Quick answer: Dull stomach pain is a aching or pressing pain felt in the region of the epigastrium. The most common causes are gastro-oesophageal reflux disease, gastric ulcer, gastritis and functional dyspepsia. An endoscopy is required to make an accurate diagnosis and to rule out more serious conditions.
A dull, aching pain felt around the pit of the stomach affects many people and often causes persistent discomfort. This type of symptom is rarely sharp or cramp-like; rather, it presents as a constant, pressing sensation in the area between the lower part of the chest and the navel.
There may be a number of underlying causes, ranging from simple indigestion to a stomach ulcer. In most cases, the symptoms can be managed effectively, but it is important to recognise when a specialist examination is required.
In this article, we review the most common causes of dull stomach pain, the accompanying symptoms, and the tests that can help establish an accurate diagnosis. Our aim is to provide clear and reliable information to help allay any fears.
What is a dull stomach ache, and where does it occur?
Dull stomach pain is a sensation of discomfort felt in the epigastric region. This area is located below the breastbone and above the navel. The pain is usually aching or nagging in nature, rather than sudden and sharp.
This symptom is often accompanied by other digestive symptoms, such as a feeling of fullness or nausea. The pattern of the pain over time can reveal a great deal about the underlying cause:
- Pain that worsens after eating: often indicates a stomach ulcer
- Pain on an empty stomach, before a meal: This may typically be a sign of a duodenal ulcer
- Night-time pain (between 23:00 and 02:00): a classic symptom of a duodenal ulcer
What could be causing a dull stomach ache?
There are several common causes of upper abdominal pain. Most of these can be treated effectively if detected in good time.
Reflux disease (GERD)
In gastro-oesophageal reflux disease, stomach contents flow back into the oesophagus. This can cause a burning sensation, acid burps and upper abdominal discomfort. It affects 10–20% of the Western population, many of whom experience symptoms weekly or even daily.
Typical symptoms include heartburn, acid regurgitation and a burning sensation behind the breastbone. These symptoms may be exacerbated by certain foods (fatty, acidic or spicy) and certain body positions (bending over or lying down).
Stomach ulcers and duodenal ulcers
Peptic ulcer disease is damage to the lining of the stomach or duodenum. It causes upper abdominal pain in around 80% of patients. The most common causes are the bacterium Helicobacter pylori and the regular use of anti-inflammatory medicines (NSAIDs).
H. pylori infection is detected in 70–90% of duodenal ulcers and in 30–60% of gastric ulcers. Anti-inflammatory drugs increase the risk of developing an ulcer by an average of fourfold.
Gastritis (inflammation of the stomach)
Gastritis is an inflammation of the stomach lining. Most patients are asymptomatic, but symptoms such as loss of appetite, nausea, belching and a sudden feeling of pressure in the upper abdomen may occur. Causes include stress, alcohol, the use of anti-inflammatory drugs and H. pylori infection.
Functional dyspepsia
In cases of functional dyspepsia, the patient experiences upper abdominal discomfort, but no organic abnormalities are found during examination. It affects approximately 16% of the population, and stress contributes to its prevalence.
Symptoms include epigastric pain or a burning sensation, a feeling of fullness after eating, and feeling full early on. To make a diagnosis, it is necessary to rule out any organic causes.
What accompanying symptoms should we look out for?
Dull stomach pain is often accompanied by other symptoms. These help the doctor to identify the underlying cause. The most common accompanying symptoms are:
- Heartburn and acid reflux
- Nausea or occasional vomiting
- Feeling of fullness after a meal, feeling full too soon
- Bloating and belching
- Loss of appetite
When is it important to see a doctor?
If you experience certain symptoms, you must not delay seeking medical attention. These are known as „alarm” symptoms, as they may indicate a more serious condition. Please consult a specialist immediately if you experience any of the following:
- Difficulty swallowing (dysphagia) or pain when swallowing
- Weight loss of unknown cause and loss of appetite
- Anaemia or its symptoms (weakness, fatigue)
- Haemoptysis (fresh blood or coffee-ground-like vomit) or black, tar-like stools
- Recurrent vomiting
- Persistent pain, not related to meals
These symptoms may indicate a more serious condition of the upper digestive tract, or even a tumour, and therefore always require an endoscopic examination.
