Pain in the epigastral area: current aspects of differential diagnosis

Abstract

Epigastric pain can have a variety of etiologies, including not only diseases of the upper gastrointestinal tract (GIT): gastroesophageal reflux disease, hiatal hernia, gastritis and duodenitis, gastric and/or duodenal ulcers, polyps and stomach cancer, functional dyspepsia, but also other gastrointestinal diseases, somatic diseases of other organs and systems, vascular pathology, infections and invasions, medications and a number of other reasons. More than 10 years have passed since the publication of our previous article on the issues of differential diagnosis of pain in the stomach. In the Elibrary.ru information base, both in the period of time preceding the publication and to this day, we have not found similar publications. This explains its placement in full or in fragments on specialized gastroenterological sites and guidelines for differential diagnosis in gastroenterology. Over the past 10 years, new consensuses and clinical recommendations have been published on diseases and conditions associated with epigastric pain, and the number of publications on other diseases and conditions that were previously considered very rare, but which today must be taken into account when carrying out differential diagnosis, has increased. Several foreign publications on the problem in recent years were found in the PubMed electronic database. In this regard, we consider it appropriate to consider the current aspects of the differential diagnosis of epigastric pain from the perspective of today. The list of diseases and conditions presented in the review, in which epigastric pain occurs in the clinical picture, indicates that the differential diagnosis of this syndrome is an interdisciplinary problem and is of interest not only to the gastroenterologist and therapist, but also to doctors of other specialties.