Stomach ulcer in a pregnant woman: symptoms and therapy

One of the important and urgent problems of modern gastroenterology to this day is a stomach ulcer. If we consider the data of world studies, hundreds and thousands of people face this pathology every day. It would seem that you just need to follow a diet and regularly take medications, what else is needed? But what to do if gastric ulcer develops in a pregnant woman? It is often difficult to adhere to a certain diet during pregnancy, and many medicines are completely contraindicated. Why does the disease arise and how can the pathology be dealt with?

Stomach ulcer in a pregnant woman: causes of development

In fact, a stomach ulcer rarely manifests itself during pregnancy: in 90% of cases, the disease existed earlier. Peptic ulcer is a chronic recurrent pathology, which is accompanied by the formation of a defect on the mucous membrane. It is known that, on average, its prevalence among pregnant women does not exceed 0.25%, but there is an unfavorable trend towards an increase in the incidence. It is believed that this is due to increased stress loads and high social activity of patients. The development of the disease is based on the following factors.  

  • Violation of the integrity of the gastric mucosa

Many external factors have a negative effect on the mucous membrane, provoking its ulceration. These include malnutrition with an excess of spicy, salty, fatty and fried foods, smoking, alcohol abuse, and caffeine-containing drinks. Also, nonsteroidal anti-inflammatory drugs and some antibiotics, exposure to chronic stress can damage the mucous membrane . 

  • Hereditary predisposition

It is known that the genetic determinant also plays a significant role. For example, the disease most often occurs in patients with the first blood group: this is due to the excessive proliferation of parietal cells of the gastric mucosa, which produce hydrochloric acid.

  • Infection of Helicobacter pylori

In most cases, the ulcer manifests itself against the background of contamination of the mucous membrane with Helicobacter pylori . It is detected in at least 40% of women who seek medical help. However, in recent years, peptic ulcer disease that is not associated with Helicobacter pylori has often been encountered .

Pain and other symptoms of the disease

In most cases, the first sign of the development of pathology is pain. It is weak, aching in nature, occurs in the epigastrium immediately after eating or after 30-60 minutes. Also, patients note the presence of heaviness in the abdomen, and pain can be given under the left shoulder blade, in the region of the heart, thoracic and lumbar spine. Often, patients get rid of unpleasant sensations by applying a heating pad to the stomach area. Examination reveals a large amount of plaque on the tongue and an unpleasant odor from the mouth. Pregnant women note a more frequent occurrence of dyspeptic disorders: nausea, vomiting, excessive gas formation. Vomiting occurs at the height of stomach pain and is accompanied by marked relief. Some patients complain of stool ruptures, alternating diarrhea and constipation. Due to developing digestive disorders, a pregnant woman does not gain weight well, which negatively affects the condition of the baby.

Peptic ulcer and pregnancy: what is the danger

In pregnant patients suffering from peptic ulcer disease, toxicosis occurs with more pronounced manifestations. Often, iron deficiency anemia develops , which is accompanied by severe weakness, brittle nails and hair, and a decrease in blood pressure. Against the background of digestive disorders, hypovitaminosis is also possible. A stomach ulcer can cause the development of placental insufficiency, fetal growth retardation and hypoxia. In 4% of cases, the disease is complicated by the occurrence of gastrointestinal bleeding against the background of perforation of the ulcer, which poses a serious threat to the mother’s life, and also increases the risk of fetal death to 10-15%. 

Nutrition for illness

After confirming the diagnosis, all women need to follow a special diet. Despite the fact that pregnancy is traditionally considered a period in which some indulgences, quirks and liberties in the diet are permissible, in the case of a peptic ulcer, it is better not to risk it. A stomach ulcer requires the regular implementation of all dietary recommendations: this allows you not to irritate the mucous membrane and reduce the severity of pain. Often, pain syndrome forces a woman to give up food altogether: however, this behavior will harm the baby even more.  

During an exacerbation, experts advise eating more cereals, mucous soups, jelly and mashed potatoes: chopped food does not irritate the stomach. Gradually, you can add soft steamed chicken or fish cutlets, pasta, thermally processed vegetables to the diet. Such nutrition will help maintain long-term remission. It is also recommended to drink at least 2 liters of water daily.

Stomach ulcer treatment

Therapeutic tactics in pregnant women are aimed at reducing stomach acidity and relieving pain. Of all medications, non-absorbable antacids are shown, which envelop the mucous membrane and reduce the activity of enzymes, sorbents that allow increasing the production of protective mucus, as well as myotropic antispasmodics. It is quite rare that doctors prescribe histamine H2 receptor blockers due to their lack of effectiveness. Proton pump inhibitors and bismuth preparations traditionally used for stomach ulcers are contraindicated during pregnancy, since they have a teratogenic effect.

Surgical treatment is used only for perforation or perforation of the ulcer, as well as for bleeding. A peptic ulcer is not an indication for a caesarean section. In the absence of other obstetric and gynecological indications, the patient is shown natural childbirth using epidural anesthesia.

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