What is epigastric pain? Epigastric pain is pain that is localized to the region of the upper abdomen immediately below the ribs. Often, those who experience this type of pain feel it during or right after eating or if they lie down too soon after eating. It is a common symptom of gastroesophageal reflux disease (GERD) or heartburn. It may be associated with the gastric contents moving upward into the back of the throat, causing inflammation and a burning pain. Epigastric pain may also occur with conditions that cause inflammation of the digestive organs, such as gastritis and pancreatitis. Pregnant women may experience epigastric pain due to increased abdominal pressure and hormonal changes that slow the digestive process. Epigastric pain can also arise from conditions that impair the normal digestive process, such as peptic ulcers, hiatal hernias, or gallstones. In these cases, it may occur frequently after meals, and it may become chronic. Some people have mild epigastric pain that occurs after eating and subsides quickly, while others may have a severe burning feeling in the abdomen, chest and neck that prevents sleep. Other symptoms that may accompany epigastric pain include abdominal bloating, constipation, diarrhea, and vomiting, depending on the underlying cause. In rare cases, epigastric pain is due to heart conditions such as heart attack and angina (chest pain due to the heart not getting enough oxygen). Epigastric pain is not a serious symptom on its own. However, if it occurs with other life-threatening symptoms, it may be a sign of a condition that should receive immediate medical treatment, such as a heart attack. Seek immediate medical care (call 911) if you, or someone you are with, experience epigastric pain along with life-threatening symptoms such as severe breathing problems; chest pain, pressure or tightness; or vomiting blood or black material. Seek prompt medical care if you are being treated for epigastric pain but mild symptoms recur or are persistent.