Pain in the left hypochondrium during pregnancy

Pain in the left hypochondrium during pregnancy is a common cause of woman's concern for her and her baby's health. The etiological factor of such pain may be the processes associated with the pregnancy itself, but it is not necessary to exclude the disease or acute pathology, which requires immediate medical measures. 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 time to consult a doctor and find the right treatment.

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Causes of the pain in the left hypochondrium during pregnancy

Etiologically, the pain in the left side during pregnancy can have many causes, ranging from normal functional changes to severe surgical pathology. It is also important to know about the term of pregnancy, because it has a direct value in diagnosing this or that pathology.

To begin with, you need to identify all conditions in which the pain of such a localization is not threatening, and can be associated with pregnancy, and therefore does not require immediate treatment to the doctor. The pathogenesis of the development of symptoms is due to the fact that during the pregnancy the uterus increases every week to a certain size, which can cause compression of the internal organs and provoke the appearance of various symptoms. The enlarged uterus presses on the small and large intestine, stomach, pancreas, spleen, vessels - this is the reason for the appearance of certain unpleasant sensations. With the compression of these organs, their function may be impaired - a consequence of which is a violation of the circulation and various symptoms associated with such a pain syndrome. Such pain is not expressed all the time and not very intense, it occurs after overeating or a certain load and not persistent. However, the general condition of a 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 significant symptoms, then one should not worry. In this case, it should be noted that this condition occurs in the third trimester of pregnancy, when the uterus reaches such a size that it can cause compression. In case of pain on the first terms of bearing a child, one can suspect a serious pathology, such as an ectopic pregnancy, the pain syndrome in which can be accompanied by the irradiation of such pain. Therefore, if you know about pregnancy, but have not yet been examined by a doctor and do not register, you definitely need to do this.

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

[2], [3], [4]

Pathogenesis

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

Gastritis or peptic ulcer is one of the contenders for the main role in the development of such a pain syndrome. As a rule, gastritis and peptic ulcer are chronic diseases. In pregnancy, all chronic diseases have a property to activate due to a decrease in immune defense. Therefore, pregnancy itself is a risk factor for exacerbation of gastritis and ulcers. In this case, pain in the left hypochondrium arises from the inflammatory reaction of the mucosa and has its own characteristics.

The pancreas is an organ that, because of its topic, can only cause pain, from inflammatory reactions to injuries. Women with chronic pancreatitis are especially inclined to this, which is also a risk factor for the aggravation 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 there is pain of a similar nature and such localization. The pathogenesis of the onset of symptoms in this disease is caused by the release of pancreatic enzymes and their action on the intestine, stomach - this carries a serious threat to the normal functioning of the gastrointestinal tract, as well as to other neighboring organs. Violated blood circulation due to the action of toxins on the vessels, which threatens to violate the function of all organs. Therefore, such a pathology should be diagnosed in time.

Not so often there is a cause of pain in the left hypochondrium in expectant mothers is a disease of the spleen. If there is a history of trauma, then it is possible to suspect an incision or rupture of the spleen, since this organ has a thin capsule. Therefore, if the anamnestic data indicate the presence of any abdominal injury, regardless of strength, in the first place, it is necessary to exclude this acute pathology. But pregnant women are very sparing their health and the health of the baby in this state, so this reason for happiness is not frequent.

Violation of peristalsis and normal bowel activity can also be manifested by left-sided pain in the abdomen. In fact, the compression of the small and large intestine leads to the fact that not only their peristalsis is disturbed, but in due course also the biocenosis - which subsequently affects the symptoms. There may be other manifestations that need to be considered in the diagnosis.

In pregnancy, the location of the kidneys and ureters is disturbed, they rise higher, so inflammatory or mechanical disorders in these organs can cause pain irradiation. That is why it is also necessary to exclude renal colic during differential diagnosis.

Given the variety of causes of pain in the left hypochondrium during pregnancy, you need to carefully diagnose all the symptoms to accurately determine the etiology of this pain and determine the need for treatment. Therefore, you need to know all the symptoms that are with this or that pathology, in order to make a correction in a timely manner.

