Epigastric pain - Indigestion

(known as stomach ache or abdominal complaints)

A. Gastroesophageal reflux disease (GERD)

Our gastrointestinal system is divided into upper and lower tract, the ligament of Treitz being their anatomical border. The upper gastrointestinal tract consists of the buccal cavity, pharynx, esophagus, stomach and duodenum (where bile and pancreatic juice are expelled).

Sometimes, if lying down, acidic stomach contents come back into the esophagus. If this is a chronic condition, acid reflux can also occur in an upright position. The resulting feeling is "heartburn" and pain in the chest (retrosternal pain), which can sometimes be confused with heart disease. Therefore, cardiac monitoring is necessary.

Gastroesophageal reflux disease is due to poor closure of the lower esophageal sphincter (the junction between the stomach and the esophagus), which should normally prevent the return of the stomach contents back into the esophagus. When we suspect this condition, we must consult our family doctor to get medical treatment and a special diet. If left untreated, acid reflux may cause serious complications affecting both the respiratory and the digestive system (Barrett`s esophagus) since gastric acid can reach the respiratory system through the esophagus.

B. Hiatal hernia

This is the protrusion of the upper part of the stomach into the chest cavity through the esophageal hiatus because of a tear or weakness in the diaphragm. Symptoms are similar to those of GERD.

C. Gastritis

It is inflammation of the lining of the stomach, which is usually caused by a bacterium, Helicobacter pylori. It may also be due to bile reflux from the duodenum to the stomach, due to failure of a second sphincter (pyloric sphincter), which allows one-way flow of gastric contents to the duodenum.

All these diseases of the upper gastrointestinal tract can occur anytime throughout the year, however they are more frequent in spring and autumn.

For all of the above one should always consult their family doctor.