Question: What causes upper abdominal pain during pregnancy?
Whether you are in your first, second or third trimester of pregnancy, having to deal with any form of abdominal pain will get you concerned about the well being of your baby.
The truth is, most women who get pregnant will experience some form of pain/cramps in their abdomen that may also radiate to other parts of the body.
In the first trimester, abdominal cramps could be a sign of pregnancy. In the second and third trimester of pregnancy, it is not abnormal for women to experience irregular, unpredictable contractions (Braxton hicks contractions) or abdominal pain attributed to gas formation, constipation and stretching of the supportive uterine ligaments.
Having said that, upper abdominal pain during pregnancy may be due to serious health issues. In the first trimester, abdominal pain can be the first sign of a miscarriage. Also, ectopic pregnancy, which affects one in fifty pregnant women, may also cause abdominal pain.
In the second trimester, strong uterine contractions and dilated cervix precede preterm deliveries. Other serious causes of abdominal pain during pregnancy are Preeclampsia (raised blood pressure while pregnant), urinary tract infections, gallbladder infections, and gastroesophageal reflux disease (GERD).
This article explains causes of upper abdominal pain during pregnancy and simple lifestyle changes that can make your pain go away.
What causes upper abdominal pain during pregnancy
Like already mentioned, pain in the abdominal is not unusual during pregnancy. In fact, most experienced mothers ignore mild abdominal pain and only inform their doctor or midwife if the pain gets too severe, or if they experience vaginal bleeding, body weakness, fever or vomiting.
Here are causes of upper abdominal cramps while pregnant.
1. Pressure effect of growing uterus
One common reason women have abdominal discomfort, especially in the second and third trimester of pregnancy, is increasing the size of the uterus. As your baby grows, the womb expands and occupies much more intra-abdominal space.
As a result, you could feel abdominal discomfort. You should inform your doctor if pains get worse.
2. Progesterone effect
During pregnancy, your hormones spike up and could interfere with normal intestinal movement.
Estrogen and progesterone are elevated once you get pregnant and can slow down the movement of food within your intestines. Because of this, its take quite a long time for intra-abdominal content to be expelled through your anus. This, and the compressive effect of your growing uterus, will allow constipation to set in.
Constipation and gas can easily make you feel uncomfortable with pain in your abdomen. If symptoms get worse, I recommend you see your doctor for help.
Usually, taking fiber diets, vegetables, drinking lots of water, or cessation of your iron supplements (please inform your doctor first) may ease your pain.
3. Round ligament stretching
Another reason you will feel a sharp pain in your abdomen is stretching of the round ligament that supports the uterus.
The round ligament supports the uterus and originates from the upper part of the womb (where your fallopian use fuses with the body of the uterus) and attaches at the mons pubis.
During pregnancy, this ligament is stretched as your baby increased in size. Because of this, its common for women in the second and third trimester to experience abdominal pain, back pain, and buttocks pain.
4. Ectopic pregnancy
Ectopic pregnancy is a common cause of abdominal pain during pregnancy and occurs when your baby grows outside the uterus. Abdominal cramps due to ectopic pregnancy happen in the first trimester, usually before the 11th week of pregnancy.
In ectopic pregnancies, the baby is situated in the fallopian tube and cause severe cramps if the fallopian tube burst open and bleed into the abdomen.
Risk factor for developing an ectopic are previous untreated pelvic infections that affected your fallopian tubes, chlamydia and gonorrhea infections, and women with prior history of fallopian tube surgery.
Symptoms include abdominal cramps with or without vaginal bleeding, though you may also feel fatigue, dizziness, fast heart/pulse rate depending on the severity of bleeding.
If you are in the first trimester and have mild to severe abdominal cramps, it could be an early warning sign of a miscarriage.
A miscarriage means your pregnancy stop and the baby dies with severe intermittent contraction-like belly cramps. Other symptoms of a miscarriage are disappearing pregnancy symptoms, vaginal bleeding (usually in clots), body weakness, back pain, and abdominal cramps.
