Left subcostal pain in pregnancy

Pain in the left hypochondrium during pregnancy is a common cause of concern for a woman about her health and that of her baby. The etiological factor of such pain may be processes associated with the pregnancy itself, but one should not exclude a disease or acute pathology that requires immediate treatment. Therefore, in order not to harm the child, any discomfort or pain in the abdomen should be carefully diagnosed. To do this, it is important to understand all the possible causes of such a condition in order to consult a doctor in time and choose the right treatment.

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Causes left subcostal pain in pregnancy

Etiologically, pain in the left side during pregnancy can have many causes, ranging from normal functional changes to serious surgical pathology. It is also important to know the gestational age, because it has a direct meaning in diagnosing a particular pathology.

First, it is necessary to determine all the conditions in which pain of such localization is not threatening, but may be associated with pregnancy, and therefore does not require immediate medical attention. The pathogenesis of the development of symptoms is associated with the fact that during pregnancy the uterus increases every week to a certain size, which can cause compression of internal organs and provoke the appearance of various symptoms. The enlarged uterus presses on the small and large intestines, stomach, pancreas, spleen, blood vessels - this is the reason for the appearance of certain unpleasant sensations. When these organs are compressed, their function may be impaired - the consequence of which is circulatory disorders and various symptoms combined with such a pain syndrome. Such pain is not expressed all the time and is not very intense, it occurs after overeating or a certain load and is not persistent. At the same time, the general condition of the woman does not change, and there are no other symptoms. This indicates that such pain is a physiological condition and if it does not bring any other pronounced symptoms, then you should not worry. In this case, it should be noted that such a condition occurs in the third trimester of pregnancy, when the uterus reaches such a size that it can cause compression. If pain occurs in the early stages of bearing a child, then one can suspect a serious pathology, such as an ectopic pregnancy, the pain syndrome in which can be accompanied by irradiation of such pain. Therefore, if you know about pregnancy, but have not yet been examined by a doctor and are not registered - you must do this.

One should not forget about a number of other etiological factors that can initiate such a problem.

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Pathogenesis

The pathogenesis of the development of symptoms, for example, in reflux disease, is associated with the reflux of acidic gastric secretion into the esophagus, which irritates the esophageal mucosa. This is also caused by the fact that the enlarged uterus presses on the stomach and its anatomical location changes - so the secretion from the stomach gets onto the esophageal mucosa, which is not at all intended for such an acidic environment, which causes pain in the left hypochondrium. This may require the use of special drugs that relieve the irritating effect of acid.

Gastritis or peptic ulcer disease are among the contenders for the main role in the development of such a pain syndrome. As a rule, gastritis and peptic ulcer disease are chronic diseases. During pregnancy, all chronic diseases tend to become active due to a decrease in immune protection. Therefore, pregnancy itself is a risk factor for exacerbation of gastritis and ulcers. In this case, pain in the left hypochondrium occurs due to an inflammatory reaction of the mucous membrane and has its own characteristics.

The pancreas is an organ that can cause pain due to its location alone, from inflammatory reactions to injuries. Women with chronic pancreatitis are especially prone to this, which is also a risk factor for exacerbation of this disease. Pain in pregnant women caused by exacerbation of chronic pancreatitis has its own characteristics due to the high location of the gland itself. This is a very serious condition that requires immediate treatment, so it is important to exclude this pathology when pain of this nature and localization occurs. The pathogenesis of the symptoms of this disease is due to the release of pancreatic enzymes and their effect on the intestines, stomach - this poses a serious threat to the normal functioning of the gastrointestinal tract, as well as other neighboring organs. Blood circulation is impaired due to the effect of toxins on blood vessels, which threatens to disrupt the function of all organs. Therefore, such a pathology should be diagnosed in time.

It is not so often that the cause of pain in the left hypochondrium in expectant mothers is a disease of the spleen. If there is a history of trauma, then one can suspect a rupture or rupture of the spleen, since this organ has a thin capsule. Therefore, if the anamnestic data indicate the presence of any abdominal trauma, regardless of the force, first of all, it is necessary to exclude this acute pathology. But pregnant women are very careful about their health and the health of the baby in this condition, so this reason is fortunately not common.

