30 October 20269 min read

Upper Stomach Pain: Common Causes and When to Worry

Medical Review

Medically Reviewed by Dr. Pedro Yelamo Vera, MD

Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 31 October 2026

Upper stomach pain is usually indigestion. Other causes, H. pylori tests, when you need a scope in Spain, the UK or US, and when to call 112.

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Upper stomach pain, felt between the bottom of the breastbone and the belly button, is most often indigestion. Stomach acid, a large meal, alcohol or painkillers such as ibuprofen are common triggers. Less often it comes from an ulcer, gallstones or the pancreas. Rarely it is the heart, so a few warning signs mean calling 112.

TL;DR

Most upper stomach pain is indigestion (dyspepsia). It often settles with simple changes and pharmacy remedies.
A stomach ulcer causes burning pain in the upper tummy, often worse at night. H. pylori and anti-inflammatory painkillers are the main causes.
Severe, constant pain for over 30 minutes in the middle of the tummy or under the right ribs can be gallstones.
Pain with sweating, breathlessness, or pain in the chest, arm, neck or jaw: call 112.
Weight loss, trouble swallowing, repeated vomiting or black stools need a doctor, whatever your age.

Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).

For a medical emergency, call 112 or go to the nearest local emergency department. Do not wait for a video consultation or an online reply.

Where exactly is upper stomach pain?

Doctors call this area the epigastrium. It sits just below the breastbone, above the belly button. In Spain people call it the boca del estómago. A Spanish doctor may write epigastralgia (upper stomach pain) or dispepsia (indigestion) on your report.

MSD Manuals defines indigestion as pain or discomfort in the upper tummy. People describe it as fullness, gas, gnawing or burning.

What are the most common causes of upper stomach pain?

Indigestion. The NHS says it is often caused by acid irritating the stomach lining or throat. Coffee, alcohol, chocolate, fatty or spicy food, smoking, stress, being overweight and some painkillers make it worse.
Gastritis or a stomach ulcer. Ulcer pain is usually in the upper tummy. It may burn and is often worse at night. The NHS names two main causes: H. pylori infection and regular use of anti-inflammatory painkillers (NSAIDs), such as ibuprofen.
Acid reflux. A burning feeling rises into the chest, often after eating.
Gallstones. The NHS describes severe, constant pain in the middle of the tummy or under the right ribs. It lasts more than 30 minutes, sometimes hours, and may make you sick.
Pancreatitis. The NHS describes sudden, severe, sharp pain in the upper tummy. It can spread to the back and ease when you lean forward.
Medicines. NICE asks doctors to review NSAIDs, steroids, bisphosphonates, some heart and blood pressure tablets (calcium channel blockers and nitrates) and theophylline.
The heart. MSD Manuals warns that a heart attack or unstable angina can feel like indigestion alone, with no chest pain.

Why does my upper stomach hurt after eating?

A big or rich meal is the usual reason. Fatty or spicy food, alcohol and coffee all trigger indigestion, says the NHS. An ulcer can also hurt after food, and pancreatitis pain often gets worse after eating. Pain that wakes you at night, or keeps coming back for weeks, deserves a check.

What can I do at home?

The NHS suggests these steps for indigestion:

Cut down on tea, coffee, cola and alcohol.
Avoid eating in the 3 to 4 hours before bed, and avoid rich, spicy or fatty food.
Raise your head and shoulders in bed.
Lose weight if you are overweight, and stop smoking.
Do not take ibuprofen or aspirin unless a doctor prescribed them.

A pharmacist can suggest an antacid, an alginate or an acid-reducing tablet called a proton pump inhibitor (PPI). Spanish pharmacies sell some of these; our guides to omeprazole in Spain and Almax explain what you can buy and when to ask a doctor.

Upper stomach pain that keeps coming back?

You can book a video visit with a GP licensed in Spain, in English or Spanish. He asks about your pain, your medicines and any warning signs, and explains whether you need an H. pylori test, a blood test or a scope.

See H. pylori testing and care

Could it be H. pylori, and how is it tested?

H. pylori is a common germ that lives in the stomach lining. Most people who carry it have no symptoms. MedlinePlus says it is still the commonest cause of ulcers, so NICE advises a "test and treat" approach for people with ongoing indigestion.