[5], [6], [7]

Epidemiology

The epidemiology of a problem such as pain in the left hypochondrium during pregnancy indicates that only 35% of women are associated with organic pathology, and more than 80% of cases are exacerbation of chronic diseases. This, in turn, underscores the need for thorough diagnosis and examination during pregnancy planning. Speaking of the deadline, this 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, in the first place is an exacerbation of gastritis or peptic ulcer, on the second - exacerbation of pancreatitis, but the injuries and ruptures of the spleen are less than 5%. But, despite this, even a minor injury (for example, a woman slipped and fell on the ice on her left side) could cause a burst of the spleen capsule during pregnancy, which is associated with the features of the organ function, and with its increased load.

[8], [9], [10]

Symptoms

First of all, it is necessary to determine the clinical manifestations when left-sided pain does not fall under the division of serious diseases in pregnant women, but is caused by the body's reaction to the pregnancy itself. Pain, caused by compression of the organs due to the explained increase in the uterus, does not cause strong irritating sensations and does not require taking painkillers. However, this pain is unstable, it is not accompanied by a headache or dizziness and does not cause any other symptoms. Such pain does not require medication and passes, just as it began. In this case, do not immediately call a doctor, or you can just say this at the next scheduled examination.

The first signs of an exacerbation of a gastritis or a peptic ulcer can begin with pain. Such pain is intensely expressed, and can be provoked by the ingestion of spicy food. In this case, the pain occurs an hour or two after a meal, and there are other symptoms of dyspepsia. If it is an aggravation of an ulcer, then the first signs can be in the form of vomiting blood (hematomesis) 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 of symptoms from the gastrointestinal tract, it must also be said that the weakness of the esophageal sphincter can cause a reverse flow of gastric juice, and this is accompanied by symptoms of heartburn or perspiration in the throat, especially in the horizontal position. This is also one of the factors considered pathology.

Aching pain in the left hypochondrium during pregnancy often develops against the background of diaphragmatic hernia. Then the pain is persistent and often accompanied by dyspepsia. Elevated pressure in the abdominal cavity causes these symptoms and after a birth such a hernia can pass by itself.

Pancreatitis is a serious pathology, in which pain in the left hypochondrium has its own peculiarities - it is strong, constant, has a girdling character. Such an attack is caused by errors in eating - 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 women, but also for the child, as 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 impaired urination, which is also characteristic of kidney pathology.

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

Diagnostics of the pain in the left hypochondrium during pregnancy

Diagnosis of this problem should be primarily complete, to exclude conditions that are potentially dangerous to the health of women and children. Therefore, you need 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, its connection with food. It is necessary to find out whether a woman has chronic diseases, such as gastritis, pancreatitis, peptic ulcer, urolithiasis. One should also ask about other symptoms, whether they are related to pain and whether the woman has taken painkillers.

Analyzes that a woman must take must also be done for the purpose of differential diagnosis. It is necessary to give a general blood test, a general urine test and determine the level of blood glucose. Further, special tests are needed, which exclude this or that pathology. If you suspect a pancreatitis - you need a biochemical blood test, as well as the level of urine and blood amylase. The pathology of the pancreas can be suspected with an increase in amylase several times higher than normal. Gastritis and peptic ulcer in the anamnesis also require the analysis of stool and the determination of the reaction to latent blood.

If a woman has a clinic of kidney colic, then in the analysis of urine there will be changes in the form of fresh red blood cells, protein, cylinders.

If all laboratory parameters are within the limits of the norm, then an instrumental study is needed to exclude or confirm a specific diagnosis. The main method of instrumental diagnosis during pregnancy can be considered ultrasound. This method makes it possible to diagnose the presence of a stone in the ureter or a renal pelvis, and also to determine the condition of internal organs and free fluid in the cavity. If the disease occurs in the third trimester, then in addition to the ultrasound of the fetus, cardiocoograms must be carried out in order to determine the child's condition and the risk of complications.

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

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Differential diagnosis

Differential diagnosis of pathology, which causes pain in the left side, is mainly aimed 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.

It is necessary first of all to differentiate the attack of pancreatitis, renal colic or perforation of the stomach ulcer. All these diseases have their own features of the pain syndrome and other signs that are needed for differentiation.

