Epigastric pain in pregnancy

What are the causes of epigastric pain in pregnancy?

Epigastric pain in pregnancy can have various causes. One of the most common is heartburn, which happens to most pregnant women at some stage of pregnancy. It is due to physiological changes that take place during pregnancy. The high concentration of progesterone relaxes the lower esophageal sphincter, causing a burning sensation behind the sternum or a backflow of food. Gastrointestinal peristalsis also decreases, and the enlarging uterus puts pressure on the stomach and exacerbates symptoms.

Among the causes of epigastric pain in pregnancy, do not forget about food poisoning or dietary error.

Epigastric pain in pregnancy can also be a symptom of serious organ disorders such as the pancreas, gallbladder or liver. Biliary colic or acute pancreatitis often manifests itself with epigastric pain and vomiting. Epigastric pain during pregnancy also occurs in the course of HELLP syndrome, which is, for example, a complication of hypertension. Similar symptoms can occur with appendicitis, which changes its typical position during pregnancy.

How to diagnose epigastric pain in pregnancy?

If severe epigastric pain occurs during pregnancy, diagnosis is necessary. Especially when accompanied by symptoms such as fever, vomiting or other worrisome discomforts. In such a situation, tests are usually performed for acute pancreatitis, biliary colic, HELLP syndrome or kidney stones. These include abdominal ultrasound, general urinalysis, morphology, liver parameters such as AST, ALT, GGTP, bile acids or bilirubin. In addition, creatinine levels, blood pressure values and CRP (an inflammatory parameter) are checked. With laboratory and imaging tests, it is possible to find the cause of the ailment and implement appropriate treatment.

What is the treatment of epigastric pain in pregnancy?

If the epigastric pain is caused by food poisoning or indigestion, an easily digestible diet and adequate hydration are recommended. In some cases, hospitalization is necessary, but fortunately, most symptoms pass without a hospital visit. When a mother-to-be struggles with heartburn, neutralizing treatment with proton pump inhibitors is recommended. However, they should not be used on their own during pregnancy. Acute pancreatitis or an attack of biliary or renal colic require hospitalization. A strict diet or the inclusion of antibiotic therapy may be necessary. The management depends on the particular case and the clinical condition of the mother-to-be. In the case of HELLP syndrome, parameters such as ALT, AST, creatinine, platelets and blood pressure are monitored. It may be necessary to complete the pregnancy more quickly.