Why Does the Middle of My Upper Abdomen Hurt When Pressed?

Abdominal pain is a common phenomenon in daily life. Any problem with any organ in the abdominal cavity may manifest as pain. The cause of abdominal pain can be roughly judged based on its location, but a final diagnosis requires examination at a hospital. When there is tenderness in the middle of the upper abdomen, we can briefly understand the possible causes. So, what is the cause of tenderness in the middle of the upper abdomen? Let's take a look.

The most common clinical manifestation of duodenal ulcer is pain in the middle of the upper abdomen, which can manifest as dull pain, burning pain, distension pain, or severe pain. It can also manifest as mild discomfort only when hungry. The pain can be relieved by taking antacids or eating. Clinically, about 2/3 of the pain is rhythmic: upper abdominal pain begins to appear 1 to 3 hours after breakfast, and if medication is not taken or food is not eaten, it will persist until lunchtime before relief. Pain recurs 2 to 4 hours after eating and is relieved after eating. About half of the patients have midnight pain, and they often wake up due to pain. Rhythmic pain usually lasts for several weeks, relieved for several months, and can recur.

Gastritis is an acute and chronic inflammation of the gastric mucosa caused by various etiologies, often accompanied by epithelial injury, mucosal inflammatory response, and epithelial regeneration. The pain is generally diffuse upper abdominal burning pain, dull pain, distension pain, etc. During examination, there is tenderness when pressing the upper abdomen or the umbilicus, but there is usually no muscle tension and rebound tenderness, and bowel sounds are slightly hyperactive.

Pancreatitis is a disease caused by the self-digestion of pancreatic enzymes. Abdominal pain is often located in the middle and upper abdomen, sometimes radiating to the waist and back in a belt-like pattern. Bending over or leaning forward in a sitting position can reduce the pain. Therefore, if there is frequent pain in the middle of the upper abdomen, it is considered to be caused by pancreatitis. Mild chronic pancreatitis rarely has positive signs, and some cases have mild tenderness in the upper abdomen; late chronic pancreatitis may manifest as malnutrition due to fatty diarrhea; if acute onset occurs, there may be moderate to severe tenderness in the middle of the upper abdomen.

Abdominal pain caused by gallbladder stones mostly occurs in the middle and upper abdomen and the right upper abdomen, often occurring after eating greasy food or suddenly changing body position during sleep. When there is no complication of cholecystitis, it is only mild pain in the right upper abdomen. When there is severe infection, it can involve tenderness in the middle and upper abdomen, and sometimes the enlarged gallbladder can be palpated.