Violation of peristalsis and normal bowel function can also manifest itself as left-sided abdominal pain. After all, compression of the small and large intestines leads to the fact that not only their peristalsis is disrupted, but over time, the biocenosis is also disrupted - which subsequently affects the symptoms. At the same time, there may be other manifestations that must be taken into account during diagnosis.

During pregnancy, the kidneys and ureters are displaced, they rise higher, so inflammatory or mechanical disorders in these organs can cause irradiation of pain. That is why renal colic should also be excluded when conducting differential diagnostics.

Given the diversity of causes of pain in the left hypochondrium during pregnancy, it is necessary to carefully diagnose all the symptoms in order to accurately determine the etiology of this pain and determine the need for treatment. Therefore, it is necessary to know all the symptoms that occur with a particular pathology in order to carry out timely correction.

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Epidemiology

The epidemiology of such a problem as pain in the left hypochondrium during pregnancy indicates that only 35% of women have it due to organic pathology, and more than 80% of cases are exacerbations of chronic diseases. This, in turn, emphasizes the need for thorough diagnostics and examination even when planning a pregnancy. Speaking about the period, such a problem occurs in the third trimester in 90% of women, which is also associated with a change in the topic of internal organs at this time. For reasons of pain syndrome, exacerbation of gastritis or peptic ulcer disease is in first place, exacerbation of pancreatitis is in second place, but injuries and ruptures of the spleen make up less than 5%. But, despite this, even a minor injury (for example, a woman slipped and fell on the ice on her left side) can cause a rupture of the spleen capsule during pregnancy, which is associated with both the peculiarities of the organ's function and its increased load.

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Symptoms

First of all, it is necessary to determine those clinical manifestations when left-sided pain does not fall under the section of serious diseases in pregnant women, but is caused by the body's reaction to the pregnancy itself. Pain caused by compression of organs due to the explained enlargement of the uterus does not cause strong irritating sensations and does not require taking painkillers. At the same time, such pain is not constant, it is not accompanied by a headache or dizziness and does not cause any other symptoms. Such pain does not require taking medications and passes, just as it began. In this case, you should not urgently contact a doctor, but you can simply say about it at the next routine examination.

The first signs of exacerbation of gastritis or peptic ulcer disease may begin with pain. Such pain is intense and can be provoked by eating spicy food. In this case, the pain occurs an hour or two after eating, and there are other symptoms of dyspepsia. If we are talking about an exacerbation of an ulcer, then the first signs may be vomiting blood (hematemesis) or melena. This, as a rule, appears some time after the pain syndrome and is a sign of complications. Therefore, with such features of the pain syndrome, combined with other manifestations, you need to consult a doctor.

Speaking about the symptoms from the gastrointestinal tract, it should also be said that the weakness of the esophageal sphincter can cause the backflow of gastric juice, and this is accompanied by symptoms of heartburn or sore throat, especially in a horizontal position. This is also one of the factors of the pathology in question.

Aching pain in the left hypochondrium during pregnancy often develops against the background of a diaphragmatic hernia. Then the pain is persistent and is often accompanied by dyspeptic disorders. Increased pressure in the abdominal cavity causes these symptoms and after childbirth such a hernia can go away on its own.

Pancreatitis is a serious pathology, in which pain in the left hypochondrium has its own characteristics - it is strong, constant, has a girdle character. Such an attack is caused by errors in food - which is also important to remember for diagnosis. In this case, vomiting is expressed, which is not accompanied by nausea and is not accompanied by relief. This condition is dangerous not only for the woman, but also for the child, since toxins and pathological enzymes penetrate to the fetus and disrupt its vital functions.

If the pain on the left is caused by renal colic, it begins in the lumbar region and only radiates to the left hypochondrium. This is accompanied by urination disorders, which is also typical for kidney pathology.

Thus, the multitude of etiological factors of pain in the left hypochondrium during pregnancy require careful verification of all symptoms in order to accurately determine the treatment tactics.

Diagnostics left subcostal pain in pregnancy

The diagnosis of this problem must first of all be complete in order to exclude conditions that are potentially dangerous to the health of the woman and the child. Therefore, it is necessary to conduct all the necessary tests to clarify the diagnosis.

