Abdominal Pain Causes: The Upper Stomach Trick
Causes of upper abdominal pain made easy! Learn this simple trick to remember the main emergent causes of upper stomach pain!
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Causes of Upper Abdominal Pain
Abdominal pain is a common symptom most of us will experience at some point in our life.
Abdominal pain can vary by:
Location or Quadrant - Right sided, left sided, upper, lower, etc.
Presentation - After eating, during pregnancy, with exercise, etc.
Quality - Sharp, stabbing, pulsating, cramping, etc.
Timing - Intermittent (comes and goes), constant, etc.
Quantity - Severity, fluctuation, etc.
Associated Symptoms - Diarrhea, nausea, vomiting, constipation, etc.
Epidemiology - Males, females, children, adults, ethnicity, etc.
To make matters more challenging, there are many conditions that can cause abdominal pain.
While all types of abdominal pain should be addressed, it is the emergent or life-threatening causes that definitely do not want to be missed.
But with so many conditions leading to abdominal pain, how can you remember all the different emergent causes?
We’re going to show you how with a simple trick!
Many of you enjoyed The 4-2-1 Rule to remember the main emergent causes of chest pain.
If you have not viewed The 4-2-1 Rule, make sure to check it out here!
Now you will learn a simple trick to remember the main emergent causes of upper abdominal pain!
This trick can be used 2 ways, so let’s get right into it!
Leave a comment down below if you enjoy the trick!
Upper Abdominal Pain List
As you can see below, there are many conditions that cause upper abdominal pain.
This is why it is important to have an organized simple way to remember the main life-threatening or urgent causes, so they do not get missed.
Let’s take the long list below and condense it into an easy trick to remember those emergent causes!
Causes of Upper Abdominal Pain: Differential list of conditions causing upper stomach pain
The “UPPER STOMACH” Trick
If you are familiar with this platform, then you probably know tricks and mnemonics are commonly used….especially mnemonics that spell out the topic being discussed.
And that’s the case here!
You can use the mnemonic “UPPER STOMACH” to remember the main emergent causes of upper abdominal pain!
Here’s the cool part!
We can approach this mnemonic in 2 ways!
By Disease Process
By Organ System
Let’s first go by disease process, and then we will go by organ system in the next section! Read on to find out!
UPPER STOMACH
U = Urinary Stones/Infections
P = Pancreatitis
P = Pulmonary Embolism, Pneumonia, Pleural Effusion
E = Ectopic Pregnancy
R = Really Early Appendicitis
S = Stomach Perforation/Bleed
T = Twisting Bowel (Volvulus, Ischemic Bowel)
O = Obstruction (Bowel, Foreign Body)
M = Myocardial Infarction
A = Aortic Aneurysm/Dissection/Rupture
C = Cholecystitis/Cholangitis
H = Hepatitis
Causes of Upper Abdominal Pain: Use the mnemonic “UPPER STOMACH” to remember some of the emergent causes of upper abdominal pain
Causes of Upper Abdominal Pain: Use the mnemonic “UPPER STOMACH” to remember some of the emergent causes of upper abdominal pain
Let’s walk through what “UPPER STOMACH” stands for below.
U = Urinary Stones/Infections
The “U” stands for urinary stones and infections.
You can use the “U” to remember urinary causes in general, particularly kidney stones and urinary infections.
Kidney stones (nephrolithiasis) and kidney infections (pyelonephritis) typically cause flank pain that might even radiate to the groin, but some individuals may experience upper abdominal as well.
Urinary tract infections (UTIs) or bladder infections (cystitis) usually present as lower abdominal or pelvic pain, but some patients may experience generalized abdominal pain especially early on or in the elderly.
P = Pancreatitis
The first “P” stands for pancreatitis.
You can use the “P” to remember pancreatic causes in general, particularly pancreatitis or a pancreatic mass among others.
Pancreatitis is inflammation of the pancreas, and it typically presents as upper abdominal pain radiating to the back.
P = PE, Pneumonia, Pleural Effusion
The second “P” will help you remember pulmonary conditions in general.
Remember not all abdominal pain originates from disease processes in the abdomen.
Conditions in the chest or thorax can also cause upper abdominal as well.
For example, disease processes involving the lower lungs can irritate the diaphragm and present as upper abdominal pain too.
This may include a pulmonary embolism (PE), which is a blockage in the artery in the lungs.
This can also include pneumonia (lung infection), especially when the pneumonia involves one of the lower lung lobes.
A pleural effusion, which is an abnormal collection of fluid in the pleural space or cavity between the lungs and chest wall, may also cause upper abdominal discomfort.
E = Ectopic Pregnancy
The “E” stands for ectopic pregnancy.
This is to help you remember pregnancy in general, and that pregnancy should be considered in any female who is of child-bearing age presenting with abdominal pain.
Ectopic pregnancy occurs when the fetus develops outside the uterus.
R = Really Early Appendicitis
The “R” stands for really early appendicitis.
This is important because early appendicitis may cause generalized or upper abdominal pain before migrating to the right lower quadrant.
Remember appendicitis is inflammation of the appendix.
