Upper stomach pain during pregnancy could develop due to the changes in the positions of the abdominal organs caused by the developing fetus. Other possible causes for upper stomach pain are gas, indigestion, etc. In addition, similar biochemical and physiological changes in the woman’s body may give rise to accompanying pregnancy symptoms such as bloating, cramps, aches, and nausea. However, these symptoms may vary from one woman to another (1).
Read about the factors that might cause upper stomach pain and home remedies to manage the discomfort.
Is Upper Stomach Pain Common During Pregnancy?
Upper abdominal pain is a common complaint during pregnancy. As the fetus grows inside your belly, the organs and tissues adjust themselves to accommodate it and, in the process, may get pressed or stretched, causing discomfort.
It may be a sharp or dull pain, but it usually goes away with a little rest, a change in position, or passing stools or gas. However, persistent pain or severe stomach pain may indicate an underlying problem (2).
What Causes Upper Stomach Pain When Pregnant?
The figure shows the organs that get re-positioned during pregnancy. Conditions associated with these organs, and with the muscles and tissues of the upper stomach wall, can contribute to pain in this region.
Common conditions that are not very serious and may be resolved with lifestyle and dietary changes are:
1. Growing pains
Ligaments in the torso often stretch to support the growing uterus, leading to sharp pains and cramps in various parts of the abdomen (1).
2. Acid reflux
The stomach and intestines are pushed up by the growing uterus, causing compression and delayed gastric movements. This causes stomach acid to move up the food pipe and cause heartburn, and its severe form is termed gastroesophageal reflux disorder (GERD).
It may cause severe upper abdomen pain, requiring medical attention. Antacids are useful in treating the condition, but you should consult your healthcare provider to know the safe medications during pregnancy (3).
3. Stomach gas
Increased level of the hormone progesterone is often responsible for more stomach gas formation. Progesterone relaxes the intestinal muscles and slows food movement and digestion, causing flatulence (gas build-up in the gut) and bloating. The problem increases with the pressure created by the enlarged uterus later in pregnancy and may cause upper stomach pain (4).
Irregular bowel movement, passing hard stools, straining during passing stools with abdominal pain, and discomfort are all indicators of constipation. Less body movement, inadequate fluid intake, low fiber intake, relaxed intestinal muscles, iron supplements, and even mental stress may cause constipation when pregnant (5).
Conditions that may harm the mother or baby and requires immediate medical attention are:
It is a common liver disease in pregnancy caused due to reduced bile release from the liver. Bile builds up in the liver and causes malfunctions. The condition is seen in the late second trimester to the early third trimester and can complicate pregnancy. An identifying symptom is itchiness in palms and soles. Other symptoms include right upper quadrant abdominal pain, nausea, loss of appetite, dark urine, and pale stool (6). This condition typically goes away after delivery, but if you suspect that you may be having cholestasis, do speak to your doctor immediately.
Bile flow and clearance get restricted during pregnancy, increasing the risk of gallstone formation. The risk is further enhanced if you have high cholesterol and affects about one percent of pregnancies. Pain in the right upper abdomen with bloating, nausea, and stomach discomfort after meals may indicate gallbladder stones. An ultrasound (ultrasonography or USG) is used for diagnosis (2).
It is the inflammation of the pancreas occurring mostly in the third trimester. Gallstones and high cholesterol are usually responsible for it. Dull upper abdominal pain radiating to the back along with sudden nausea and vomiting are the indicative signs. It is usually diagnosed through ultrasound and biochemical tests for pancreatic enzymes, such as amylase and lipase (2).
8. HELLP syndrome
HELLP stands for hemolysis (breakdown of red blood cells), elevated liver enzyme levels, and low platelet count. It is a life-threatening complication common in pregnant women with preeclampsia or eclampsia. Symptoms include pain in the upper right or middle abdomen, swelling in hands and face, fatigue, headache, blurred vision, excess weight gain, nausea, and vomiting (7).
9. Placental abruption
The detachment of the placenta from the uterine wall is known as abruption. It is a serious condition that causes stomach pain with or without vaginal bleeding. It may lead to premature delivery or stillbirth and requires prompt medical attention (8).
10. Ectopic pregnancy
Implantation outside the uterus, such as in fallopian tubes, is termed ectopic pregnancy. Characteristic symptoms include missed periods, vaginal bleeding, and lower abdominal pain. However, rare incidences of upper abdominal and chest pain have been reported (9).
Besides these, any food intolerance or stomach infection may cause upper abdominal pain, for which you should consult your doctor and take prescribed medications only.
What Are The Home Remedies For Upper Abdominal Pain During Pregnancy?
Mild abdominal pain can be effectively treated at home, but if you feel anything unusual, you should contact your healthcare provider. If pain persists or becomes severe, you should seek immediate medical attention. You must avoid any over-the-counter (OTC) medicine to address upper abdominal pain. No such medication should be used without consulting your doctor.
You can manage discomfort due to acid reflux, heartburn, and stomach gas if you:
- Take meals in small portions multiple times a day, allowing proper digestion
- Eat slowly and chew your food properly
- Avoid excessively spicy and oily foods
- Avoid carbonated drinks and artificial sweeteners
- Include light exercises, such as walking, in your lifestyle to aid mobility and stimulate digestion (4) (10).
You may take antacids, but only after consulting your healthcare provider.
Constipation can be eased by:
- Drinking lots of water
- Including fiber-rich food such as apples, bananas, lentils, raspberries, split peas, and whole-wheat preparations. However, excess fiber may cause gas formation, and 25 grams of fiber per day is considered ideal (11)
- Administering stool softeners only after seeking a prescription from your physician
Frequently Asked Questions
1. Does my upper stomach feel tight during pregnancy?
Besides gas or constipation, stomach muscles may also tighten due to Braxton Hicks contractions or false contractions during pregnancy (12).
2. Do contractions start at the top of the stomach in pregnancy?
No. True labor contractions are felt in the back and lower abdomen. You may feel pressure in the pelvic area as well (13).
If the pain does not improve with simple measures or is accompanied by symptoms such as back pain, swelling, itchy palms and soles, vaginal bleeding, excess vaginal discharge, vomiting, or contractions, you need to inform your healthcare provider. After diagnosis, your doctor will suggest medical treatment for the underlying cause. It is important not to miss your prenatal appointments and notify anything unusual you experience during your pregnancy to avoid any complications of upper stomach pain.
- Upper stomach pain during pregnancy might occur when organs and tissues adjust to accommodate the baby.
- Growing fetus, acid reflux, stomach gas, and constipation are a few causes of pain.
- Light exercises, less spicy food, more water intake, more fiber in the diet, etc., can relieve the pain.
- Take advice from a doctor for severe pain as it may indicate underlying issues, such as ectopic pregnancy and placental abruption.
- Stomach pain in pregnancy.
- Sanoop Koshy Zachariah et al. (2019), Management of acute abdomen in pregnancy: current perspectives.
- Pregnancy Care Guidelines Reflux (heartburn).
- Pregnancy Gas.
- Constipation in Pregnancy.
- Leela Sharath Pillarisetty and Ashish Sharma (2021), Pregnancy Intrahepatic Cholestasis.
- HELLP syndrome.
- What complications can affect the placenta?
- Bonnie Woolnough (2018), An Atypical Presentation of Ectopic Pregnancy With Unicornuate Uterus and Undescended Fallopian Tube.
- Common symptoms during pregnancy.
- What can help with constipation during pregnancy?
- Stomach Pain in Pregnancy.
- True Vs. False Labor.