Stomach pain during pregnancy: causes, treatment

Gastralgia (painful sensations in the stomach) is the main symptom of most gastrointestinal pathologies. It can be acute, chronic or recurrent, that is, recurring more than 3-4 times a year. Exacerbation of gastralgia is facilitated by bad habits (dependence on toxic substances), eating disorders, psychosomatic pathologies, as well as pregnancy. Stomach pain during pregnancy can be associated with diseases of the digestive system, neurotic disorders or physiological characteristics of the body during gestation, for example, toxicosis.

Treatment of gastric pain in pregnant women includes correction of diet, stabilization of the emotional state and the use of medications (if indicated).

Possible reasons

Not always stomach pain in pregnant women is associated with diseases of the gastrointestinal tract. Moderate stomach discomfort in the second and third trimester is normal, as the growing uterus compresses nearby organs, which can cause spasm and irritation of the nerve receptors. By the last month of pregnancy, the uterus increases by about 5-5.5 times, therefore, a slight gastralgia after 20 weeks in the absence of other alarming symptoms is a physiological norm.

To avoid severe pain during this period, a woman is advised to follow a fractional diet (5-7 times a day), limit the use of foods that can stimulate the formation of intestinal gas, and refuse heavy and fatty foods that create an increased load on the organs involved in the digestive process.

The pathological conditions listed below can also contribute to the appearance of painful spasms and local pain sensations.

1. Constipation. Constipation during pregnancy occurs in 35-40% of women. Stool stagnation in the intestines provokes pain in the upper and central abdomen, which a woman can perceive as stomach pain. The main causes of constipation during pregnancy, gastroenterologists consider malnutrition and the rapid growth of the uterus.
   

   Constipation, which affects most pregnant women, is one of the causes of pain.

2. Binge eating. The stomach during pregnancy is under increased stress, so eating a large amount of food can provoke an intense painful spasm (the walls of the stomach cannot stretch due to the fact that they are "propped up" uterus).
   

   Overeating is not good for anyone, much less pregnant

3. Hormonal changes. Changes in hormonal levels during pregnancy can lead to increased production of certain hormones that produce hydrogen chloride (hydrochloric acid). For example, gastrin, synthesized by endocrine cells of the pancreatic mucosa and pyloric part of the stomach, increases the level of hydrochloric acid, which can damage epithelial cells and irritate pain receptors.
   

   The hormones that are produced by the digestive tract can also provoke stomach pain.

4. Toxicosis. Almost 70% of pregnant women suffer from toxicosis. Pathology is manifested by headaches, dizziness, severe nausea, frequent vomiting. In women with early toxicosis, appetite is impaired, so such patients may experience the so-called "hunger pains" that occur when damage to the walls of the stomach by digestive juice, which contains not only hydrochloric acid, but also pepsin (can provoke peptic ulcer).
   

   Severe toxicosis is the cause of impaired appetite and digestive processes in pregnant women, which can be manifested by sharp pain in the stomach

A relatively stable and comfortable period is considered to be the time from 15 to 27 weeks of pregnancy. At these times, the uterus is rather small and does not press so much on the nearby organs, therefore, in the second trimester, complaints of pain in the stomach are recorded less often.

Note! If the pain in the abdominal area does not go away within a few hours, despite taking painkillers and antispasmodic drugs, you should consult a doctor and exclude the likelihood of injury. Prolonged pain can also be due to physical fatigue, acute stress, an allergic reaction, or certain medications (abdominal pain is the most common side effect of most synthetic drugs).

Inflammation of the stomach in pregnant women

If a woman was diagnosed with gastritis before pregnancy, the likelihood of its exacerbation during gestation increases several times. This is facilitated not only by the nutritional characteristics associated with toxicosis, but also by a systemic decrease in immunity, which is characteristic of 80% of pregnant women. With gastritis, the mucous membranes of the cardiac and pyloric stomach become inflamed, which leads to irritation of the nerve receptors and the appearance of painful sensations.

Pain in inflammatory-dystrophic processes in the stomach can be acute, pressing, bursting. Less commonly, women complain of tingling, dull and burning sensations in the epigastric region, which are combined with heaviness, flatulence, nausea and heartburn.

