The epigastric region is the anatomical area located in the upper central portion of the abdomen. It sits directly below the sternum, or breastbone. Recognizing this specific area is often the first step in understanding the potential origin of abdominal pain. This central location is a frequent site of discomfort where symptoms from several digestive and non-digestive organs can manifest.
Defining the Epigastric Region
The abdomen is anatomically mapped using a system of nine distinct regions to help locate internal structures and symptoms. The epigastric region is the uppermost of the three central divisions, positioned superiorly to the umbilical region, which contains the navel. Its lateral boundaries are the left and right hypochondriac regions, situated beneath the lower rib cage.
External landmarks help define this area on the body’s surface. It extends downward from the subcostal margin (the lower edge of the rib cage) to an imaginary line above the navel. The region is centered along the midline, making it the upper central anchor point in the nine-region abdominal grid.
Underlying Anatomical Structures
A variety of major digestive organs and related structures are positioned directly beneath the surface of the epigastric region. This makes the area prone to discomfort when these organs experience irritation or disease. The majority of the stomach, particularly its pyloric end, occupies a large portion of this space.
The head of the pancreas, which produces digestive enzymes, also lies within this central area. Furthermore, the first part of the small intestine, known as the duodenum, is situated here as it connects to the stomach. Parts of the liver’s left lobe also extend into the right side of the epigastrium.
Common Sources of Epigastric Discomfort
Pain in the epigastric region is frequently caused by conditions related to the digestive tract, often involving the stomach or esophagus.
Gastroesophageal Reflux Disease (GERD)
GERD occurs when stomach acid flows back up into the esophagus, leading to a burning sensation known as heartburn. This burning sensation can be felt in the upper abdomen and often presents as a sour taste. Discomfort intensifies when an individual lies down after eating.
Gastritis and Peptic Ulcers
Gastritis, inflammation of the stomach lining, typically causes a dull or burning ache. This pain tends to be worse immediately following meals as the stomach increases acid production. Peptic ulcers are sores in the lining of the stomach (gastric) or the duodenum (duodenal), causing a characteristic gnawing or burning pain. Duodenal ulcer pain may temporarily improve with food, while gastric ulcer pain may be made worse by eating. Both are often more noticeable at night.
Functional Dyspepsia and Warning Signs
Functional dyspepsia is diagnosed when chronic epigastric discomfort is present without any identifiable structural cause. Symptoms commonly include bloating, a feeling of excessive fullness after eating, or pain localized to the upper abdomen.
Individuals should seek immediate medical attention if epigastric pain is sudden, severe, or unrelenting. Warning signs that signal a more serious underlying issue include vomiting blood, difficulty breathing, or pain that radiates to the back or shoulder.