It is very important to differentiate the pathology of internal organs directly with the causes of pregnancy itself. Premature detachment of the placenta has a clinic with a similar pain syndrome, especially if the placenta has peeled off in this place. But in this case, bloody discharge is often observed, and it can be confirmed with the help of ultrasound examination - a retrocopental accumulation of blood is detected. This is an urgent situation that requires immediate action, so in a pregnant woman this condition must be differentiated with other pathologies in the first place.

In case of correct diagnosis and differential diagnosis, it can be established with accuracy, pain in the left hypochondrium is caused by a disease or physiological features of pregnancy. Only on the basis of determining the cause can further carry out treatment.

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Treatment of the pain in the left hypochondrium during pregnancy

If the pain in the left hypochondrium during pregnancy is only a symptom, then it is impossible to carry out treatment before the cause is established. And only after that it is possible to prescribe etiologic treatment. Naturally, until the precise diagnosis is established, it is not advisable to take painkillers, but if it is already difficult to tolerate, for pregnant women, drugs from the group of myotropic antispasmodics are recommended.

1. Drotaverin is a myotropic antispasmodic that reduces the tone and motor activity of the smooth muscles of the internal organs, dilates the blood vessels. Thanks to this, an analgesic effect occurs, and it also has a good effect on the tone of the uterus. The method of application is 120-240 mg / day in 2-3 doses. Side effects that can be skin hyperemia, fever, chills, body t0, weakness, palpitations, 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 esophagus mucosa with the development of heartburn, then the use of antacids is justified. These are drugs that neutralize the aggressive effect of stomach acid.

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

1. In case the pain is caused by a disturbance of the peristalsis due to compression by the uterus, then together with antispasmodics one can use medicines from the group of probiotics. This normalizes the function of intestinal digestion and restores the balance of microflora, which neutralizes discomfort and pain in the hypochondrium.

Linex - a drug that has in its composition of 3 types of lactic acid bacteria. Due to this, linex forms favorable conditions for the development of useful intestinal microflora, the bacteria that make up the drug have the property to suppress 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. Dosage sufficient to restore microflora and intestinal peristalsis is one capsule twice a day. Side effects are diarrhea or a feeling of heaviness and overflow in the abdomen that goes away after a while. Precautions - if there are symptoms of food poisoning, the drug should be taken with a doctor.

1. If the phenomenon of abdominal pain is associated with compression of the intestine, then often there are disorders of the stool, disperse phenomena, which leads to inefficient feeding of the woman. Therefore, vitamin therapy in an integrated approach to treatment will help to neutralize any deficiencies in the diet and the associated symptoms.

Quadevite is a vitamin remedy that is used with a curative purpose to correct the lack of certain micronutrients. The composition of the drug is rich not only with different vitamins of all groups, but also with microelements, which not only replenishes their deficiency, but also affects the general condition of the intestine and its functions. The dosage of the medicine for pregnant women is one tablet once a day. Side effects occur when the dose is exceeded - then there may be dyspepsia and allergic manifestations. Precautions - do not take it with gastritis and ulcer in history, urolithiasis, gallstones, and combine with the intake of other vitamins, it 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 it is a gastritis or peptic ulcer disease, then the treatment is complex, using at least three drugs, one of which is necessarily an antibiotic. When the cause is renal colic, the pregnant woman should be hospitalized in the urological department with an invasive intervention - stenting the ureter. Acute pancreatitis or chronic exacerbation requires immediate complex treatment with antacid drugs, antispasmodics, analgesics, proteolysis inhibitors, proton pump inhibitors and detoxification therapy.

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

Surgical treatment is indicated if complications occur in the form of intestinal or gastric bleeding, penetration or perforation of the stomach ulcer. In this case, the operation is shown by the vital indicators. If the cause of the pain is premature detachment of the placenta, then the woman should immediately be hospitalized in the maternity hospital with the determination of the need for delivery.

Thus, the main principle in correcting the pain syndrome in the left hypochondrium during pregnancy is an etiological approach - it is necessary to first establish the cause, and only then to conduct treatment.

