Rational Investigation of Upper Abdominal Pain

Background: Upper abdominal pain is a common problem with an extraordinary diversity of possible causes. Many patients have no structural disease, and making the correct diagnosis can be a challenge. The roles of endoscopy, testing for Helicobacter pylori, and imaging techniques have been debated widely and continue to be a matter for discussion.

Objective: This article details the value of various investigations in the setting of specific presentations of upper abdominal pain.

Discussion: Functional dyspepsia is a common cause of upper abdominal pain but the diagnosis should only be made after consideration of more serious pathology. The various organic causes of upper abdominal pain and the appropriate investigations are discussed. Early endoscopy is advisable in the presence of alarm symptoms and in patients over 55 years of age.