The manifestations of gastritis in early pregnancy can be perceived by many as signs of toxicosis. Nausea and vomiting, combined with a lack of appetite and abdominal discomfort are considered physiological symptoms of toxicosis, therefore, very often with with such complaints, women turn to the doctor only after 12-14 weeks of pregnancy, when the most informative diagnostic signs are at the stage attenuation.

Acute or recurrent inflammation of the stomach can be suspected in the presence of other symptoms, which include:

• upset stool (a common sign of gastritis, which is not a specific manifestation of the inflammatory process);
  

  Diarrhea is one of the signs of gastritis

• bad breath;
• belching with a sour or offensive odor;
• burning sensation in the oral cavity (can occur simultaneously with inflammation of the oral mucosa - stomatitis);
  

  A burning sensation in the mouth or stomatitis also indicates stomach problems.

• heaviness in the epigastric region that occurs while eating or immediately after eating;
• behavioral changes (irritability, lethargy, possibly aggressive behavior);
• change in heart rate;
  

  Changes in heart rate during pregnancy - a reason to get tested

• arterial instability;
• violation of sensitivity in the upper extremities (an important diagnostic sign of gastritis is the symmetry of paresthesia);
• sweating
  

  Health problems and decreased immunity are often accompanied by increased sweating

Diagnosis of gastritis during pregnancy is complicated not only by a blurred clinical picture, the symptoms of which may be variants of the individual physiological norm, but also the impossibility of conducting a number of informative studies, for example, gastroscopy. The introduction of an endoscope into the cavity of the stomach and duodenum can provoke an increase in the uterine tone, internal bleeding (in case of damage to the mucous membranes and walls of the organ by elements gastroscope).

It should also be borne in mind that any invasive diagnostic methods are associated with a certain risk. infection, therefore, such studies are prescribed to pregnant women only in the case of acute necessity.

How to treat?

The drugs traditionally used for the treatment of chronic Helicobacter pylori-associated gastritis (according to the eradication protocol), contraindicated during pregnancy, therefore, the main methods of stopping the inflammatory process in this category of patients are therapeutic and prophylactic nutrition, correction of psychoemotional status (including for the prevention of stress ulcers) and gentle drug therapy.

Pregnant women can take the drugs listed in the table below as directed by their doctor.

Preparations for the sparing medical treatment of gastritis during pregnancy

Pharmacological group	Drugs
Antibiotics for the destruction of the causative agent of infection - bacteria Helicobacter pylori	"Amoxicillin", Flemoxin, "Panklav", Clarithromycin "Tetracycline" "Hemomycin", "Azithromycin".
Preparations for the normalization of intestinal microflora	Helinorm, "Bion-3" (the drug contains vitamins and minerals, so if a woman takes any vitamin and mineral complex, its use is contraindicated), "Bifiform", "Narine".
Antacids to neutralize hydrogen chloride and fight heartburn	Rennie, "Maalox", "Gastal", "Gaviscon".
Antispasmodics to relieve painful stomach and intestinal cramps	"No-shpa" "Drotaverin", "Papaverine hydrochloride 1%", "Spazmol", "Spazmonet".

Important! Bismuth preparations and proton pump inhibitors are contraindicated for pregnant women, therefore they are not included in the treatment protocol in this category of patients.

When is treatment required?

Quite dangerous conditions in which a woman needs medical help (and in severe cases, hospitalization) can also cause pain in the stomach. To understand what exactly triggered the appearance of pathological signs, it is necessary to conduct a physical examination of the woman (including palpation and abdominal percussion, if necessary). In some cases, a gynecologist's examination may be required to rule out pregnancy pathologies, which may manifest as abdominal pain, mistaken for stomach cramps.

Taste disorder

Almost half of pregnant women develop various taste disorders (for example, dysgeusia - distortion taste perception), which leads to the use of substances that are not intended for this, for example, chalk or whitewash. In about a third of women, dysgeusia may be manifested by a desire to combine sweet and salty tastes (herring with strawberries, pickles with honey, etc.). Such combinations can provoke catarrh of the mucous membranes of the stomach and cause intense contractions of its walls, as a result of which a woman will feel severe pain in the epigastric region.

