dr9ohm · Epigastric Severity Score

Epigastric burn severity index
Stomach-coating layer / URD

Quick answer (BLUF): A 0–15 index for epigastric burn and meal-related pain. Does not diagnose ulcers and does not prescribe URD. Black stools or vomiting blood need care now.

5 core items (0–3) inspired by Rome IV EPS + lifestyle + urgent — not a diagnosis; not a URD prescription

How to answer

Symptoms: 0/1/2/3 · Other sections: Yes/No. Urgent Yes → see a doctor now even if the score is low.

Synthesized from Rome IV EPS / NIDDK peptic-ulcer education frameworks · Asst. Prof. Dr. Norawit Raatpiboon

Symptom score (Raw Score)

0 / 15

Symptoms answered 0/5 · Lifestyle 0/5 · Urgent 0/5

Part 1 — Core symptoms (scored)

Q1: Epigastric burn

How often is burn, fullness, or pain under the xiphoid stronger than mid-chest heartburn?

0 — None
1 — Mild (1–2 days/week)
2 — Moderate (3–4 days/week)
3 — Severe / almost daily, life-disrupting

Q2: Meal-related

How often does epigastric pain worsen on empty stomach, after meals, or with coffee/spicy food, with little change from sleep position?

0 — None
1 — Mild (1–2 days/week)
2 — Moderate (3–4 days/week)
3 — Severe / almost daily, life-disrupting

Q3: Early fullness

How often do you feel early fullness or pressure after small meals?

0 — None
1 — Mild (1–2 days/week)
2 — Moderate (3–4 days/week)
3 — Severe / almost daily, life-disrupting

Q4: Mucosal irritant

How often does epigastric burn follow NSAID painkillers, coffee on empty stomach, or spicy/very sour food?

0 — None
1 — Mild (1–2 days/week)
2 — Moderate (3–4 days/week)
3 — Severe / almost daily, life-disrupting

Q5: Antacid / coating reliance

How often in a week do you need antacids or stomach-coating supplements to quiet epigastric burn?

0 — None
1 — Mild (1–2 days/week)
2 — Moderate (3–4 days/week)
3 — Severe / almost daily, life-disrupting

Part 2 — Lifestyle profile (for personalized guidance)

Not in the 15 — helps personalize Intensive Summaries.

1. You are considering stopping a PPI and using a stomach-coating sachet instead

Yes
No

2. You regularly take NSAID painkillers or aspirin

Yes
No

3. You drink coffee/tea on an empty stomach or skip meals then get epigastric burn

Yes
No

4. You have egg-white allergy, or your sachet label lists egg-white protein

Yes
No

5. Epigastric burn lasting >2 weeks without clinician review / endoscopy

Yes
No

Part 3 — Urgent symptoms (not in the 15)

Any Yes → see a doctor now.

1. Black stools or vomiting blood / coffee-ground material

Yes — see a doctor now
No

2. Food sticking or painful swallowing

Yes — see a doctor now
No

3. Unintentional abnormal weight loss

Yes — see a doctor now
No

4. Chest pain to the arm, cold sweat, or shortness of breath (may be a different layer than epigastric burn)

Yes — see a doctor now
No

5. Unrelenting vomiting, sudden pale weakness, or unbearable epigastric pain

Yes — see a doctor now
No

0 points

Start your epigastric assessment

When all 5 symptom items are answered, the score updates automatically — a high score is not a URD prescription

Important notes (Red Flags)

Black stools, vomiting blood, food sticking, unintentional weight loss, or cardiac-sounding chest pain → seek care now. URD/coating sachets are not H. pylori eradication therapy.

What a 0–15 score means

Symptom-density bands — not a diagnosis

Score	Band	Meaning	What not to do
0–4	Not dense yet	Keep tracking; do not skip red-flag signals	Do not delay exams because of ads
5–7	Starting to recur	Plan to see a clinician for this system	Do not add supplements on your own
8–10	Clearly disruptive	Do not ignore — book a visit	Do not use a quiz instead of a clinic visit
11–15	High density	Check Red Flags now	Do not treat this as a diagnosis

Frequently asked questions

Does this score prescribe URD?

No. URD is a supplement layer code here — not an ulcer drug order.

Is epigastric burn the same as GERD?

Not always. Mid-chest reflux/LPR is the GERD layer; under-xiphoid meal-related burn is this layer.

Can I stop my PPI for a coating sachet?

Not without your clinician. Ads are not deprescribing orders.

Do NSAIDs matter?

Yes — mucosal irritants can worsen epigastric burn; discuss safe alternatives with a clinician.

When is endoscopy needed?

Persistent burn >2 weeks, alarm features, or clinician judgment — the quiz does not replace that decision.

Medical Disclaimer: For general education only — not personalized medical advice. Stomach-coating supplements are not ulcer drugs.
Seek care immediately for dangerous signals · Asst. Prof. Dr. Norawit Raatpiboon
· Thai twin: https://dr9ohm.com/urd-epigastric-severity-score/