Epigastric abdominal pain


  • This page outlines the general approach to adult epigastric pain

Classification by Abdominal pain location

Side-by-side comparison of quadrants and regions.
Chart of commonly reported referred pain sites.
RUQ pain Epigastric pain LUQ pain
Flank pain Diffuse abdominal pain Flank pain
RLQ pain Pelvic pain LLQ pain

Clinical Features

  • Pain in the epigastrum

Differential Diagnosis

Epigastric Pain



  • CBC
  • Chem
  • LFTs
  • Lipase
  • Coags
  • Urinalysis
  • Urine pregnancy (females)
  • ?ECG (if >50 or at risk for cardiac disease)
  • ?RUQ US
  • ?CXR
    • Consider if at risk for perforated ulcer



  • Treat underlying disease process
  • Consider PO antacid (e.g. Maalox Plus)
    • The addition of viscous lidocaine 2% and/or Donnatol (i.e. "GI Cocktail") is no more effective than plain liquid antacid[1]


  • Disposition per underlying disease process

See Also

External Links


  1. Berman DA, Porter RS, Graber M. "The GI Cocktail is no more effective than plain liquid antacid: a randomized, double blind clinical trial." J Emerg Med. 2003 Oct;25(3):239-44.