Pain in the right hypochondrium during pregnancy

Quite often pregnant women complain of the occurrence of pain in the area under the right rib. Such manifestations intensify as the term of gestation increases. Usually pain in the right hypochondrium during pregnancy is a sign of the development of dyskinesia of the biliary tract.

[1], [2], [3], [4]

Causes of the pain in the right hypochondrium during pregnancy

In pregnant women, dyskinesia of the hypomotor type is most often observed (when the motor activity of the bile ducts decreases). A similar disorder occurs due to a change in the hormonal background. In the second half of the term, the pregnant woman begins to produce progesterone in large quantities - it is necessary in order to relax the uterus and thereby exclude the possibility of premature birth or miscarriage. But simultaneously with the uterus, other organs with smooth muscles relax (among them also the gallbladder). Hypomotor dysfunction occurs due to weak emptying of this organ, as a result of which it stretches, causing painful sensations.

Dyskinesia can also develop due to mechanical causes: under the pressure of the growing uterus, the gallbladder begins to contract, causing the normal bile secretion process to be disrupted.

Also, the causes of pain in the right upper quadrant during pregnancy can be the following diseases and conditions:

• acute or chronic cholecystitis,
• cholelithiasis,
• biliary or hepatic colic,
• cholangitis,
• hepatitis of various etiologies,
• inaccuracies in the diet.

[5], [6], [7], [8]

Epidemiology

Dysfunction of the bile ducts develops in 3% of pregnant women.

[9], [10], [11], [12], [13],

Symptoms

With hypomotor type dysfunction, the main symptom is dull pain in the right hypochondrium. Pregnant women often note the appearance of burping air, bitter taste in the mouth, flatulence, nausea, and in addition, worsening appetite.

Stitching pain in the right hypochondrium during pregnancy

The appearance of stitching pains in the area under the right rib can testify to the development of cholecystitis (inflammatory process in the gallbladder).

Diagnostics of the pain in the right hypochondrium during pregnancy

To make a diagnosis in this case, you need an appeal to the gynecologist and gastroenterologist. Previously, the disease is diagnosed based on the patient's complaints.

You may need to take urine and blood for laboratory tests. 

During the diagnosis, ultrasound of the gallbladder is performed . The procedure is carried out by measuring the size of this organ before taking a cholagogue breakfast (for this it is required to eat raw egg yolks of 2 eggs), and then after it. On this basis, the doctor diagnoses the type of dysfunction of the GVP, and also determines the nature of the motor activity disorder.

[14]

Differential diagnosis

In the process of diagnosis, it is necessary to exclude the possibility of developing cholelithiasis, as well as exacerbation of the chronic form of cholecystitis.

Treatment of the pain in the right hypochondrium during pregnancy

Most importantly, with the development of biliary dyskinesia during pregnancy, relieve the patient of pain and eliminate the symptoms of the disease. In most cases, a full-fledged treatment process is possible only after childbirth, as during pregnancy most drugs are prohibited.

It is required to make a correct diet of food - to eat food is necessary in fractional portions, at least 5-6 times / day. It should include food that helps the gall bladder to shrink - these are fish or weak meat broths, sour cream and cream, as well as eggs, cooked soft-boiled, various soups, butter (sunflower and creamy), and in addition decoction from rose hips. It will also be helpful to eat protein omelets, cod and cottage cheese (because they contain a lot of substances that help to prevent the risk of obesity of the liver), and in addition, food containing a lot of vegetable fiber and magnesium salts (such products as buckwheat, cabbage, bran, and also apples and cabbage).

Medications

In some cases, may be administered Hofitol in a dose of 2 tablets three times a day before meals for 1.5-2 months.

But it is not always possible to drink it during pregnancy - among the contraindications to taking medication during this period: blockage of the bile duct, liver failure, and intolerance of the elements of the drug. With prolonged use of Hofitol, it is possible to develop side effects such as diarrhea and allergies.

In the second half of the period, you should also carefully monitor the amount of fluid used. If there are edemas, it is required to drink flamin (flowers of immortelle in dry concentration) in a dosage of 1-2 tablets three times a day for half an hour before meals. Instead, the remedy can also be used holosas (a syrup from rose hips) in a dosage of 1 teaspoon 2-3 times / day.

Alternative treatment

To remove stagnation of bile, you can use the method of tjubazha (you should consult a doctor beforehand). To make this medicine, you need to use one of the following ingredients:

• sunflower (olive or corn) oil (30-40 ml);
• Karlovy Vary salt (for 1 glass of water 1 teaspoon of salt);
• xylitol or sorbitol (per 1 glass of water 1 tablespoon of the substance);
• if there are no edemas - warm mineral water (volume 500 ml).

The procedure of tjubazh is performed as follows - in the morning you need to drink on an empty stomach any of the above means, then for 1.5-2 hours lie on your right side in bed. You can not put on a hot-water bottle. The medicine can have a laxative effect - this is normal.

[15], [16], [17], [18], [19]

Herbal Treatment

Cholagogue drugs, manufactured on the basis of medicinal herbs are usually prescribed in the form of herbal teas or cholagogue.

Cholagogue collection mainly consists of grass / leaves of cut grass (2-3 parts), flowers of sand cumin (4 parts), and also fruits of coriander (2 parts). The medicine is prepared as follows - take 1 tablespoon of the collection and pour 2 cups of boiling water. After that, insist 20-30 minutes, and then strain. Eat 0.5 glasses three times a day for half an hour before meals.

Cholagogue tea contains dogrose, stigma of corn, and also tansy. You should drink 0.5 cup of the substance 2-3 times / day in intervals between meals.

Complications and consequences

Dysfunction of the bile ducts at an early stage of pregnancy can provoke a severe and protracted toxicosis. As a result of the appearance of this pathology, the appetite deteriorates sharply in the pregnant woman, which can lead to severe weight loss. This period can last for only the first trimester, reach 16+ weeks. Often in such cases, treatment in a hospital in hospital is required.

[20], [21]

Forecast

Pain in the right hypochondrium during pregnancy usually has a favorable prognosis, since dysfunction of the biliary tract does not interfere with the course of pregnancy and does not have a negative impact on the child. The disease does not interfere with the birth in a natural way, and after them the motor activity of the bile ducts usually recovers after 1 month. If, at the end of this period, the manifestations of the disease have not disappeared, you need to consult a doctor.

[22], [23], [24]