Alternative treatment of pain in the left side during pregnancy

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

1. The root of the althea with honey has excellent detoxification and antioxidant properties, which reduces the amount of harmful substances and speeds up digestion. This helps not only reduce the soreness of the intestines, but also neutralizes nausea and heartburn. To make medicinal tea you need ten grams of grass to fill with water in the amount of half a liter, and then after he has fed twenty minutes, strain and drink. Dosage - about a liter of tea you need to drink a day, controlling another fluid in the presence of edema.
2. Flax is an excellent means for neutralizing the corrosive effect of gastric juice, and flax also has a protective property on the gastric mucosa, forming a film. To prepare the medicine, you need to fuse the flax seeds with a liter of hot water, the solution must be infused until the morning. After this, the mucous mass is formed, which must be taken on an empty stomach every day for a hundred grams.
3. Birch buds have a tropism to the intestines and well manifest antispasmodic properties. For medical infusion, you need to take a 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 calms the increased peristalsis, and also normalizes the appetite.

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

1. Plantain - a plant whose effect is to improve the tone of the intestine and reduce the severity of pain of a spasmodic nature. To prepare a medicine from plantain, three tablespoons of washed and cut plantain leaves should be boiled for five minutes in a liter of clean water, then add a few spoons of honey and mix. After the tea has cooled, you need to drink it three times a day for half a cup. Treatment should be conducted for at least three weeks.
2. Very useful properties for reducing pain and normalizing the tone of the digestive system is tea made from viburnum and rose hips. To prepare for a liter of water, you need to take 50 grams of each fruit and make compote, which should be drunk throughout the day in sufficient quantities.
3. Sage - a plant that has a good effect on the work of food enzymes, normalizes the tone of the esophageal sphincter, neutralizes the effect of gastric juice. To prepare the medicine, you need to pour sage leaves with a glass of warm water and insist, and then add five spoonfuls of honey and drink on a tablespoon three times a day.

Homeopathy can be widely used to treat such a pathology, taking into account the fact that tropic preparations are being selected for the digestive system. The main medicines that are most effective are the following:

1. Ferrum Plus is a preparation of homeopathic origin from a group of inorganic preparations. Used for the treatment of digestive disorders with severe nausea and vomiting. The way of using the drug depends on the form. Dosage in case of taking drops - one drop per year of life, and with capsules - two capsules three times a day. Side effects are possible in the form of hyperemia of the skin of hands and feet, as well as sensation of heat. Precautions - do not use in combination with antispasmodics.
2. Borrum is a complex homeopathic medicine, in the form of a liquid. Issued in the form of drops and used in the dosage of eight drops at a time. 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 not less than three months. Precautions - with recent cerebral trauma and the pathology of the vessels of the brain, use with caution. Side effects are rare, allergic skin reactions are possible. Precautions - it is impossible to use the drug in women with an allergy to iodine.
3. Hinum arsenicum is a homeopathic remedy that has a composition of organic substances and promotes normalization of the liver, spleen and pancreas with a slight 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 dosed four drops twice a day for half an hour before meals at the same time. The course of treatment is three months. There were no side effects. Contraindications for taking Hina - is hypersensitivity to the components of the drug.
4. Traumeel S is a homeopathic remedy that has a composition of organic substances and helps to normalize digestion, especially if the symptoms of pain are accompanied by a stool disorder. The dosage of the drug for pregnant women begins with two pellets per day, and during the first week, the leuchenia increases to five. Further, 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. Further, the bowel function is normalized.

[13], [14]

Complications and consequences

The consequences of untimely diagnosis of pain can be very serious, especially when it comes to such diseases as gastritis, peptic ulcer or pancreatitis. Complications of peptic ulcer can be bleeding, which causes severe anemia, and against this background and hypoxia of the fetus. This carries a potential threat not only to the mother's life, but also to the child. Complications of pancreatitis can also affect the fetus and cause a sharp depression 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 the appearance of pain in the left hypochondrium during pregnancy is nonspecific, since this condition is difficult to foresee. To avoid complications and exacerbations of chronic diseases before planning pregnancy, you need to carefully monitor and prevent these symptoms.

[16], [17], [18], [19]

Forecast

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

Pain in the left hypochondrium during pregnancy is not such a frequent pathology, but one should not write off all this for pregnancy, especially if the pain is intense. It is very important to make sure that there is no threat to your health and the child's health. Therefore, with severe symptoms, especially if there is nausea or vomiting, it is necessary to be examined. You need to take your health seriously, especially if you are a future mother.

[20], [21], [22], [23]