Upper abdominal pain and nausea can occur in connection with many different clinical pictures. Some of these are harmless and others pose an acute threat to the person affected. It is therefore important to examine the abdominal pain and nausea in detail and to consider them in connection with accompanying symptoms.
The upper abdominal pain can occur as acute pain or occur over a longer period of time in connection with other conditions, i.e. it can be chronic. Acute pain is usually accompanied by irritation of the peritoneum, disturbances in the circulation and motility of the digestive tract. Depending on the intensity and general symptoms, a decision can be made between conservative and surgical therapy.
Organs of the upper abdomen
In the area of the upper abdomen there are many different organs. First, of course, the organs of the digestive tract. The end piece of the esophagus passes into the stomach in this area, which ends in the small intestine.
A part of the large intestine lies above the stomach in this area as well. But other digestive organs, such as the liver or the pancreas, are also associated with the upper abdomen. In addition, the heart and large vessels of the abdomen are also associated with the upper abdomen, and when these organs are injured or diseased, the pain is passed on to the upper abdomen.
The kidneys are also located in the upper part of the abdomen. This list shows how many organs or different structures can be responsible for pain or nausea in the upper abdomen. The upper abdomen can be divided into three regions that make it easier to make a correct diagnosis: the right upper abdomen, an area in the middle and the left upper abdomen.
Pain in the right upper abdomen
In the area of the right upper abdomen, the bile ducts are most frequently the cause of upper abdominal pain. Many people unknowingly suffer from gallstones, which can cause biliary colic in the course of the disease. Most frequently affected are women with families who eat a high-fat diet and regularly consume alcohol.
The stones obstruct the bile duct and the bile accumulates in the gallbladder, causing colic and seizure-like pain in the right upper abdomen, which can even radiate into the right shoulder. If this obstruction of the bile ducts occurs frequently and over a long period of time, an inflammation of the gallbladder (acute cholecystitis) can occur, which is also very painful. In contrast to biliary colic, however, this pain is persistent and fever occurs.
Patients with gallstone disease often undergo surgery to remove the gallbladder in order to prevent complications such as gall bladder perforations, fistula formation, chronic inflammation of the gallbladder or pancreas. Associated with the bile duct system is the liver, which is also located in the right upper abdomen. Hepatitis can also cause pain in the upper abdomen with nausea, but often the symptoms of icterus (yellow skin and sclerae, dark urine, discolored stools) still occur.
As a result of hepatitis or poisoning, the liver can also fail. Pain in the right upper abdomen can also be caused by a liver tumor or liver abscess. An emergency develops rapidly with a ruptured liver tumor.
Very rarely, the liver is affected by parasites (echinococcosis), which are responsible for upper abdominal pain. In addition, the pain in the right upper abdomen can also be triggered by the intestines. On the one hand, appendicitis can radiate into the upper abdomen, where it can be painful and accompanied by fever.
On the other hand, a carcinoma can grow in the colon flexure in the right upper abdomen, which is responsible for the pain. Furthermore, diseases of the urinary tract, such as stones in the kidney or ureter, or inflammation of the renal pelvis, can cause pain in the right (and left) upper abdomen. If the ureteral system is affected, it is possible that the pain may also occur in the back.
In addition, blood in the urine and pain in the flanks may occur. However, the pain in the upper abdomen is not always triggered there organs of the abdominal cavity. In some cases, organs of the thorax are also responsible.
Pneumonia or pleuritis can be responsible for upper abdominal pain, but are accompanied by fever and breath-related pain, which makes it easier to distinguish between them.The heart can also cause upper abdominal pain on the right side. If the right heart fails, the pain can extend to the right upper abdomen, because the blood backs up to the liver. In this clinical picture, water retention also occurs.
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