7 Frequent Causes of Upper Abdomen Pressure & Shortness of Breath.
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1. Functional dyspepsia.
Functional dyspepsia is one of the commonest conditions affecting about 20% of people worldwide.
Functional dyspepsia (AKA indigestion) is a functional gastrointestinal disease that causes upper abdominal fullness, discomfort, or pressure. It also can cause mild shortness of breath after eating.
ONE or MORE of the following.
- Recurrent Sense of fullness or pressure in the upper abdomen after eating.
- Early satiety (inability to finish a regular-size meal).
- Recurrent upper abdominal pain, discomfort, or pressure.
- Recurrent burning sensation in the upper abdomen.
- Shortness of breath after eating: the shortness of breath is often mild and decreases when the stomach empties its contents.
Sudden severe shortness of breath is unlikely to be due to functional dyspepsia. However, consult your doctor if you suspect something serious such as a heart attack (acute coronary syndrome).
Dyspepsia is a term doctors use to describe indigestion or (difficult digestion of food).
The hardness, discomfort, and shortest of breath from functional dyspepsia are exacerbated by bad dietary habits such as:
- Eating large meals.
- High-fat foods.
- Spiced foods.
- Carbonated drinks.
- Fried food.
How it is diagnosed:
Functional dyspepsia is a (clinical diagnosis). No test or imaging technique can diagnose such a condition.
Your doctor is the only person who can establish the diagnosis based on:
- A set of symptom-based criteria (illustrated in the table below).
- Exclusion of conditions such as peptic ulcer disease and acid reflux (this may include performing endoscopy).
The ROME IV criteria is a symptom-based criterion used by doctors to diagnose functional dyspepsia.
Functional Dyspepsia ROME IV Criteria.
1. One or more of the following:
|a. Bothersome postprandial fullness|
|b. Bothersome early satiation|
|c. Bothersome epigastric pain|
|d. Bothersome epigastric burning|
|No evidence of structural disease (including at upper endoscopy) that is likely to explain the symptoms|
|* The above criteria must be fulfilled for the last three months|
* symptom onset at least six months before diagnosis.
Patients with functional dyspepsia frequently complain of shortness of breath and pressure in the upper abdomen after eating.
Please read our complete guide, Functional Dyspepsia 101: Causes, Symptoms, and Treatment.
- Avoid anxiety and psychological stress.
- Eat small meals
- Avoid trigger foods such as fat, species, fried foods, and carbonated drinks.
- Medications reduce stomach acids such as omeprazole, pantoprazole, dexlansoprazole, and famotidine.
- Medications that promote the motility of the stomach (prokinetic drugs).
- In resistant cases, your doctor may prescribe antidepressants or medications that relax the stomach fundus.
2. GERD and hiatal hernia.
GERD (gastroesophageal reflux disease) is a common disease affecting one in every five persons in western countries (reference).
Hiatal hernia is one of the causes of GERD. It occurs when a part of your stomach bulges into your chest through your diaphragm.
The acid reflux with GERD and hiatal hernia causes burning chest pain and may cause shortness of breath.
Symptoms of GERD and hiatal hernia include:
- Heartburn: burning sensation in the chest, particularly after eating.
- Regurgitation of food particles or sore fluid into your throat.
- The discomfort of pressure in the upper abdomen and the chest.
- Shortness of breath (either due to the reflux, hiatal hernia, or acid aspiration into the chest).
- Cough, wheezes in the chest (reflux asthma).
- Sore throat.
- Badmouth odor.
- Dental caries.
- Nausea and/or vomiting.
Diagnosis and treatment.
- GERD is suspected based on its characteristic features (heartburn and regurgitation of food or acid into the throat).
- Often, your doctor will confirm the diagnosis with endoscopy (especially if a hiatal hernia is suspected).
- GERD treatment needs an acid-reducing medication (such as omeprazole) for weeks.
- Avoid fatty, spicy, and fried foods.
- Head elevation during sleep.
- Losing weight.
Gastroparesis or (slow stomach) occurs when your stomach fails to move adequately. With gastroparesis, your stomach has difficulty emptying its contents.
As a result, food stays for several hours after eating, leading to stomach distension. Which, in turn, causes pressure in the upper abdomen and shortness of breath.