It is important to find out all the anamnestic data with the definition of the nature of pain, its intensity, connection with food. It is necessary to find out whether the woman has chronic diseases, such as gastritis, pancreatitis, peptic ulcer, urolithiasis. It is also necessary to ask about other symptoms, whether they are associated with pain and whether the woman took painkillers.

The tests that a woman should take should also be carried out for the purpose of differential diagnostics. It is necessary to take a general blood test, a general urine test, and determine the blood glucose level. Further, special tests are needed that exclude one or another pathology. If pancreatitis is suspected, a biochemical blood test is needed, as well as the level of amylase in urine and blood. Pathology of the pancreas can be suspected if amylase increases several times above the norm. Gastritis and peptic ulcer disease in the anamnesis also require a stool test and determination of the reaction to occult blood.

If a woman has clinical signs of renal colic, then urine tests will show changes in the form of fresh erythrocytes, protein, and cylinders.

If all laboratory parameters are within normal limits, it is necessary to conduct an instrumental examination to exclude or confirm a certain diagnosis. The main method of instrumental diagnostics during pregnancy can be considered an ultrasound examination. This method makes it possible to diagnose the presence of a stone in the ureter or renal pelvis, and it is also possible to determine the condition of the internal organs and free fluid in the cavity. If the disease occurs in the third trimester, then in addition to an ultrasound of the fetus, a cardiotocogram is required to determine the condition of the child and the risk of complications.

The main method of diagnosing peptic ulcer disease is fibrogastroduodenoscopy. This method allows you to see the state of the ulcer from the inside and its potential for healing. Therefore, despite pregnancy, this method allows you to accurately establish a diagnosis.

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Differential diagnosis

Differential diagnostics of the pathology that causes pain in the left side is aimed mainly at determining the cause. Therefore, it is important to carefully study the symptoms and only after a thorough examination and exclusion of acute pathology, you can go home.

First of all, it is necessary to differentiate an attack of pancreatitis, renal colic or perforation of a gastric ulcer. All these diseases have their own characteristics of pain syndrome and other signs that are needed for differentiation.

It is very important to differentiate the pathology of internal organs directly from the causes of pregnancy itself. Premature placental abruption has a clinical picture with a similar pain syndrome, especially if the placenta has separated in this place. But at the same time, bloody discharge is often observed, and can be confirmed by ultrasound - retroplacental blood accumulation is determined. This is an urgent situation that requires immediate action, so in a pregnant woman this condition must be differentiated from other pathologies first of all.

In case of correct diagnosis and differential diagnosis, it is possible to establish with certainty whether the pain in the left hypochondrium is caused by a disease or physiological characteristics of pregnancy. Only on the basis of determining the cause can further treatment be carried out.

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Treatment left subcostal pain in pregnancy

If pain in the left hypochondrium during pregnancy is only a symptom, then treatment cannot be carried out until the cause is established. And only after that can etiological treatment be prescribed. Naturally, it is not advisable to take painkillers until an accurate diagnosis is established, but if it is already difficult to endure, then drugs from the group of myotropic antispasmodics are recommended for pregnant women.

1. Drotaverine is a myotropic antispasmodic that reduces the tone and motor activity of smooth muscles of internal organs, dilates blood vessels. Due to this, an analgesic effect occurs, and it also has a good effect on the tone of the uterus. Method of administration - 120-240 mg / day in 2-3 doses. Side effects that may be - skin hyperemia, fever, chills, increased body temperature, weakness, increased heart rate, arterial hypotension headache, dizziness, insomnia, nausea, constipation, vomiting, local reactions at the injection site. Precautions - do not use in congenital pathologies - malabsorption and lactose intolerance.
2. If the cause of pain is reflux and irritation of the esophageal mucosa with the development of heartburn, then taking antacids is justified. These are drugs that neutralize the aggressive effect of stomach acid.

Sucralfate is a drug that consists of a disaccharide and aluminum sulfate. These components, getting into the stomach, lead to the fact that the aggressive gastric juice is split into individual proteins, and then with the help of sucrose a special protective structure is formed that covers the mucous membrane from the inside. Due to this, the acid does not affect the structure of the esophagus and the symptoms disappear. How to use the drug - 1 tablet before each meal. Side effects may include dizziness, drowsiness, constipation, diarrhea, nausea, vomiting, flatulence, dry mouth, pain in the lower back. Precautions - do not take more than five tablets per day.

