What Is the Pain in the Center of the Abdomen Under the Breasts?

October 2, 2025 •

5 min read

According to the American College of Gastroenterology, gastroesophageal reflux disease (GERD), a common cause of pain in the center of the abdomen under the breasts, affects up to 20% of the U.S. population. This type of discomfort is medically known as epigastric pain, and its causes range from common indigestion to more serious conditions involving the esophagus, stomach, gallbladder, or pancreas. Identifying the source of this pain is crucial for proper treatment and management.

Quick Summary

Pain located in the upper-middle abdomen, known as epigastric pain, can stem from various digestive and organ-related issues. Common culprits include acid reflux, gastritis, and peptic ulcers, while more severe causes can involve the pancreas or gallbladder. The origin of the pain often requires a medical evaluation for accurate diagnosis and effective management.

Key Points

Epigastric Pain: Pain in the center of the abdomen under the breasts is known as epigastric pain, which can be caused by various digestive and organ-related issues.
Common Causes: Most cases are related to common digestive problems like GERD, gastritis, peptic ulcers, and overeating.
Red Flags: Severe or persistent pain, especially accompanied by fever, bloody vomit or stools, or radiating to the back or shoulder, warrants immediate medical attention.
Lifestyle Management: For milder causes, dietary adjustments (avoiding trigger foods, smaller meals), proper posture after eating, and stress management can help.
Professional Diagnosis: A healthcare provider can determine the exact cause of epigastric pain through a physical exam and diagnostic tests, leading to the correct treatment plan.
Potential for Organ Involvement: More serious causes include gallbladder problems (like gallstones) and pancreatitis, which require specific medical evaluation.

Understanding Epigastric Pain

Epigastric pain refers to discomfort or aching felt in the upper-middle region of the abdomen, specifically beneath the ribcage and above the stomach. While often mistaken for simple indigestion or heartburn, it can be a symptom of several conditions affecting the upper gastrointestinal (GI) tract and surrounding organs. The character of the pain can vary from a dull ache to a sharp or burning sensation, and it may occur occasionally or be persistent. Because this area contains vital organs like the stomach, liver, and pancreas, pinpointing the cause is essential.

Common Digestive Causes

Many of the most frequent causes of epigastric pain are related to digestive system issues. These conditions affect how the body processes food and can lead to inflammation and irritation.

Gastroesophageal Reflux Disease (GERD) and Heartburn

Heartburn is the most recognizable symptom of GERD, a chronic condition where stomach acid frequently flows back into the esophagus. This backward flow irritates the lining of the food pipe and causes a burning sensation that can be felt in the chest or upper abdomen.

Location: Upper abdomen or mid-chest, behind the breastbone.
Triggers: Fatty foods, spicy foods, alcohol, and lying down or bending over after eating.
Associated Symptoms: Sour taste in the mouth, difficulty swallowing, or a dry cough.

Gastritis

Gastritis is the inflammation of the stomach lining. It can be acute (occurring suddenly) or chronic (lasting for years). Common causes include bacterial infection (most notably H. pylori), regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, or excessive alcohol consumption.

Location: Upper abdomen.
Triggers: Certain medications, alcohol, spicy foods.
Associated Symptoms: Nausea, vomiting, bloating, and a feeling of fullness.

Peptic Ulcer Disease

Peptic ulcers are open sores that develop on the lining of the stomach or the first part of the small intestine. They can cause significant epigastric pain that may feel dull or burning and often occurs when the stomach is empty. The main causes are H. pylori infection and NSAID use.

Location: Upper abdomen, sometimes radiating to the back.
Triggers: Can be worse on an empty stomach; alleviated temporarily by eating.
Associated Symptoms: Nausea, feeling full quickly, bloating, or dark, tarry stools in severe cases.

Potential Organ-Related Conditions

Beyond common digestive issues, pain in the epigastric region can indicate a problem with other nearby organs. These conditions often require specific medical evaluation and treatment.

Gallbladder Disorders

The gallbladder is located in the upper right abdomen, just below the liver, but pain from a gallbladder attack can sometimes be felt in the center of the abdomen or back. This intense pain is typically caused by gallstones blocking a bile duct and may worsen after eating fatty foods.

Location: Upper right abdomen, but can radiate to the center and back.
Triggers: High-fat meals.
Associated Symptoms: Nausea, vomiting, fever, chills, and possibly yellowing of the skin or eyes.

Pancreatitis

Pancreatitis is the inflammation of the pancreas, an organ situated behind the stomach. This condition can cause severe, band-like pain in the upper abdomen that often radiates to the back. The pain is typically worse after eating and may be accompanied by other serious symptoms.

Location: Upper abdomen, often radiating to the back.
Triggers: Eating, especially high-fat foods.
Associated Symptoms: Fever, nausea, vomiting, and a rapid pulse.