Common causes include:
- A long history of diabetes mellitus (diabetes causes damage to the nerves supplying the stomach).
- Certain medication.
- Injury to the vagus nerve during surgery to the esophagus or stomach.
- Viral infections of the stomach.
Symptoms of gastroparesis:
- Nausea is the most common symptom.
- Vomiting of undigested food.
- Abdominal pain or pressure in the upper abdomen.
- Early satiety.
- Fullness after meals or bloating.
- In severe cases, weight loss may occur.
- Shortness of breath also occurs after eating.
4. Gastritis or Peptic ulcer disease.
Gastritis is an inflammation of the lining of the stomach. In contrast, peptic ulcers are open sores in the stomach lining, duodenum, or both.
Both conditions are commonly caused by:
- Non-steroidal drug abuse such as ibuprofen, keotorolac.
- H. Pylori infection.
Gastritis and peptic ulcers cause symptoms similar to functional dyspepsia but often with a more severe form of pain.
People with chronic gastritis or peptic ulcer disease frequently complain of upper abdominal fullness or pressure and occasional shortness of breath after eating.
- Upper abdominal pain,
Stomach problems such as gastroparesis, chronic gastritis, peptic ulcers, and functional dyspepsia can cause shortness of breath without having a chest disease.
5. Irritable bowel syndrome.
IBS is another common and underdiagnosed condition of extreme bloating.
Irritable bowel syndrome is a functional disease characterized by abdominal pain. The abdominal pain is associated with changes in bowel habits or stool form (loose or hard stools).
Although bloating is not a clinical criterion for IBS diagnosis, IBS patients very commonly experience it. This is particularly common among female IBS sufferers (ref).
This study estimates that Bloating with IBS affects about 61.6% of IBS patients. In addition, the study found that it is more common in people with IBS-diarrhea.
Interestingly, Bloating after eating is associated with depression and catastrophic psychological events in IBS patients.
How to suspect IBS as a cause of Bloating:
According to the Rome foundation of functional gastrointestinal diseases (ROME IV criteria), IBS is diagnosed by:
- Abdominal pain or discomfort that occurred at least one day per week for the past three months:
- The onset of pain must be associated with 2 of 3 of the below:1- Associated with Defecation: bowel movements result in relief (or worsening) of the pain.2- Associated with a change in stool form: stool becomes looser or more hard.3- Associated with a change in stool frequency: AKA diarrhea or constipation.
6. Food intolerance.
Food intolerance is difficulty digesting certain foods (often due to a deficiency or absence of certain digestive enzymes). Food allergy is another condition in which your immune system may become allergic to certain foods.
The most common type is lactose intolerance (found in milk and dairy products).
Other common foods that trigger intolerance or allergy symptoms include:
- Fructose is found in most fruits, honey, and others.
- Artificial sweeteners such as aspartame.
- Amines intolerance.
- Caffeine intolerance.
Symptoms of food intolerance.
- Abdominal pain.
- Bloating and/or distension.
- Waves of nausea that come after eating the offending food.
- Food allergy causes the above symptoms plus allergic symptoms such as skin rashes, headaches, and swollen lips or face.
7. Gallbladder conditions.
Your gallbladder stores bile and secretes it to help digest and absorb fat and fat-soluble vitamins.
The most common gallbladder problem is the formation of stones (gallstones). Gallstones are the most common cause of gallbladder-related pain.
Gallstones may be entirely asymptomatic or cause mild non-specific symptoms such as fullness or pressure in the upper abdomen and even shortness of breath.
The symptoms of gallbladder stones often start after eating a high-fat meal; however, they may occur.
Mild attacks of biliary colics are
- Pain in the right upper abdomen and/or the epigastric area.
- The pain builds up gradually till it reaches maximum intensity after an hour or so. Then, it decreases gradually until it fades away.
- Intense nausea just before or during the pain is very common with biliary colics.
- The pain may spread to the back of the right shoulder.
- Vomiting may occur in severe cases with intense pain.
- Small intestinal bacterial overgrowth.
- Acute gastroenteritis and food-born illnesses.
- Esophageal motility disorders.
- Heart attack (acute coronary syndrome).
- Enlarged abdominal organs.
- Acute and chronic pancreatitis.
- Intraabdominal tumors or metastases.