How can the cause of the pain be determined?
To make an accurate diagnosis, the doctor will review the symptoms and medical history in detail. Gastroscopy is the most important tool for investigating upper abdominal complaints.
The role of gastroscopy
Gastroscopy is the most accurate method of examining the upper digestive tract – the oesophagus, stomach and duodenum. During the procedure, the doctor uses a thin, flexible instrument to view the mucous membrane directly and may take a tissue sample (biopsy).
Gastroscopy is the gold standard for diagnosing ulcers and stomach cancer. The procedure can also detect the presence of Helicobacter pylori, which enables targeted treatment. In detail On this page, you can read about gastroscopy under general anaesthesia.
Helicobacter pylori screening
The presence of the bacterium can be detected using several different diagnostic methods. These include the urea breath test, the faecal antigen test, and the examination of a tissue sample taken during an endoscopy.
How can dull stomach pain be treated?
Treatment always depends on the underlying cause. The most common treatment options are as follows:
- Acid-reducing medicines (PPIs): Proton pump inhibitors form the basis of treatment for ulcers, reflux and inflammation. They are most effective when taken 30–60 minutes before a meal.
- Eradication of Helicobacter pylori: If the bacterium is detected, targeted antibiotic treatment is administered, typically in combination with an acid-reducing agent.
- Avoiding the underlying causes: Stopping or changing anti-inflammatory medication may help to alleviate symptoms.
- Lifestyle changes: Avoiding fatty, spicy and acidic foods, eating smaller, more frequent meals, and raising the head of the bed can help to relieve the symptoms.
The role of Endomedix in the investigation of stomach complaints
At Endomedix’s gastroenterology centres, experienced specialists investigate upper abdominal symptoms. The tests required for an accurate diagnosis, including gastroscopy and Helicobacter pylori screening, are available.
For medical reasons, at Endomedix we carry out endoscopic examinations under general anaesthesia rather than under sedation. General anaesthesia is supervised by a qualified anaesthetist, who monitors the patient’s vital signs throughout the entire procedure. As a result, the procedure is completely painless, and the patient feels nothing during the procedure.
If you experience persistent stomach problems, or if treatment with antacids does not bring any relief, it is advisable to consult a specialist. A medical examination will help to rule out more serious conditions and find the right treatment. Book an appointment at Endomedix to investigate the complaints.
Frequently asked questions
What is the difference between a dull stomach ache and cramp-like pain?
Dull stomach pain is a constant, aching or pressing sensation in the upper abdomen. Cramp-like pain, by contrast, comes and goes, intensifying and subsiding periodically. The nature of the pain helps the doctor to identify the underlying cause.
Can a dull stomach ache be dangerous?
In most cases, a dull stomach ache is a sign of a condition that can be treated effectively, such as acid reflux or gastritis. However, if warning signs (weight loss, anaemia, difficulty swallowing, bloody stools) are present, a more serious underlying condition may be to blame, so immediate medical investigation is required in such cases.
Does a gastroscopy hurt?
A gastroscopy under general anaesthesia is completely painless. The patient is asleep during the procedure, so they feel nothing and do not experience any retching or discomfort.
How long might it take for my symptoms to improve?
The rate of improvement depends on the cause and the treatment. With acid-reducing treatment, the symptoms of reflux and inflammation typically subside within a few weeks. It may take several weeks for an ulcer to heal, and follow-up examinations are often necessary.
When is a gastroscopy needed?
An upper gastrointestinal endoscopy is indicated if symptoms are persistent or recurrent, do not respond to acid-reducing treatment, or if warning signs appear. The examination is particularly important for patients aged 40–50 and over who present with new-onset symptoms.
