Abdominal discomfort occurs commonly in pregnancy. The growing uterus, an active fetus and shifted intestines can all contribute to abdominal discomfort. But pain in the upper abdomen can be caused by problems beyond the usual pregnancy aches and pains, though less serious concerns can also be to blame. Call your medical practitioner to determine the source of upper abdominal pain in pregnancy and get guidance for treatment.
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Gastroesophageal Reflux Disease
Gastroesophageal reflux disease -- also called GERD or heartburn, due to the burning pain it causes in the upper abdomen or chest -- is common in pregnancy, affecting up to 80 percent of pregnant women, a 2012 "BMC Gastroenterology" article reports. Other symptoms seen with GERD include a sour taste in the mouth or regurgitation; symptoms are generally worse after eating. As pregnancy progresses, you are more likely to develop GERD as the growing uterus puts more pressure on the intestinal tract. GERD can also result from decreased muscle tone in the lower esophageal sphincter, which separates the stomach from the esophagus and keeps undigested food from entering the esophagus. Slower-than-normal transit times through the gastrointestinal tract due to hormonal changes may also cause GERD. Certain foods may worsen this disorder, although no foods are universally associated with GERD. Ask your doctor before taking antacids or other medications.
Gallbladder problems can flare up during pregnancy, with around 10 percent of women developing gallstones at this time, according to the December 2009 issue of "World Journal of Gastroenterology." Gallbladder issues arise because cholesterol secretion into bile increases in pregnancy, leading to the formation of cholesterol crystals that eventually form gallstones. The gallbladder also empties more slowly during pregnancy, which encourages sludge buildup in the gallbladder that can lead to gallstones. Symptoms include pain in the upper right abdomen, especially after eating a meal high in fat. If gallstones needs to be removed, your doctor might prefer to do this in the second trimester, when the risk of complications is lower and the surgery easier to perform than in the third trimester, when the uterus is larger.
The pancreas and the gallbladder share a common drainage duct. Because of this, a blockage in the duct caused by gallstones can also cause problems in the pancreas. Acute pancreatitis, an inflammation of the pancreas, increases in frequency during pregnancy but remains a rare disorder, affecting just 3 in 10,000 pregnant women, according to the December 2009 issue of "World Journal of Gastroenterology." You may experience pain in your upper abdomen that wraps around your back. Leaning forward may decrease the pain. The increased incidence of gallstones in pregnancy accounts for approximately 70 percent of all cases of acute pancreatitis in pregnancy. Having high triglyceride levels or abusing alcohol can also cause acute pancreatitis. Any severe abdominal pain in pregnancy merits immediate medical evaluation.
Preeclampsia of Pregnancy
Preeclampsia can lead to serious pregnancy complications for mother and baby. In Western regions, it affects between 2 and 7 percent of all pregnancies, with first pregnancies more commonly afflicted than subsequent ones, according to a 2005 review in "Nature Clinical Practice Nephrology." Being older than 40, having long-standing hypertension or diabetes or being obese also puts pregnant women at greater risk for developing preeclampsia, which develops in the latter half of pregnancy. Classic signs of this disorder include upper right quadrant abdominal pain, visual disturbances, facial swelling, headache, protein in the urine and high blood pressure. See your practitioner immediately if you develop symptoms of preeclampsia, as this condition can be life threatening for you and your baby.
- World Journal of Gastroenterology: Acute Pancreatitis of Pregnancy
- BMC Gastroenterology: A Prospective Longitudinal Cohort Study: Evolution of GERD Symptoms During the Course of Pregnancy
- Nature Clinical Practice Nephrology: Mechanisms of Disease -- Pre-eclampsia
- Wolters Kluwer Health: Acute Pancreatitis
- Gastroenterology and Hepatology: Advances in GERD