Epigastric distention usually appears in the substernal region. Whatever causes it, it is brought on by ascending and descending disorder of qi of the middle energizer and closely correlated with stomach qi.
It's not necessarily chronological, but at the same time it gives you a sense of successive metaphysical philosophers thinking about first causes, origins, and about whatever it is that determines everything else.
On the other hand there's plenty of reason for him to make a cosmetic reach-out in order to show that whatever happens it's not really his fault, and if the sequester causes pain at least the responsibility is shared.