Epigastric pain (dyspepsia, upper abdominal pain)
DDx
Don’t miss
- Pancreatitis
- Cholangitis
- Myocardial ischemia
- Pneumonia
- Abdominal hernia
- Pregnancy
- Intestinal ischemia
DDX
- Functional or nonulcer dyspepsia (most common)
- Peptic ulcer disease
- Gastroesophageal reflux
- Gastritis, eg, NSAIDs, alcohol, stress, H. pylori, pernicious anemia
- Pancreatitis or pancreatic cancer
- "Indigestion" from overeating, high-fat foods, coffee
- Other drugs: aspirin, antibiotics (eg, macrolides, metronidazole), corticosteroids, digoxin, narcotics, theophylline
- Gastroparesis
- Lactase deficiency
- Malabsorption
- Gastric cancer
- Parasitic infection, eg, Giardia, Strongyloides, Ascaris
- Cholelithiasis, choledocholithiasis, or cholangitis
- H. pylori (controversial)
- Myocardial ischemia or pericarditis
- Pneumonia
- Abdominal hernia
- Pregnancy
- Intestinal ischemia
- Esophageal rupture
- Gastric volvulus
- Physical or sexual abuse
See related DDx
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Citation
Zeiger, Roni F.. "Epigastric Pain (dyspepsia, Upper Abdominal Pain)." Diagnosaurus, 4th ed., McGraw-Hill Education, 2015. 5minute, www.unboundmedicine.com/5minute/view/Diagnosaurus/114440/all/Epigastric_pain__dyspepsia__upper_abdominal_pain_.
Zeiger RFR. Epigastric pain (dyspepsia, upper abdominal pain). Diagnosaurus. McGraw-Hill Education; 2015. https://www.unboundmedicine.com/5minute/view/Diagnosaurus/114440/all/Epigastric_pain__dyspepsia__upper_abdominal_pain_. Accessed May 21, 2022.
Zeiger, R. F. (2015). Epigastric pain (dyspepsia, upper abdominal pain). In Diagnosaurus (4th edition). McGraw-Hill Education. https://www.unboundmedicine.com/5minute/view/Diagnosaurus/114440/all/Epigastric_pain__dyspepsia__upper_abdominal_pain_
Zeiger RFR. Epigastric Pain (dyspepsia, Upper Abdominal Pain) [Internet]. In: Diagnosaurus. McGraw-Hill Education; 2015. [cited 2022 May 21]. Available from: https://www.unboundmedicine.com/5minute/view/Diagnosaurus/114440/all/Epigastric_pain__dyspepsia__upper_abdominal_pain_.
* Article titles in AMA citation format should be in sentence-case
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PB - McGraw-Hill Education
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