1. If the pain is caused by peristalsis disorders due to compression by the uterus, then together with antispasmodics, you can use drugs from the probiotic group. This normalizes the function of intestinal digestion and restores the balance of microflora, which neutralizes discomfort and pain in the hypochondrium.

Linex is a drug that contains 3 types of lactic acid bacteria. Due to this, Linex creates favorable conditions for the development of beneficial intestinal microflora; the bacteria included in the drug have the property of suppressing the growth of pathogenic bacteria. These properties of the drug contribute to the fact that spasmodic phenomena in the intestine pass and the pain decreases, if the cause is physiological changes. The dosage sufficient to restore microflora and intestinal peristalsis is one capsule twice a day. Side effects are diarrhea or a feeling of heaviness and fullness in the abdomen, which passes after some time. Precautions - if there are symptoms of food poisoning, then the drug intake should be agreed with a doctor.

1. If the phenomenon of abdominal pain is associated with intestinal compression, then stool disorders and dyspepsia often occur, which leads to irrational nutrition of the woman. Therefore, vitamin therapy in a comprehensive approach to treatment will help to neutralize any deficiencies in the diet and the symptoms associated with it.

Kvadevit is a vitamin product used for therapeutic purposes to correct the deficiency of certain food microelements. The composition of the drug is rich not only in various vitamins of all groups, but also in microelements, which not only replenishes their deficiency, but also affects the general condition of the intestine and its functions. The dosage of the drug for pregnant women is one tablet once a day. Side effects occur when the dose is exceeded - then dyspeptic phenomena and allergic reactions may appear. Precautions - do not take it with gastritis and ulcers in the anamnesis, urolithiasis, gallstones, and also combine it with other vitamins, this can cause an overdose.

Speaking about the treatment of other pathologies that cause pain in the left hypochondrium during pregnancy, the approach is differentiated. If we are talking about gastritis or peptic ulcer, then the treatment here is complex, using at least three drugs, one of which is necessarily an antibiotic. When the cause is renal colic, then the pregnant woman should be hospitalized in the urology department with invasive intervention - ureteral stenting. Acute pancreatitis or exacerbation of chronic requires immediate complex treatment using antacid drugs, antispasmodics, painkillers, proteolysis inhibitors, proton pump inhibitors and detoxification therapy.

Vitamins and physiotherapy treatment are possible only if it is not contraindicated for a pregnant woman and will not harm the child.

Surgical treatment is indicated when complications arise in the form of intestinal or gastric bleeding, penetration or perforation of a gastric ulcer. In such a case, surgery is indicated according to vital signs. If the cause of pain is premature placental abruption, the woman should be immediately hospitalized in a maternity hospital with a determination of the need for delivery.

Thus, the main principle in the correction of pain syndrome in the left hypochondrium during pregnancy is the etiological approach - it is necessary to first establish the cause, and only then carry out treatment.

Folk remedies for pain in the left side during pregnancy

Folk treatment of such symptoms is used if such a problem is caused by compression of the stomach and intestines. The main principle of such treatment is a relaxing effect, removal of spasm or normalization of peristalsis.

1. Marshmallow root with honey has excellent detoxifying and antioxidant properties, which reduces the amount of harmful substances and speeds up digestion. This helps not only to reduce intestinal pain, but also neutralizes nausea and heartburn. To prepare a medicinal tea, you need to pour ten grams of grass with half a liter of water, and then after it has been infused for twenty minutes, strain and drink. Dosage - about a liter of tea should be drunk per day, controlling other fluids in the presence of edema.
2. Flax is an excellent remedy for neutralizing the aggressive influence of gastric juice, and flax also has a protective property on the gastric mucosa, forming a film. To prepare the medicine, you need to steam flax seeds with a liter of hot water, the solution should be infused until the morning. After this, a mucous mass is formed, which should be taken on an empty stomach every day, one hundred grams.
3. Birch buds have a tropism for the intestines and exhibit good antispasmodic properties. For a medicinal infusion, take one hundred grams of birch buds and pour half a liter of boiled water. Method of application - one teaspoon of infusion three times a day. This infusion soothes increased peristalsis and also normalizes appetite.

