Pain in the middle of the upper abdomen may be caused by chronic gastritis, peptic ulcer, pancreatitis and other diseases. 1. Chronic gastritis: refers to the lesions of the gastric mucosa caused by the damage of various harmful factors. It can cause pain in the middle of the epigastric region, and can also manifest itself as discomfort in the middle and upper abdomen, a feeling of fullness, a burning sensation, acid reflux, belching (hiccups), nausea, loss of appetite and other symptoms. 2. Peptic ulcer: refers to chronic ulcers that occur in the stomach and duodenum. It can also cause pain in the middle of the upper abdomen, usually with a certain regularity, such as gastric ulcers are mainly manifested as postprandial pain, duodenal ulcers are mainly manifested as fasting meal or night pain. It is usually accompanied by bloating, belching (burping), acid reflux, nausea, vomiting and other symptoms. 3. Pancreatitis: It is an inflammatory lesion caused by a variety of etiological factors leading to the pancreatic tissue being self-digested. It can also cause pain in the middle of the epigastric region that radiates to the back, often accompanied by nausea, vomiting, fever and other symptoms. There are many other causes of epigastric pain in the middle of the abdomen, which should be taken seriously, and the cause of the pain should be identified and further managed or treated in accordance with the doctor’s instructions.