Patient information · Upper GI symptoms
Upper abdominal pain or reflux: what could it mean?
Quick answer
Upper abdominal pain and reflux are usually caused by acid reflux/GORD, indigestion, hiatus hernia, ulcers, H. pylori or gallstones – most of which are very treatable.
Warning signs such as difficulty swallowing, weight loss, vomiting blood or new indigestion over 55 mean a gastroscopy should be arranged promptly.
Pain in the upper abdomen and reflux (heartburn) are extremely common, and most causes are not serious. But because the symptoms overlap, it helps to understand what might be behind them, which warning signs deserve prompt attention, and which tests give a clear answer.
Common causes
- Acid reflux / GORD – stomach acid travelling up into the gullet, causing burning behind the breastbone, especially after meals or when lying down.
- Indigestion (dyspepsia) – discomfort, fullness or bloating in the upper abdomen.
- Hiatus hernia – part of the stomach slipping up through the diaphragm, which can worsen reflux.
- Peptic ulcers and Helicobacter pylori – a common, treatable bacterial infection of the stomach lining.
- Gallstones – often cause pain in the upper right abdomen, sometimes after fatty meals, and may need an ultrasound and surgical assessment.
- Less commonly, problems with the pancreas or other organs.
Seek prompt medical advice if you have
- Difficulty or pain when swallowing, or food sticking
- Unexplained weight loss
- Persistent vomiting, or vomiting blood
- Black, tarry stools
- New, persistent indigestion if you are over 55
- Anaemia or a lump in the upper abdomen
These “alarm” features mean a gastroscopy should be arranged promptly. They are usually explained by something treatable, but should not be ignored.
How upper abdominal symptoms are investigated
Assessment starts with your history and an examination. Depending on the picture, tests may include a gastroscopy (to inspect the gullet and stomach and test for H. pylori), an abdominal ultrasound (particularly if gallstones are suspected) and blood tests. Where reflux is the issue, treatment often starts with lifestyle measures and acid-reducing medication; persistent or alarm symptoms warrant a closer look. Where gallstones are the cause, keyhole gallbladder removal is a very effective and well-established treatment.
When to get it checked
If your symptoms are new and persistent, are not settling with simple measures, or come with any of the warning signs above, it is worth being assessed properly. A consultation allows the likely cause to be identified and the right test – gastroscopy, ultrasound or both – to be arranged quickly, rather than living with uncertainty.
Frequently asked questions
Is reflux dangerous?
Occasional reflux is very common and usually harmless. Persistent reflux should be assessed, because long-standing acid exposure can affect the lining of the gullet, and because the symptoms can overlap with other conditions that benefit from treatment.
How do I know if my pain is from gallstones?
Gallstone pain is often felt in the upper right abdomen, can come on after fatty meals and may be severe and come in waves. An abdominal ultrasound is the usual test, and keyhole gallbladder removal is a very effective treatment.
When should indigestion be investigated with a gastroscopy?
Promptly if you have alarm symptoms such as difficulty swallowing, weight loss, vomiting blood, black stools or anaemia, or if you develop persistent new indigestion over the age of 55. Otherwise, treatment often starts with medication first.
Can I be seen quickly for upper abdominal pain or reflux?
Yes. A private consultation can usually be arranged promptly, with a gastroscopy or ultrasound organised within days where needed. Self-referrals are welcome without a GP letter.