Tests: a breath test or a stool test. In Spain, the breath test is the prueba del aliento and the stool test is antígeno en heces.
Before the test: NICE asks for a 2-week gap after acid-reducing tablets (PPIs). The SEMERGEN guide for Spanish GPs also asks for a 4-week gap after antibiotics or bismuth. Otherwise the result can be falsely negative.
If it is positive: the doctor discusses a prescribed treatment and a later test to confirm the germ has gone.

Do I need an endoscopy, and does my age matter?

An endoscopy (in Spain, gastroscopia) is a thin camera passed into the stomach. The age at which doctors use it first differs between countries:

UK: the NICE cancer guideline (NG12) sends people with trouble swallowing, at any age, for urgent checks. It does the same for people aged 55 and over with weight loss and upper tummy pain, reflux or indigestion.
US: MSD Manuals says doctors usually scope people over 60, and younger people with warning signs.
Spain: the SEMERGEN guide advises a scope for people over 55 and for anyone with warning signs. These are repeated vomiting, bleeding, a lump in the tummy, weight loss or trouble swallowing. Younger people without them are usually tested for H. pylori first.

The NHS also lists reasons to see a GP at any age: indigestion that keeps coming back, severe pain, weight loss without trying, trouble swallowing, being sick a lot, iron-deficiency anaemia, a lump in the tummy, or blood in your vomit or poo.

What about upper stomach pain in pregnancy?

Indigestion is very common in pregnancy, especially from 27 weeks, says the NHS. Hormones and the growing baby both play a part. Ask a pharmacist or your doctor which remedies are safe for you.

One sign needs fast advice. Pain just below the ribs can be a sign of pre-eclampsia, which rarely starts before 20 weeks. If you are pregnant and get this pain, contact your midwife (matrona) or go to the maternity emergency unit (urgencias de maternidad) straight away. The NHS says these signs need checking immediately.

When is upper stomach pain an emergency?

Call 112 if you have upper stomach pain with any of these:

Pain or pressure in the chest, or pain spreading to the arm, neck or jaw.
Shortness of breath, sweating, or grey or pale skin.
Vomiting blood, or vomit that looks like coffee grounds.
Black, sticky, very smelly stools, or blood in your poo.
Sudden, severe tummy pain, or a tummy that hurts to touch.
Pain spreading to your back with vomiting, a very high temperature or shivering, or yellow skin or eyes.

See a doctor today if tummy pain lasts longer than 30 minutes, says the NHS.

Talking it through with a doctor by video

Dr. Yelamo is a GP licensed in Spain. He sees adults, children and pregnant patients by video, every day from 07:30 to 20:30 (Spain time). In the visit he will:

Ask where the pain is, when it comes, and what makes it better or worse.
Check for warning signs and review every medicine you take, including painkillers.
Explain whether you need an H. pylori test, blood tests, a scope or an exam in person.
Agree a plan for diet, sleep and pharmacy remedies.

He does not promise any test or prescription before the visit. Where clinically appropriate, following a genuine evaluation. Treatment and prescriptions are issued solely at the doctor's discretion based on evidence-based clinical guidelines.

A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.

See how the Urgent Care video visit works. It lasts 15 minutes and costs €50.

This guide is general information. It does not replace a consultation with your doctor.

Frequently asked questions

What is the most common cause of upper stomach pain?

Indigestion. It is often caused by stomach acid and triggered by large or fatty meals, alcohol, coffee, smoking or painkillers such as ibuprofen.

How do I know if my upper stomach pain is serious?

Call 112 for chest pain, breathlessness, sweating, vomiting blood, black stools or sudden severe pain. See a doctor soon for weight loss, trouble swallowing or repeated vomiting.

Can upper stomach pain be a heart problem?

Yes, sometimes. A heart attack can feel like indigestion, with no chest pain. Pain with sweating, breathlessness or pain in the arm, neck or jaw needs 112.

What does an H. pylori infection feel like?

Many people have no symptoms. When it causes an ulcer or gastritis, it can give burning upper tummy pain, bloating, nausea and early fullness.

Should I stop omeprazole before an H. pylori test?

Usually yes. NICE advises a 2-week gap after acid-reducing tablets. Ask your doctor before stopping, and do not stop medicines prescribed for another reason.

What is boca del estómago?

It is the Spanish name for the area just below the breastbone. Pain there is often called epigastralgia on a Spanish report.

Sources

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Medical Citations & Sources

This content is written and reviewed by a licensed physician with reference to the following official health authorities.