Epigastric abdominal pain


  • This page outlines the general approach to adult epigastric pain

Clinical Features

Differential Diagnosis

Epigastric Pain


  • CBC
  • Chem
  • LFTs
  • Lipase
  • Coags
  • Urinalysis
  • Urine pregnancy (females)
  • ?ECG (if >50 or at risk for cardiac disease)
  • ?RUQ US
  • ?CXR
    • Consider if at risk for perforated ulcer


  • Treat underlying disease process
  • Consider PO antacid (e.g. Maalox Plus)
    • The addition of viscous lidocaine 2% and/or Donnatol (i.e. "GI Cocktail") is no more effective than plain liquid antacid[1]


  • Disposition per underlying disease process

See Also

External Links


  1. Berman DA, Porter RS, Graber M. "The GI Cocktail is no more effective than plain liquid antacid: a randomized, double blind clinical trial." J Emerg Med. 2003 Oct;25(3):239-44.