What Causes Upper Abdominal Discomfort?

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Ask the Expert

I recently have had a endoscopy for pain by the right rib cage. The test revealed slight gastritis along with 5-10 mm polyps. Nothing was revealed that would cause pain, including no infection. Hiatal hernia was ruled out, but reflux was probable. I've had this pain for about a year, but cannot seem to find a doctor who will give me an answer to this. My pains sometimes goes to my neck and back, and the pain is aggravated by eating large meals. I am currently taking Pepcid (40mg) at night. It takes care of the heartburn, but not the actual pain itself. I have been to various doctors, but they have not been able to explain this pain. I was told that it could be esophageal spasms, but I don't know if these symptoms are characteristic of these spasms. I'm frustrated with the lack of a definite diagnosis. I do have irritable bowel syndrome - is this a possible link with this pain?

Doctor's response

A recent study in the American Journal of Gastroenterology has shown that many patients with IBS also have symptoms referable to the upper digestive tract. It may represent an abnormal sensitivity to normal stimuli or may be a manifestation of abnormal contraction (spasm) of the esophagus or abnormal emptying of the stomach. This can be evaluated with a study of stomach emptying and another for esophageal motility.

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Reviewed on 1/11/2018
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