Pain at the top of your stomach (upper abdomen) is common and can come from many different issues, some minor and some serious.

Common, less serious causes

These often get better on their own but can still feel very uncomfortable.

  • Indigestion/acid reflux (GERD) : Burning or gnawing pain in the upper middle stomach or just under the ribs, often after eating or when lying down; may come with a sour taste, burping, or heartburn.
  • Gas or bloating: Crampy, gassy feeling high in the belly, lots of burping or passing gas, worse after certain foods or eating quickly.
  • Gastritis (irritated stomach lining): Burning or aching at the top of the stomach, nausea, feeling full quickly, sometimes worse with food, alcohol, or painkillers like ibuprofen.
  • Muscle strain: Sore, sharp, or pulling pain on movement, coughing, or twisting, often after heavy lifting, intense exercise, or repeated coughing.
  • Mild stomach bug (viral gastroenteritis): Ache or crampy pain with nausea, vomiting, or diarrhea and sometimes low-grade fever.

More serious causes you shouldn’t ignore

These need prompt medical evaluation, especially if the pain is strong, new, or different for you.

  • Gallbladder problems (gallstones, cholecystitis): Pain at the top right or middle of the stomach, often after a fatty meal, can spread to the back or right shoulder, with nausea or vomiting.
  • Stomach or duodenal ulcers: Gnawing or burning upper stomach pain, sometimes better or worse with eating, possible nausea or black/tarry stools if bleeding.
  • Pancreatitis: Severe upper middle or left-sided pain that may go through to the back, often with nausea, vomiting, and feeling very unwell; sometimes related to alcohol or gallstones.
  • Heart issues (including heart attack): Pressure, tightness, or pain high in the stomach or chest that can feel like bad indigestion, often with shortness of breath, sweating, nausea, or pain in arm/jaw/back.
  • Liver or bile duct problems (hepatitis, cholangitis): Upper right abdominal pain with fatigue, dark urine, pale stools, or yellowing of eyes/skin (jaundice).
  • Serious abdominal conditions (appendicitis, bowel blockage, aneurysm, etc.): Increasing, constant, or spreading pain, often with vomiting, fever, not passing gas or stool, or feeling faint.

When to seek emergency help

Get urgent medical help (call emergency services or go to ER) right away if your upper stomach pain comes with:

  • Chest pressure, tightness, or pain spreading to arm, jaw, back, or neck.
  • Trouble breathing, feeling like you can’t catch your breath.
  • Sweating, feeling faint, or passing out.
  • Vomiting blood or material that looks like coffee grounds.
  • Black, tarry, or bright red stools.
  • Sudden, severe pain that doesn’t ease, or a rigid, hard belly.
  • High fever with bad pain or you feel “really wrong” or very weak.

These can be signs of a heart attack, internal bleeding, severe infection, or other emergencies.

When to see a doctor soon

Book a same‑day or next‑day visit (urgent care or your regular doctor) if:

  • The top of your stomach has hurt for more than a couple of days and isn’t improving.
  • Pain keeps coming back, especially after meals.
  • You have ongoing nausea, poor appetite, or unintentional weight loss.
  • You have difficulty swallowing, feel full very quickly, or vomit repeatedly.
  • You use a lot of NSAIDs (ibuprofen, naproxen) or drink a lot of alcohol and now have new upper stomach pain.

Things you can try short term (if symptoms are mild)

These are general comfort tips and not a substitute for being checked, especially if anything above applies.

  • Rest the stomach: Small sips of water or clear fluids; avoid heavy, spicy, or very fatty meals.
  • Try simple foods: Bland options like toast, rice, bananas, or plain crackers if you can tolerate food.
  • Avoid triggers: Alcohol, smoking, caffeine, and large late‑night meals can worsen reflux and gastritis.
  • Positioning: Staying slightly upright after eating; some people find a slight incline in bed eases reflux discomfort.
  • Gentle heat: A warm (not hot) compress on the upper abdomen can ease muscle and cramp pains.

This can’t diagnose the exact reason the top of your stomach hurts, and upper abdominal pain can sometimes signal something serious. If your pain is strong, new, or you’re worried, it’s safest to contact a doctor or urgent care now so they can examine you and run tests if needed.