Herbal treatment is widely used because herbs not only have a good effect on the pregnant woman, but also do not harm the child.

1. Plantain is a plant whose effect is to improve intestinal tone and reduce the severity of spasmodic pain. To prepare a medicine from plantain, three tablespoons of washed and chopped plantain leaves should be boiled for five minutes in a liter of clean water, then add a few spoons of honey and stir. After the tea has cooled, you need to drink it three times a day, half a cup at a time. The treatment should be carried out for at least three weeks.
2. Tea made from viburnum and rose hips has very useful properties for reducing pain and normalizing the tone of the digestive system. To prepare, take 50 grams of each fruit per liter of water and make a compote, which should be drunk throughout the day in sufficient quantities.
3. Sage is a plant that has a positive effect on the work of digestive enzymes, normalizes the tone of the esophageal sphincter, and neutralizes the action of gastric juice. To prepare the medicine, pour a glass of warm water over the sage leaves and let it brew, then add five spoons of honey and drink a tablespoon three times a day.

Homeopathy can be widely used to treat such pathology, given the fact that drugs are selected that are tropic to the digestive system. The main drugs that are most effective are the following:

1. Ferrum Plus is a homeopathic preparation from the group of inorganic preparations. It is used to treat digestive disorders with severe nausea and vomiting. The method of administration of the preparation depends on the form. The dosage for drops is one drop per year of life, and for capsules - two capsules three times a day. Side effects are possible in the form of hyperemia of the skin of the hands and feet, as well as a feeling of heat. Precautions - do not use in combination with antispasmodics.
2. Borrum is a complex homeopathic medicine in liquid form. It is available in the form of drops and is used in a dosage of eight drops per dose. Method of application - the solution should be dripped into 100 milliliters of boiled water and drunk half an hour before meals. The course of treatment is at least three months. Precautions - in case of recent traumatic brain injury and cerebral vascular pathology, use with caution. Side effects are rare, allergic skin reactions are possible. Precautions - the drug should not be used by women with an allergy to iodine.
3. Hinum arsenicum is a homeopathic remedy that has a composition of organic agents and helps to normalize the liver, spleen and pancreas with a mild analgesic effect, which eliminates the severity of functional pain in the left hypochondrium. The drug is used in the pharmacological form of homeopathic drops and is dosed four drops twice a day half an hour before meals at the same time. The course of treatment is three months. No side effects have been identified. Contraindications to taking Hinum are hypersensitivity to the components of the drug.
4. Traumeel C is a homeopathic remedy that has a composition of organic agents and helps to normalize digestion, especially if the symptoms of pain are accompanied by stool disorders. The dosage of the drug for pregnant women begins with two granules per day, and during the first week of treatment increases to five. Then this dose should be taken twice a day. Side effects can be observed in women in the form of pallor and weakness, and there may also be diarrhea in the first days of treatment. Then the bowel function is normalized.

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Complications and consequences

The consequences of untimely diagnosis of pain syndrome can be very serious, especially when it comes to diseases such as gastritis, peptic ulcer or pancreatitis. Complications of peptic ulcer disease can include bleeding, which causes severe anemia, and against this background, fetal hypoxia. This poses a potential threat not only to the life of the mother, but also to the child. Complications of pancreatitis can also affect the fetus and cause a sharp suppression of the heartbeat. Therefore, it is important to pay attention to any pain in time to avoid such consequences.

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Prevention

Prevention of pain in the left hypochondrium during pregnancy is non-specific, since this condition is difficult to predict. To avoid complications and exacerbations of chronic diseases, before planning a pregnancy, you need to be carefully examined and prevent these symptoms.

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Forecast

The prognosis for this pathology is favorable if the pain is caused by the pregnancy itself, then after childbirth all symptoms of pain and discomfort pass. If the pain is caused by organic damage, then the prognosis is favorable with timely diagnosis.

Pain in the left hypochondrium during pregnancy is not such a common pathology, but you should not attribute all this to pregnancy, especially if the pain is intense. It is very important to make sure that there is no threat to your health and the health of the child. Therefore, if the symptoms are pronounced, especially if there is nausea or vomiting, you need to get examined. You need to take your health seriously, especially if you are an expectant mother.

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