Hiatal Hernia

A hiatal hernia occurs when the upper part of the stomach pushes through the diaphragm into the chest cavity. A large hiatal hernia can cause acid reflux and heartburn, leading to epigastric pain. Small hernias may not cause any symptoms.

Location: Upper abdomen or chest.
Triggers: Pressure from coughing, lifting, or straining; can cause symptoms similar to GERD.
Associated Symptoms: Heartburn, difficulty swallowing, or a sensation of a lump in the throat.

Other Potential Causes

Less common causes of epigastric pain include epigastric hernias (a small bulge of tissue between the navel and breastbone), certain medications (like NSAIDs), and in some cases, even cardiac problems, which can manifest as upper abdominal discomfort.

Comparison of Causes


Condition	Typical Pain Location	Common Triggers	Accompanying Symptoms	Need for Medical Attention
GERD / Heartburn	Upper abdomen, mid-chest	Lying down, spicy/fatty foods, alcohol	Burning chest pain, sour taste, cough	Persistent or worsening symptoms
Gastritis	Upper abdomen	NSAIDs, alcohol, H. pylori infection	Nausea, vomiting, bloating	Persistent symptoms, severe pain
Peptic Ulcer	Upper abdomen (may radiate)	H. pylori, NSAIDs, empty stomach	Nausea, bloating, dark stools	Sudden severe pain, bloody vomit/stools
Gallbladder Issues	Upper right abdomen, radiating to center/back	High-fat meals	Nausea, vomiting, fever, jaundice	Severe, sudden pain, high fever
Pancreatitis	Upper abdomen, radiating to back	Alcohol, fatty foods	Nausea, vomiting, fever, rapid pulse	Severe, persistent pain, fever, rapid heart rate

Diagnosis and Treatment

To diagnose the cause of epigastric pain, a doctor will perform a physical exam and review your medical history. Diagnostic tests may include blood work, imaging (like ultrasound or endoscopy), and a barium swallow to visualize the esophagus and stomach.

Treatment depends entirely on the underlying cause. For common issues like GERD or mild gastritis, lifestyle and dietary adjustments, along with over-the-counter or prescription medications, are often effective. For conditions like gallstones or large hernias, surgical intervention may be necessary.

Lifestyle and Home Remedies

For many cases of epigastric pain caused by common digestive issues, simple lifestyle changes can offer significant relief.

Modify Your Diet: Avoid trigger foods such as spicy, fatty, and acidic items. The BRAT diet (bananas, rice, applesauce, toast) can be helpful during acute episodes.
Eat Smaller, More Frequent Meals: This can reduce the pressure on your stomach and limit overproduction of stomach acid.
Stay Upright After Eating: Avoid lying down for at least 2-3 hours after a meal to prevent acid from flowing back into the esophagus.
Elevate the Head of Your Bed: Using a wedge pillow can help alleviate nighttime acid reflux.
Manage Stress: Stress is known to worsen digestive issues. Techniques like meditation or yoga can be beneficial.
Consider Over-the-Counter Remedies: Antacids can provide quick relief for heartburn by neutralizing stomach acid.

Conclusion

Pain in the center of the abdomen under the breasts is a common symptom with a wide range of potential causes, from minor and manageable digestive upset to serious conditions requiring prompt medical attention. While lifestyle changes and home remedies can be effective for managing mild cases, it is crucial to consult a healthcare professional for a proper diagnosis if the pain is severe, persistent, or accompanied by other concerning symptoms like fever, vomiting, or unexplained weight loss. Understanding the specific characteristics of your pain and seeking timely medical advice can lead to an effective treatment plan and significant relief.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional regarding any health concerns or before making any decisions related to your treatment or care.

For more information, visit the National Institute of Diabetes and Digestive and Kidney Diseases at NIDDK.NIH.gov..

Frequently Asked Questions

The most common causes include gastroesophageal reflux disease (GERD), heartburn, gastritis, peptic ulcer disease, and overeating.

You should see a doctor if the pain is severe, persistent, or accompanied by other serious symptoms such as high fever, bloody vomit or stool, difficulty breathing, or jaundice.

Yes, stress can be a contributing factor to digestive issues like gastritis and can exacerbate symptoms associated with epigastric pain.

Heartburn is a specific symptom of acid reflux, a burning sensation felt in the chest or mid-abdomen. Epigastric pain is the broader term for discomfort in the upper-middle abdomen, which can be caused by various conditions, including acid reflux.

Yes, certain foods, especially spicy, fatty, and acidic ones, can trigger or worsen epigastric pain, particularly for those with GERD or gastritis.

While it can be, especially in women, it's more often related to digestive issues. However, if the pain is sudden, severe, and accompanied by other heart attack symptoms like chest tightness or shortness of breath, seek immediate emergency medical care.

Yes, for many cases related to diet or digestive issues, changes like eating smaller meals, avoiding trigger foods, not lying down after eating, and managing stress can be very effective.