Epigastric pain: Quick guide to causes and relief

Epigastric pain is a sharp or dull ache high in your belly, right under the ribs. People feel it as burning, pressure, or a cramp between the breastbone and belly button. It can last minutes, hours, or come and go for days. Knowing the common causes helps you decide what to do next.

Most often epigastric pain comes from indigestion, acid reflux, or gastritis. Eating spicy or fatty food, drinking alcohol, or taking NSAIDs like ibuprofen can trigger it. A peptic ulcer or gallbladder problem can also cause a similar ache. Rarely, pain in this area is a sign of a heart attack — especially if it comes with sweating, shortness of breath, or pain spreading to the jaw or arm.

Simple checks at home

First, note what makes the pain better or worse. Does food help or hurt? Does antacid relieve it? Track how long each episode lasts and any other symptoms: nausea, vomiting, fever, or yellow skin. Try a bland diet, avoid caffeine and alcohol, and use over-the-counter antacids for a short time. Rest and avoid heavy lifting until you know what's causing it.

When to see a doctor

Seek immediate help if you have severe, sudden pain, fainting, trouble breathing, bloody vomit, or black stools. Call for urgent care when pain is steady and worsening, or if you have known heart disease. Make a regular appointment if pain is mild but persistent, happens after meals, or keeps you from sleeping. Your doctor may order blood tests, an abdominal ultrasound, or an endoscopy to look for ulcers or inflammation.

Treatment depends on the cause. For acid reflux and gastritis, doctors often recommend proton-pump inhibitors or H2 blockers, dietary changes, and avoiding NSAIDs. If a peptic ulcer is linked to H. pylori bacteria, a short antibiotic course plus acid control usually clears it. Gallbladder issues sometimes need surgery, while pancreatitis needs hospital care and fluids.

Common tests include blood work to check for infection or liver issues, an ultrasound to view the gallbladder and pancreas, and an endoscopy to inspect the stomach lining. An H. pylori breath or stool test looks for the bacteria that cause ulcers. Results usually come within days for blood and breath tests, while endoscopy results are immediate for visible damage and take a few days for biopsies. Ask your doctor what each test checks so you understand the next steps. If treatment starts, follow the full medicine course and return if symptoms come back or worsen.

Practical tips: eat smaller meals, avoid late-night eating, reduce spicy and fatty foods, stop smoking, and limit alcohol. Keep a food and symptom diary for a week to help your doctor spot triggers. If you take NSAIDs frequently, ask about safer alternatives or protective medication.

Most mild epigastric pain improves with lifestyle changes and simple medicines. But never ignore severe or unusual symptoms. Quick action can prevent complications and get you back to normal faster. Keep emergency numbers handy and call for help if pain becomes severe quickly.