About 20 to 30 percent of pregnancies will end in a miscarriage; So, inform your doctor, especially if you’ve had a miscarriage in previous pregnancy.
6. GERD (Gastroesophageal reflux disease)
One common cause of burning upper abdominal pain during pregnancy is gastroesophageal reflux disease.
Within your thoracic cavity (oh, I mean your chest wall) is a vertical tubing that carries food from your mouth to your stomach. This is called the esophagus, and within its lower end is a sphincter that involuntarily controls the movement of food.
After the passage of food into your stomach, the esophageal sphincter closes up, prevent backward movement of food into your esophagus.
If this sphincter goes defective, it could cause movement of acidic stomach content into the esophagus resulting in inflammation and lower chest/ upper abdominal pain.
Other factors that could affect the lower esophageal splinter are pregnancy hormones and increased pressure inside the abdomen due to the growing uterus.
Other symptoms of GERD are cough, lack of appetite, difficulty swallowing, and poor night sleep.
7. Gallbladder infection
Gallbladder stone and inflammation could be the reason you have upper abdominal pain, especially on the right side. Under your liver is a pear-shaped structure called the gallbladder which is involved in the storage of bile needed for the breakdown of fats in your meals.
After ingestion of fatty meals, your body releases an enzyme that triggers the release of bile into the intestine for breakdown fo fat.
If there is blockage of secretion or increased secretion into the gallbladder, it could cause the formation of gallstones and possible infections.
During pregnancy, the rate of emptying of the gallbladder slows down allowing stones to form. This, with the increased secretion of cholesterol in pregnancy, will result in gallstones.
As a rule, it’s best to see your doctor. Gallbladder infections will require the use of antibiotics, though, some patient will need a surgical approach.
Preeclampsia is a common cause of epigastric pain in the upper abdomen. In simple terms, preeclampsia means elevated blood pressure levels and occurs in the later stages of pregnancy after the 20th week. Usually, in mild cases, most pregnant women are asymptomatic.
However, in severe cases, patients will experience pain in the upper abdomen, headache, dizziness, blurred vision, right upper abdominal pain, vomiting, and sometimes, convulsion.
Presence of convulsion in pregnant women with elevated blood pressure is called eclampsia, and it is a life-threatening condition. Complications of eclampsia can result in HELLP syndrome which can ultimately lead to death if quick intervention is not administered.
If you’ve been diagnosed with high blood pressure during your pregnancy, quickly see your doctor if you experience burning, sharp or stabbing upper abdominal pain.
Typically, in early stages, your doctor will advise you take a lot of water, bed rest, avoid salty meals, and place you on safe anti-hypertensive medications.
How to ease upper abdominal tenderness while pregnant
If you experience abdominal pain while pregnant, you need to see your doctor to be sure it is not something serious. Here are some tips that will help alleviate your pain while preparing to see your doctor
- Instead of taking all meal at a go, it is best you take small meals at intervals. This will help prevent regurgitation or indigestion.
- Stay away from fatty diet because they can trigger gallbladder pain and cause relaxation of the lower esophageal splinters
- Don’t lie down immediately after taking your meals. It is best to wait for a while for your food to digest before sleeping
- Don’t eat late in the night because it could force regurgitation
- Avoid food that worsens constipation during pregnancy – Caffeine, bananas, red meat, iron supplements, fast junk foods, chocolates, and alcohol
When to see a doctor?
If you have abdominal cramps in the 1st, 2nd, or 3rd trimester, see your doctor immediately if you develop any of these symptoms
- Excruciating pain in your abdomen that stops you daily activities
- Fast heart rate
- Dizziness and fainting attacks
- Passage of blood in stool
- Vaginal bleeding with or without clots
- Severe back pain
- A long-lasting contraction in your abdomen especially when close to delivery
- Severe leg, face, hand swelling
- Fever (high body temperature)