Gastroesophageal Reflux Disease (GERD): This is often the most common cause of epigastric pain due to the reflux of stomach acid into the esophagus, leading to inflammation and pain.
Peptic Ulcer Disease: This includes both gastric and duodenal ulcers, which can cause episodic epigastric pain, especially related to eating.

Functional Dyspepsia: A condition characterized by recurring signs and symptoms of indigestion that have no obvious cause, often related to eating.
Gallbladder Disease: Gallstones or cholecystitis can cause epigastric pain, especially after eating fatty foods.
Pancreatitis: Inflammation of the pancreas, which can cause severe epigastric pain radiating to the back.

Myocardial Infarction: Although chest pain is the typical presentation, some patients, especially women and diabetics, may present with epigastric pain as a symptom of a heart attack.
Pulmonary Embolism: Severe, sudden-onset epigastric pain can be a presentation of a pulmonary embolism, especially if accompanied by shortness of breath or tachycardia.
Aortic Dissection: Sudden, severe epigastric pain can be a symptom of an aortic dissection, which is a medical emergency.
Esophageal Rupture or Perforation: A severe, sudden onset of epigastric pain can indicate an esophageal rupture, which requires immediate medical attention.

Gastric Cancer: Although rare, gastric cancer can present with epigastric pain, weight loss, and other non-specific symptoms.
Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause epigastric pain, though they more commonly cause lower abdominal pain.
Hepatic Artery Aneurysm: A rare condition that can cause epigastric pain due to the rupture of an aneurysm in the hepatic artery.