Note! To diagnose dysgeusia and other pathologies in which the work of the taste buds of the tongue is disrupted, methylene blue staining is used, as well as taste tests. In some cases, diagnostics using an electric current can be informative, but during pregnancy this method is rarely used.

Foodborne toxicoinfections

Poisoning by poor quality food is one of the main causes of severe stomach pain, which can accompanied by fever, vomiting with the smell of rotten eggs, nausea, pathological pallor of the skin, diarrhea. Some pathogens of intestinal infections (for example, salmonella or E. coli) may not cause severe symptoms: in this case cramping pain goes away on its own about 3-4 days after the onset, and the general condition of the woman is completely normalized by 5-7 day.

Important! If you suspect poisoning with expired or low-quality products, you must immediately take an enterosorbent, for example, smecta (1 sachet 3-4 times a day). If the cause was the use of stale eggs or meat, therapy with topical antibacterial drugs (250 mg of nifuroxazide 3 times a day) is indicated. In case of severe vomiting, it is necessary to take measures for rehydration (drinking plenty of fluids, bed rest, taking Rehydron or Hydrovit).

Diseases of the digestive system

Gastritis is not the only condition in which a pregnant woman can have stomach ache. Similar pains of varying intensity can be observed with the following pathologies:

• diseases of the biliary organs (cholecystitis, cholangitis, cholelithiasis, biliary dyskinesia, sludge syndrome);
  

  Stones in the gallbladder and bile ducts

• liver pathology (hepatitis, fatty or alcoholic liver dystrophy, cirrhosis, amyloidosis, Wegener's granulomatosis);
• stomach diseases (stomach atony, gastric fistula, polyposis);
  

  Polyposis of the stomach

• pathology of the small intestine (diverticulitis, enteritis, gastroenteritis, peptic ulcer);
• diseases of the pancreas (gastrinoma, pancreatitis).
  

  Chronic pancreatitis

Important! All these pathologies require medical supervision and control. Self-treatment is unacceptable, since there is a high risk of serious complications in the case of improperly selected therapy.

Psychosomatic stomach pain in pregnant women

Psychosomatic pain is a pain syndrome that develops against the background of an acute stressful situation or increased emotional stress. If a woman is periodically depressed, lives or works in an unfavorable emotional environment, she may experience inorganic pain in the stomach and other organs (heart, larynx, lower limbs and etc.). Especially often this pathology occurs in women with complicated pregnancy, as worries about the health of the child and the favorable outcome of the upcoming birth negatively affect the psychological state future mother.

To cope with this condition and reduce the incidence of psychosomatic pain, you can use the tips below (provided that diseases of the stomach and other digestive organs have been excluded system).

1. The best stress reliever for pregnant women is walking outdoors. You should walk at a slow pace, without rushing, about 2-3 hours a day, away from highways and factories. If during the walk there are pains and fatigue in the legs, you can just sit on the bench and breathe in the fresh air, since the main goal is to get positive emotions.
   

   Walking outdoors can help relieve stress, negative thoughts, and discomfort.

2. To cope with fatigue and nervous tension after a working day, you can take a contrast shower. It is better to refuse relaxing baths until the end of pregnancy, especially if the pregnancy is proceeding with pathologies.
   

   A contrast shower is an excellent remedy for fatigue and nervous tension

3. A glass of warm milk with a little honey, mint or chamomile tea is great for fighting insomnia - one of the main factors of bad mood and fatigue.
   

   Warm milk with honey before bed can help cope with insomnia

With severe neuroses and stresses, the use of Corvalol (analogs - "Valocordin", "Valoserdin") is allowed, but only after consultation with the attending physician. The drug has not only a pronounced sedative, but also a vasodilator and antispasmodic effect. Pregnant women can take drugs that include phenobarbital in short courses - no longer than 5-7 days.

What to do if your stomach hurts?

