Dullness and swelling in the middle of the upper abdomen may be caused by chronic gastritis, peptic ulcer, cirrhosis of the liver, etc., which should be treated with medication such as omeprazole, bismuth potassium citrate, entecavir, etc., and/or surgically under the guidance of a doctor after clarifying the cause of the disease. 1. Chronic gastritis: Chronic gastritis refers to a variety of chronic inflammatory lesions of the gastric mucosa caused by different etiologic factors, which are generally related to the patient’s personal constitution, dietary habits, smoking and drinking. Patients usually have symptoms such as vague pain in the upper abdomen, loss of appetite, fullness after meals and acid reflux. Omeprazole, bismuth potassium citrate and other drugs can be used for treatment under the guidance of the doctor. This drug is prohibited for those who are allergic to this product, those with severe renal insufficiency and infants and young children. 2. Peptic ulcer: Peptic ulcer is caused by the mucous membrane of gastrointestinal tract being digested by gastric acid and pepsin under certain circumstances, and the patients usually suffer from abdominal pain, abdominal distension, dyspepsia and other symptoms. Omeprazole, lansoprazole and other drugs can be used for treatment under doctor’s guidance. This drug is prohibited for those who are allergic to this product, those with severe renal insufficiency and infants. 3. Cirrhosis: Cirrhosis refers to diffuse fibrosis of liver tissue. Patients with cirrhosis often have discomfort such as tightness and swelling right in the middle of the upper abdomen, fatigue and poor appetite. It is necessary to actively treat the primary disease, such as entecavir anti-hepatitis B virus, strengthen the rest and nutrition, if necessary, need to endoscopic hemostasis, transjugular vein portosystemic shunt to deal with complications. Dullness and swelling in the middle of the epigastrium may also be caused by other reasons, and should be actively consulted to clarify the cause of the disease and follow the medical advice.