Gastric pain, also known as stomach ache, refers to discomfort or pain in the upper abdomen or stomach area. This pain can arise from different conditions that affect the digestive system. Determining which side the gastric pain is on can provide clues as to the underlying cause.
What causes gastric pain?
There are several possible causes of gastric pain including:
- Gastritis – inflammation of the stomach lining often due to infection with Helicobacter pylori bacteria or use of NSAIDs
- Peptic ulcer disease – ulcers in the stomach lining or upper part of the small intestine
- Gastroesophageal reflux disease (GERD) – reflux of stomach contents back up into the esophagus
- Food poisoning – infection from contaminated food or drink
- Constipation – difficulty passing stools
- Gallstones – hard deposits that form in the gallbladder
- Pancreatitis – inflammation of the pancreas
- Stomach cancer – gastric adenocarcinoma
- Indigestion – discomfort in the upper abdomen, often after meals
- Intestinal blockage – obstruction prevents proper passage of food
The location and characteristics of the pain can help determine which of these potential diagnoses is most likely.
Gastric pain on the right side
Causes of gastric pain on the right side may include:
- Gallbladder issues – Pain from gallstones or cholecystitis (inflammation of the gallbladder) is often felt in the upper right abdomen. It may be sharp, cramping, or dull.
- Pancreatitis – Inflammation of the pancreas can also cause pain in the upper right abdomen, often radiating to the back.
- Peptic ulcer – While more often causing left-sided pain, some ulcers occur on the lesser curvature of the stomach closer to the right side.
- GERD – Severe heartburn from reflux can sometimes be felt on the right.
- Constipation – In severe cases, persistent straining can trigger right upper quadrant discomfort.
Gastric pain on the left side
Causes of gastric pain on the left side may include:
- Peptic ulcer – Ulcers along the greater curvature of the stomach are more likely to cause left-sided pain.
- Gastritis – Inflammation of the stomach lining often leads to left upper quadrant discomfort.
- GERD – Heartburn from reflux typically causes left-sided or central pain.
- Gastric cancer – Tumors in the stomach, especially on the lesser curvature, can trigger left-sided pain.
- Splenic flexure syndrome – Pain from gas trapped at the splenic flexure of the colon can radiate to the left upper abdomen.
Central abdominal pain
Causes of central upper gastric pain include:
- Gastritis – Widespread inflammation of the stomach lining.
- GERD – Reflux-related discomfort is often central.
- Peptic ulcer – Some ulcers may cause central or diffuse pain.
- Functional dyspepsia– Discomfort centered in the upper abdomen with no identifiable cause.
- Early appendicitis – The early stages of appendicitis can cause vague central abdominal pain before localizing to the right lower quadrant.
How to determine which side gastric pain is on
To help identify which side your gastric pain is coming from:
- Note exactly where the pain seems centered and focused.
- Press gently on different areas of your abdomen to see if one area is more tender.
- Pay attention to any radiation of the pain to your back, chest, or other areas.
- Consider any associated symptoms like heartburn, nausea, fever, or changes in bowel movements.
- Think about what makes the pain worse or better – eating, position changes, etc.
Keeping a symptom diary with details about the nature, location and triggers of the pain can help your doctor make an accurate diagnosis.
When to see a doctor
You should consult a doctor promptly for evaluation of gastric pain if you experience:
- Severe or persistent pain, especially if interfering with normal activities
- Unintentional weight loss
- Fever or vomiting
- Black, tarry stools or trouble swallowing
- Pain that wakes you from sleep
- Tenderness with palpation of the abdomen
Prompt medical attention is crucial for identifying serious conditions requiring urgent treatment like appendicitis, pancreatitis, peptic ulcer perforation or peritonitis.
Diagnostic tests
To diagnose the cause of gastric pain, the doctor may order:
- Blood tests – Checks for infection, inflammation, kidney or liver problems
- Stool tests – Screens for blood, bacteria, or parasites
- Urine tests – Help rule out urinary tract infections or kidney stones
- Ultrasound – Images the abdomen to visualize organs like the gallbladder, pancreas and appendix
- Upper endoscopy – A camera on a flexible tube passed down the throat to examine the esophagus and stomach directly
- CT scan – Cross-sectional X-ray images of the abdomen to detect masses, pancreatitis, appendicitis etc.
Treatment options
Treatment depends on the underlying cause of the gastric pain. Options may include:
- Antibiotics – For H. pylori infection or other bacterial causes
- Antacids – To neutralize stomach acid in GERD
- H2 blockers or PPIs – Medications that reduce acid production
- Surgical repair – Fixing a perforated ulcer or removing gallstones
- Dietary changes – Avoiding foods that trigger symptoms
- Laxatives or enemas – For relief of constipation
Identifying and treating the specific problem is key to effectively resolving gastric pain. Ongoing follow-up with a doctor is often needed to prevent recurrence.
When to seek emergency care
Seek prompt emergency care if you experience:
- Sudden, severe abdominal pain
- Pain with vomiting and inability to pass gas or stool
- High fever with abdominal pain and tenderness
- Fainting, dizziness or rapid heart rate
- Blood in vomit or black, tarry stools
These can indicate a abdominal emergency like perforated ulcer, bowel obstruction, appendicitis or other condition requiring surgery. Urgent evaluation and treatment is needed to prevent dangerous complications.
Prevention
You may be able to reduce your risk of some types of gastric pain by:
- Getting treated for H. pylori infection if present
- Avoiding NSAIDs when possible
- Eating smaller, more frequent meals
- Losing weight if overweight
- Quitting smoking and limiting alcohol
- Practicing stress management techniques
However, some causes like gallstones or stomach cancer may not be preventable. Staying alert to worsening or persistent gastric pain is key.
When to worry
Seek prompt medical evaluation if you have:
- Gastric pain that persists for days or weeks
- Pain that is progressively worsening
- Difficulty eating or drinking due to pain
- Unexplained weight loss
- Pain that wakes you from sleep
- Associated fever, nausea or vomiting
While occasional mild stomach pain can be normal, worsening or persistent pain should not be ignored, as it may indicate a serious problem requiring treatment.
Bottom line
Determining if gastric pain is right-sided, left-sided or central can provide important clues to the cause. Keeping a symptom diary, promptly seeing a doctor for evaluation, and following recommended treatment are key to resolving the pain and preventing complications. Seek emergency care for any alarming signs like excruciating pain, vomiting blood or fainting.
| Cause | Location | Other symptoms |
|---|---|---|
| Gastritis | Left or central | Nausea, bloating |
| Peptic ulcer | Left more often, sometimes right | Burning pain, hunger pain |
| GERD | Central or left, sometimes right | Heartburn, regurgitation |
| Gallstones | Right upper quadrant | Pain after eating fatty foods |
| Pancreatitis | Central or right upper quadrant | Pain radiating to back, nausea |
In summary, being aware of the location and accompanying symptoms of gastric pain can assist with determining the likely cause. Prompt medical care for evaluation and treatment is key to resolving the pain and preventing complications. With an accurate diagnosis, the proper treatment can be provided to eliminate the discomfort.