Upper Middle Stomach Pain after Eating: 5 Causes, Gastroenterologist Explains.

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Often, upper stomach pain after eating arises from your stomach. Chronic gastritis, peptic ulcer disease, and functional dyspepsia are the most common causes of such pain.

Summary of the causes of upper-middle stomach pain after eating:

Gastritis and peptic ulcer disease.
Functional dyspepsia.
Gallbladder diseases.
Pancreatic diseases, especially chronic pancreatitis.
GERD and hiatal hernia.
Other less frequent causes such as gastric cancer, liver diseases, and others.

1- Gastritis or peptic ulcer disease.

Gastritis is the inflammation of the lining of your stomach. Peptic ulcer disease is a result of gastritis. The development of an ulcer in your stomach or duodenum is called peptic ulcer disease (PUD).

Gastritis and PUD are very common. Around 50% of people suffer from gastritis at some point in their life (reference).

Acute and chronic gastritis is the most common cause of upper-middle stomach pain after eating.

Cause:

Drug-induced gastritis and PUD: most commonly, Non-steroidal antiinflammatory drugs as ibuprofen and diclofenac.
H. Pylori infection.
Food: spicy foods, caffeine, alcoholo, fats, and acidic foods.
Less frequent causes of gastritis include immune-mediated gastritis, bile reflux, iron supplements, Crohn’s disease, and autoimmune diseases.

Symptoms:

Pain in the epigastric area (upper middle part of your abdomen).
The pain is burning, aching, or gnawing in nature.
With chronic gastritis and stomach ulcers, the pain starts shortly after eating.
With duodenal ulcers, the pain is relieved by eating!
Nausea, sometimes vomiting after eating.
Fullness in the upper middle part of your stomach.
Chronic gastritis usually follows an intermittent course with the recurrence of symptoms for months and years.
With peptic ulcer disease, the symptoms are the same but more extreme.
PUD can cause vomiting of blood (hematemesis) or passage of dark blackish stool (melena) when it bleeds.

MORE: 5 Duodenal Ulcer Pain Locations and mimics.

2- Functional dyspepsia.

Functional dyspepsia is another widespread condition. Also, it is a common cause of upper-middle abdominal pain.

Functional dyspepsia affects up to 5-11% of people without apparent cause (reference).

Symptoms and differences from gastritis (reference):

Upper middle abdominal pain after eating.
Early satiety soon after you start eating.
A sense of fullness in the upper-middle part of your abdomen after eating.
Epigastric (upper-middle abdomen) burning.
Bloating after eating.
Excessive bleching.
Nausea can also be present.

The above symptoms are non-specific and can occur with chronic gastritis. The differentiation without the help of your doctor is impossible.

The differences between functional dyspepsia and gastritis are:

The pain is less severe (usually in the form of discomfort).
The sense of fullness and bloating after eating.
Your doctor has to exclude gastritis by performing an endoscopy exam of your stomach and duodenum.

MORE: Functional Dyspepsia 101: Causes, Symptoms, and Treatment.

3- Gallbladder diseases.

The gallbladder lies on the right side of the upper abdomen. However, diseases affecting your gallbladder can result in the whole upper part of your abdomen. Sometimes, It presents with upper-middle abdominal pain.

Causes of gallbladder pain include:

Gallbladder stones (commonest).
Gallbladder inflammation: without the presence of stones. The most common cause of inflammation is infections with viruses or bacteria.
Bile duct blockage (connects the gallbladder to the duodenum): by a stone, a kink, or a tumor.
Blood vessel diseases: damage of blood vessels supplying the gallbladder can result in gallbladder pain (rare).

Symptoms of gallbladder pain:

Severe pain in your upper right or upper middle part of your abdomen. ‘
The pain starts as prolonged colic that builds up and may last for up to 30 minutes.
The pain resolves partially. Then it starts to worsen again (attacks of pain lasting anytime between 10 and 30 minutes on average).
Pain is often triggered when you eat a large fatty meal.
Severe nausea after eating.
Sometimes, severe vomiting occurs after eating.
The biliary colic can be very intense, radiates to your back and the back of the right shoulder.

4- Pancreatic diseases.

The pancreas lies in the upper left part of your abdomen. Your pancreas can get inflamed in an acute or chronic form.

Acute pancreatitis is a critical medical condition. It causes extreme upper middle abdominal pain with or without eating.

Chronic pancreatitis causes a less extreme form of symptoms. Chronic pancreatitis is more likely to cause mild pain in the upper abdomen after eating.

Causes of chronic pancreatitis:

A previous attack of acute pancreatitis.
Autoimmune pancreatitis (your immune system attacks your pancreas).
Alcoholo.
Smoking.
Cancers blacking the pancreatic duct.
A rare disease called cystic fibrosis.
Unkown cause in some cases.

Symptoms of chronic pancreatitis:

Upper middle abdominal pain (especially after eating).
The pain spreads to the middle back (opposite to the upper-middle part of your abdomen).
Nausea.
Vomiting.
Chronic or recurrent diarrhea (especially after eating fatty foods).
The stool is usually oily or greasy (containing fat).
Weight loss and fatigue.

5- GERD and hiatus Hernia.

Gastrointestinal reflux disease (GERD) is the reflux of gastric acid into your esophagus.

Hiatal hernia is the herniation of a part of your stomach into your chest. The herniation is through the esophageal opening in the diaphragm.

Hiatal hernia is one of the causes of GERD.

GERD causes heartburn and regurgitation of acidic material into your esophagus.

However, few patients with GERD experience upper middle abdominal pain (epigastric pain). Epigastric pain is more common if you have GERD with a hiatal hernia.

Symptoms of GERD & hiatal hernia:

Burning chest pain after eating.
Regurgitation of acid material (fluid or semisolid) from the stomach to your throat or mouth.
Upper middle abdominal pain after eating.
Nausea and/or vomiting.
Globus sensation in your throat.
Difficulty swallowing foods or drinks (dysphagia).
Chest pain.
Water brush or hypersalivation.

6- Others (less frequent causes).

The below causes are less frequent causes of upper-middle abdominal pain after eating.

A- Food intolerance and food allergy:

food allergies and food intolerance are adverse reactions of your body or digestive system to certain foods. Pain after eating is a common symptom. Learn More.

B- Gastric cancer.

Gastric cancer is a dangerous cause of upper-middle abdominal pain. However, it is less frequent than other widespread conditions discussed above. Learn more about the symptoms of gastric cancer.

C- Irritable bowel syndrome. Learn More.

Irritable bowel syndrome is a disease of the colon. Irritable bowel syndrome (IBS) symptoms include recurrent abdominal colics, changes in bowel habits, change in stool form, and others.

However, the pain from irritable bowel syndrome is less localized in the upper-middle abdomen. IBS pain typically affects all areas of your abdomen. Also, it may become more localized in the lower abdomen rather than the upper stomach.

D- Liver diseases and liver cancer: Learn More.

E- Pancreatic cancer: Learn More.

F- Gastroparesis (especially in patients with diabetes). Learn More.