S = Stomach Perforation/Bleed
The “S” stands for stomach perforation or bleed.
You can use the “S” to remember stomach conditions in general, particularly gastric or bowel perforations and GI bleeds.
A gastric (stomach) or bowel perforation is a hole that develops in the stomach or intestines.
Gastrointestinal (GI) bleeds can be caused by a number of conditions including gastric or intestinal ulcers, which can cause upper abdominal pain.
T = Twisting Bowel
The “T” stands for twisting bowel.
This will help you remember volvulus which is an obstruction caused by twisting of the stomach or intestines.
Twisting of the bowel can also lead to ischemia or reduced blood flow to the intestines, and this can help you remember ischemic bowel as a potential emergent cause of abdominal pain as well.
O = Obstruction
The “O” stands for obstruction.
This will help you remember bowel obstruction, which is a partial or complete blockage of the intestines that prevents food and substance from passing through.
This will also help you think of a possible foreign body ingestion.
M = Myocardial Infarction
Next we have the “M” which stands for myocardial infarction or a heart attack.
This is an important one.
Some patients may present with upper abdominal pain that is actually a myocardial infarction.
This can be true in patient populations who are elderly, female, history of diabetes, among others.
As previously mentioned with the pulmonary conditions, remember conditions in the chest/thorax may cause upper abdominal pain too.
You do not want to miss a myocardial infarction in someone presenting with upper abdominal pain, so make sure to always consider it and order an EKG and cardiac blood work as appropriate.
A = Aorta (Aneurysm, Dissection, Rupture)
The “A” will help you remember conditions involving the aorta such as aortic aneurysm, aortic dissection, and aortic rupture.
An aortic aneurysm is ballooning of the aorta, an aortic dissection is a tear in the aorta, and an aortic rupture is a hole in the aorta.
C = Cholecystitis, Cholangitis
The “C” will help you remember gallbladder and biliary causes.
Some of the more urgent conditions include cholecystitis and cholangitis.
Cholecystitis is inflammation of the gallbladder.
Cholangitis is inflammation of the bile duct or biliary system.
These are usually caused by obstructed gallstones.
Gallstones are also called cholelithiasis.
An obstructed gallstone in the cystic duct can lead to inflammation and/or infection of the gallbladder (cholecystitis).
A gallstone in the common bile duct is called choledocholithiasis.
An obstructed gallstone in the common bile duct can lead inflammation and/or infection of the bile duct and biliary system (cholangitis).
Here is the cool part!
Cholecystitis, cholangitis, cholelithiasis, choledocholithiasis, cystic duct, and common bile duct all start with the letter “C”.
So you can use the “C” in the UPPER STOMACH mnemonic to remember all gallbladder and biliary causes.
H = Hepatitis
Finally the “H” stands for hepatitis, which will help you remember hepatic causes of upper abdominal pain.
Remember hepatitis is inflammation of the liver.
As previously mentioned, there is another way to use the mnemonic!
Let’s take a look below!
Organ System Approach - Trick #2
Now here is the cool part!
There is a second way to use that same exact mnemonic!
Without even knowing it, the mnemonic “UPPER STOMACH” also got you thinking about the main organ systems that are pertinent to upper abdominal pain!
So if you are someone who does not want to remember the specific disease processes and would rather just remember the organ systems involved, then this is perfect for you!
This is also great for those who are more advanced and can already create their own differential diagnosis based on organ system, and just need a quick mnemonic to go through the organ systems.
Here is how it works!
Use the UPPER STOMACH mnemonic to go by organ system that could be causing upper abdominal pain:
U = Urinary
P = Pancreatic
P = Pulmonary
E = Ectopic (Pregnancy/Reproductive)
R = Really Early Appendicitis (Appendix)
S = Stomach
T = Twisting Bowel (Intestines/GI)
O = Obstruction (Intestines/GI)
M = Myocardial (Heart)
A = Aorta
C = Chole-/Cholangio- (Gallbladder/Biliary)
H = Hepatic (Liver)
We can see in the word “upper” that we are including the kidneys and urinary system, the pancreas, the lungs, it also makes you consider pregnancy, and it also helps you think of the appendix.
We can see the word “stomach” covers the stomach, intestines, heart, aorta, gallbladder along with the biliary system, and the liver.
Causes of Upper Abdominal Pain: Use the mnemonic “UPPER STOMACH” to remember the main organ systems and causes of upper abdominal pain
Causes of Upper Abdominal Pain: Use the mnemonic “UPPER STOMACH” to remember the main organ systems and causes of upper abdominal pain
Summary
Whether you go by disease process or organ system, the “UPPER STOMACH” mnemonic is a great way to summarize the main emergent causes of upper abdominal pain.
Since there are so many conditions that can cause abdominal pain, using this mnemonic can help simplify and organize those emergent causes in a way that is easy remember.
Keep in Mind…
Keep in mind that while this mnemonic is a great way to remember a lot of the emergent causes of upper abdominal pain, it is not a complete list.
The conditions in the mnemonic may also cause different symptoms other than upper abdominal pain.
Other less urgent causes can potentially become emergent as well.
This mnemonic is for educational purposes only.
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