Ask a doctor on the topic of Internal medicine

Upper abdominal pain

August 30, 2012 | 20,00 EUR | answered by Dr. med. Michael Schröter

Dear Sir or Madam,

I am female, 38 years old, 1.85m tall and weigh 85kg, (unfortunately) a smoker. I am a mother of two sons (8 and 2), married and working full time.

I have been experiencing recurring upper abdominal pain for almost exactly 6 years. The pain is burning to piercing (hard to describe) and radiates to the back between the shoulder blades. They usually occur at night or in the early morning hours, waking me up, and last for about 10 minutes. Since these pains are quite severe and frightening, my husband took me to the emergency room in 2006. Gastritis and gallstones were diagnosed. As a result, my gallbladder was removed and Nexium was prescribed.

In addition, my lungs were X-rayed and a blood test was done. Everything was normal. Unfortunately, I still have the symptoms described above and I am really desperate. There are times when they hardly occur, only about once a month or even less. But currently, I have them almost daily. I couldn't identify a specific trigger, maybe stress is a factor - I seem to have it permanently.

I must also mention that I suffer from anxiety and panic attacks from time to time. Therefore, my primary care physician believes that the symptoms could be psychosomatic in nature. He examined my blood and performed a "normal" EKG last month, with no significant findings.

My question now is, could the symptoms also be related to the heart or lungs? Should I undergo further examinations? I am not someone who goes to the doctor regularly, as I always feel a bit silly describing my symptoms. But they are real...

Thank you for your help.
Katrin W.

Dr. med. Michael Schröter

Good morning,

for complete reassurance, especially if you suffer from anxiety, I would recommend a stress ECG and a CT scan of the thorax. This can then reveal any focal findings and heart issues.
I also think a gastroscopy would be useful, as for example a hiatal hernia can cause such symptoms (pain when lying down at night). Finally, if not already done, the orthopedist should examine the spine, perhaps you have the wrong mattress.
Only after all physical causes are ruled out, can a psychosomatic disorder be considered.

I wish you all the best and a speedy recovery.

Best regards,

Dr. Schröter