Gastric pain is one of the most common medical complaints. Gastric pain is centered in the upper abdomen, and the pain varies from a dull ache to severe, throbbing pain. It is sometimes associated with symptoms such as vomiting or diarrhea.

Gastric pain could signal more serious conditions that need attention or could indicate that you need a change in lifestyle. Gastritis can improve quickly with treatment. However, if left untreated, it could lead to stomach ulcer and eventually stomach cancer.

When is gastric pain abnormal? What should you do if you are experiencing chronic gastric pain?​​​​​

Dr Poh Choo Hean, Consultant from the Department of Gastroenterology at Changi General Hospital, gives detailed answers to your questions.

Question by radhanagesh

Dear Doctor,

My daughter, 23 years old, has this gastric problem for the last 10 years. She feeels bloated and becomes her abdomen becomes painful the day her menses starts. The gas does not seem to get released. She experiences comfort only when she burps or pass gas.

We got a scan done last month, under the advice of a gynae, more to rule out fibroids /cysts, everything is fine.

Kindly advice.

Answered by Dr Poh Choo Hean

Abdominal bloatedness is a common presentation in patient with dyspepsia. It is important to stratify uninvestigated dyspepsia into organic or idiopathic causes. Investigations that are involved include upper endoscopy and ultrasound scan of the abdomen. In some of the patients with idiopathic cause, an identifiable microbiologic abnormality of uncertain clinical relevance (example Helicobacter Pylori) may be present.

Patient with irritable bowel syndrome (IBS) can present with abdominal bloatedness. Patients commonly undergo colonoscopy to exclude other organic causes before a diagnosis of IBS can be made.

Question by stimbrell

Hello Doctor,

My daughter is 15 yrs old and is complaining of severe abdominal pain just below the ribs in the centre of her abdomin with nausea (not vomiting). She has had an endoscopy that found no cause. She has had an abdominal scan that has not found a cause and numerous blood tests that have not shown anything out of the norm.

Her doctor has diagnosed Non ulcerated peptitis and prescribed tolumide s​tating that he feels there is a stress component to the pain.

Is this logical or are there other avenues we should explore

Answered by Dr Poh Choo Hean

The patient is most likely having functional dyspepsia. Occasionally stress can precipitate the symptoms. The initial treatment is usually to prescribe a course of proton pump inhibitor (PPI) and to eradicate helicobacter pylori if present. If the patient does not respond to the PPI, alternative pain modulators can be given to help to relieve the symptoms.

Question by bettychan

Hi Dr Poh

Is antral gastritis common in our population? Can PPIs be taken on a longterm basis? And would you suggest a repeat OGD >12 months to ascertain if the gastritis has resolved?


Answered by Dr Poh Choo Hean

Gastritis is common and it is usually acid related. If there is a present of helicobacter pylori, eradication of the bacteria can help to improve symptoms. PPIs on the whole are a safe to take if need to be taken long term.

The common side effects of PPIs include headache and constipation. However patients are usually advised to take the medications for a period of 6 to 8 weeks and would subsequently be advised to take it as when necessary. There are currently no clinical indications to keep repeating OGD to ascertain if the gastritis has been resolved.

Question by jerrygtan

Dear Doctor,

I have been having regular gastric pains in the last 15 years and I experience them every 3-4 weeks. Each time I get it it last between 3-5 days and I get sharp pains on my left shoulder blade down to the area around by left rib. I also get a sharp pain on my buttocks which the pain gets intense towards the evening and throughout the night. On occasions the pain on my buttocks are so severe tha I have problem walking and even turning myself on the bed.

Answered by Dr Poh Choo Hean

It would be important to check if the pain is from the lungs (pleuritic pain) or merely muscularskeletal chest pain. Pertaining to the pain from the buttocks region, one should consult the orthopaedic specialist to ensure that it is not a referred pain.​​

Ref: V10