If a pregnant woman has stomach pains, it is necessary to start by finding out the cause. To do this, you should contact a gynecologist leading a pregnancy, or a local therapist, who will collect a detailed history and give directions for the necessary examinations and tests. It is allowed to independently take 1-2 tablets of drotaverine ("No-shpa") or drink 500 mg of paracetamol.

Eating culture is of great importance for the prevention and elimination of gastralgia during pregnancy. By observing the recommendations listed below, you can reduce the intensity of pain or prevent its occurrence (in cases where we are talking about a healthy woman with a normal pregnancy).

1. Every week of pregnancy, the uterus increases in size and compresses the stomach, so an important stage of treatment is fractional nutrition (up to 7 times). The recommended volume of one serving is up to 250 ml.
   

   The weight of one portion should not exceed 250 g

2. If pain is accompanied by heartburn, you should not use baking soda to eliminate it. In almost 80% of cases, the abuse of baking soda causes an "acid ricochet" (a sharp increase in acidity 2-2.5 hours after application).
   

   Baking soda has many beneficial properties, but it is best not to use it to combat heartburn.

3. After eating for 20-30 minutes, it is not recommended to be in a horizontal position or, conversely, to perform sharp movements and bends.
   

   So that the stomach does not hurt, you should not engage in physical activity after eating or immediately go to rest.

4. While eating, you should not watch TV, sit at the computer or read magazines. It is also not recommended to talk, as air entering the stomach can cause bloating and bursting pain in the upper abdomen.
   

   It is also not recommended to eat while watching movies or TV shows.

In the absence of contraindications and a tendency to allergies, folk remedies can also be used to eliminate pain in the stomach, many of which are not inferior in effectiveness to drugs.

Important! In order for the stomach to work normally during pregnancy, it is important to get enough fiber (at least 30 g per day), which is found in vegetables, fruits, herbs, cereals and berries.

Safe folk remedies for gastralgia

You can use each of the funds listed below for no longer than 7-10 days. If the pain persists within this time, you should go to the hospital.

Flaxseed gruel

With good lactose tolerance, such gruel can be cooked in milk. To prepare it, you need 4 tablespoons of ground flaxseed or flaxseed flour, pour a glass of warm milk, mix thoroughly, cover and put in a warm place for 30 minutes. Consume once a day 1-1.5 hours before the main meal.

Infusion of Potentilla

Cinquefoil (galangal root) helps to quickly cope even with severe stomach cramps, but this recipe can only be used by women who are not prone to constipation. To prepare the infusion, you must:

• chop dried rhizome;
• Pour 5 g of the crushed root into a container and pour 220 ml of boiling water;
• to cover with a lid;
• insist 25 minutes.

Take half a glass 3-4 times a day between meals.

Beetroot and carrot juice

Freshly squeezed juice from beets and carrots helps not only to cope with stomach pain, but also to reduce nausea, as well as reduce vomiting. Vegetables can be taken in any proportion, the best option is a 1: 1 ratio. You need to take the juice, 30-40 ml 3 times a day, 1 hour after meals.

When should you call an ambulance?

Abdominal pains do not always have gastric localization, and in most cases it is impossible to determine what exactly caused the painful sensations. Acute pain syndrome, forcing a woman to take a certain body position and limiting her mobility, is already the basis for contacting a medical institution.

It is necessary to call an ambulance team without waiting for a planned appointment with a doctor when the following alarming symptoms appear:

• febrile fever (temperature above 38.5 ° C, hot flashes, sweating, chills);
• bloody discharge from the vaginal tract;
• profuse, indomitable vomiting, leading to dehydration of the body (can cause intrauterine fetal death);
• bloody diarrhea.

Important! Any abdominal pain, regardless of their location, combined with vaginal bleeding, is a reason to call the medical team. In the early stages, such a symptom may be the onset of a miscarriage or placental detachment, in the later stages - premature onset of labor.

Stomach pain is a common and rather alarming symptom that can indicate both chronic gastrointestinal diseases. tract (gastritis, pancreatitis, duodenitis), and for acute surgical pathologies requiring emergency intervention (appendicitis, peritonitis). A pregnant woman should immediately report all pains to the gynecologist leading the pregnancy, since the health of the fetus and the outcome of the upcoming birth may depend on timely treatment for help.

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