may need to prescribe a more aggressive drug treatment or even a surgery, so that the ulcers can heal.

Abdominal Aortic Aneurysm

When a person suffers from this problem, the permanent aortic localized dilation is around 1.5 times the normal diameter. This condition usually affects the aorta that is between the iliac and renal arteries. Abdominal aortic aneurysm is generally characterized by epigastric pain radiating to back. The risks of suffering from this condition could increase with age, especially in men. There are certain ways in which this condition can be treated, which include open abdominal surgery or endovascular surgery. However, minor cases of this condition may not require any treatment.

Irritable bowel syndrome

This is a very common disorder, affecting the large intestines in several people. This condition can trigger off some painful and uncomfortable symptoms. However, irritable bowel syndrome is not likely to cause any major or long term damage to the intestines. This condition is generally marked by symptoms like mucus in the stool, flatulence, constipation or diarrhea, left epigastric pain or bloating in the abdominal region. Treatment for this condition is not very specific, mainly because the exact causes of irritable bowel syndrome are not yet clear. Apart from incorporated healthy dietary changes that have been recommended by a health expert, doctors may also suggest using fiber supplements, anti diarrhea medication, anticholinergic medicines, antibiotics, antidepressants,

Pancreatitis

An inflammation in the pancreas can be referred to as pancreatitis. People can either suffer from acute pancreatitis or chronic pancreatitis. There are many people who do not get this condition treated, as it can go away on its own. Some of the common symptoms that are associated with acute pancreatitis are nausea, tenderness, vomiting and epigastric pain radiating to back. The symptoms of chronic pancreatitis include indigestion, weight loss for no apparent reason and severe epigastric pain. In case people do need to get this condition treated then, hospitalization is required, at least until the inflammation is controlled. The methods used for treating this problem include pain relievers, IV fluids and surgery.

Chronic Cholecystitis

Cholecystitis is a medical condition, which can be described as an inflammation in the gallbladder. This is usually caused by gallstones, which block the tube that goes out of the gallbladder. Any trauma, infection, injuries and tumors in the gallbladder can also have a similar effect. One of the first symptoms of chronic cholecystitis is epigastric pain that originates in the right side. Gradually the epigastric pain may move towards to back or the shoulder. Some of the other symptoms of this condition include sweating, chills, nausea, loss of appetite, vomiting and fever. The treatment of this condition generally requires hospitalization, where the inflammation is first controlled with the help of antibiotics and pain relievers. In order to keep the symptoms from recurring, the gallbladder may need to be removed too.

Gallstones

At times, the digestive fluid in the human body gathers in the gallbladder and forms hardened deposits, which are referred to, as gallstones. These stones can vary in size, some of them being as small as a grain of sand, while a few may even be as big as a golf ball. It is possible for a person to develop more than one gallstone at a time. The presence of a gallstone on its own may not necessarily lead to any signs and symptoms; however, in case a gallstone causes an obstruction in a duct, the symptoms that could be seen are sudden and rapid abdominal pain, back pain that extends to the shoulder blades and right shoulder ache. In case symptoms like yellowing of the skin, chills, high fever and intense abdominal pain, are evident, then emergency medical care should be sought. The most common ways of treating this condition involve medication to dissolve gallstones or surgery.

Epigastric pain can be the indication of quite a serious problem, which is why it should never be ignored. It is important for people of all ages to get any instance of epigastric pain investigated by a medical health care provider, as early as possible, even if the pain is dull and not too intense.

The upper central region of the abdomen or the epigastrium consists, for the most part, of organs such as the stomach, a small portion of the duodenum (small intestine), the lower end of the esophagus, and part of the left liver. Apart from skin, muscles, and bones that hold the upper abdominal structure, many blood vessels and the aorta also pass through this region.

Causes of epigastric pain may arise due to a problem in any of the above organs. Although organs like the heart or the gall bladder may not be part of the epigastrium, any pain in these organs may transmit to this region and relay as an epigastric pain. Thus, epigastric pain is any pain in the upper central abdomen, starting right below your breastbones, encapsulating the rib cage up to the belly button or umbilicus. In some cases, epigastric pain radiating to the back could also signify a number of causes such as gastritis, hepatitis, ulcerative colitis, and so on. Doctors often call this referred pain, as the pain may be prevalent in a specific organ; however, epigastric pain causes an overall ache in the abdomen reaching all the way to the back and spine.

Causes of epigastric pain. Individuals suffering from poor digestion or indigestion may suffer from epigastric pain. Epigastric pain due to indigestion may cause a feeling of discomfort, nausea, belching, and flatulence. Excessive or trapped flatulence can also cause epigastric pain radiating to the back. Your doctor may recommend antacid or digestive pills for indigestion resulting from a particularly heavy or rich meal. Persistent pain in the stomach or symptoms of indigestion may need medical attention. A heart attack might sometimes cause an epigastric pain that resembles indigestion.

The lower end of the esophagus forms part of the epigastrium. In the case of individuals suffering from acid reflux, the stomach acids reflux into the lower esophagus causing heartburn. Although acid reflux causes a burning sensation in the chest, it may sometimes resemble an epigastric pain transmitted all the way to the upper central abdomen.  Acid reflux is a common problem and can be treated with mild antacids or prescription medicine. However, if the burning sensation persists, you may want to consult a doctor for further diagnosis.

Another common epigastric pain cause is gastritis. Simply put, it is an inflammation or erosion of the stomach lining. The pain can range from mild to chronic and may start out as a dull pain before increasing to sharp, jabbing pains all over. Alcohol, smoking, excessive consumption of hot foods, stomach infections, and even stress can cause gastritis. Certain medications may also cause gastritis as a side effect. Left untreated, moderate symptoms of gastritis may develop into stomach ulcers, stomach bleeds, and other chronic stomach conditions.

Since a part of the duodenum extends to the upper central abdomen, any ulcers or fissures in this region may also be a cause of epigastric pains. Many of the symptoms of pancreatitis are also similar to those of gastritis. The sharp epigastric pain radiating to back and spine may reveal pancreatitis, an inflammation of the pancreas, and you must seek immediate medical attention.

Usually gall stones and kidney stones may cause pain the lower abdominal region. However, if you have suffered from these in the past or have a hereditary tendency towards them, any sudden epigastric pain must be diagnosed for gallstones or kidney stones. Epigastric pain may also signify hernia. If you suffer from epigastric pain accompanied by vomiting, you may want to consult your doctor for any symptoms of hernia.

Heart aneurysms may result in sharp epigastric pain. Individuals suffering from high blood pressure must watch out for any epigastric pains that may result in a ruptured aorta. Angina and heart attack may also cause epigastric pain that may go undetected as they cause discomfort in the abdomen and not in the chest region. Any epigastric pain that does not respond to medications and is persistent or worsens must secure immediate medical attention.

Epigastric pains may also be the first sign of appendicitis, although the pain quickly spreads to the lower abdominal region. Certain stomach cancers or tumors are causes of epigastric pain.