I am about 30 weeks pregnant and have been suffering from abdominal pain primarily under my right rib cage for nearly three weeks now. It gets worse after I eat and goes from a dull and uncomfortable ache to stabbing that makes me stop dead in my tracks. The pain seemed to be intensified as they performed the ultrasound on my gallbladder and were pushing around up underneath my ribs. It also tends to get worse when coughing, sneezing or taking very deep breaths. Applying a little bit of pressure seems to comfort me a little bit, but I am unable to lay on my right side due to the frequent pain. I have a slight dull and uncomfortable ache under my left rib cage and these pains tend to radiate almost to my back. I have gone to the ER and they have done an ultrasound on my gallbladder and it appears that I have no stones or thickening of the wall of my gallbladder. I have a decreased appetite due to the pain that eating anything causes and just feel exhausted because I am not sleeping well at night, mostly due to pregnancy I think. I was wondering what else this may be caused by. I would have sworn it was my gallbladder, but they proved me wrong there. I am a smoker in my late 20's in fairly good overall health. This is my third pregnancy and the pregnancy has gone very smoothly without any complications or side effects. Please help.... what else could be causing this discomfort? I am at my wit's ends!
Thickening of your gallbladder wall is suggestive of inflammation. Just because the ultrasonographers didn't see a stone doesn't mean one doesn't exist. Perhaps it's already partially lodged in your bile duct. Or there's sludge there. Or there's something else compressing the duct such that everytime your gallbladder contracts in response to (fatty, greasy, oily) food, the bile can't go anywhere and thus leads to pain as pressure increases in your gallbladder. This is what we call biliary colic. Make sure your liver function tests (LFTs) are normal since an elevated alkaline phosphatase could suggest gallbladder disease while an elevated bilirubin could suggest bile buidling up.
Another less welcome cause of pain in the right upper quadrant is HELLP syndrome or hemolysis, elevated liver & low platelets which is usually associated w/pregnancy-induced hypertension and could lead to pre-eclampsia. So you'll need to keep an eye on your blood pressure as well as certain blood tests, eg liver & blood count.
Less commonly, Fitz-Hugh-Curtis syndrome is a manifestation of pelvic inflammatory disease. This is less likely as you'd most likely be feeling sick as a dog w/fevers, sweats & chills.
Most important, keep in close contact w/your obstetrician and family physician regarding how you're doing. You've only got another 10 weeks. Good luck! And congratulations!
Thank you so much for your response. I am very thankful! They have put me on some steroids and antacids for now which has seemed to help tremendously with the discomfort and have thought my discomfort to be due to the overly active baby kicking around my gallbladder regularly. I have tried countless times to quit smoking with this pregnancy, I did quit with my first two children, however I was unable to do so successfully. My OB/GYN has said that is okay this time around. I was smack dab in the middle of being scheduled for back surgery after a spinal injury when I found out I was pregnant. Since finding out, I refused to take any pain relieving medications whatsoever, I have ceased epidural injections and Physical Therapy and have had an increased level of stress overall from dealing with the pain completely naturally for such a long period of time compiled with the realization that this baby will suffer from Marfans Syndrome as do his brothers and sisters. In the end, I feel that the lack of medications taken will be more beneficial to my child and the benefits from not taking those medications by far outweigh my inability to completely quit smoking this time around. Once our baby boy is born, I fully anticipate quitting via chantix after I am done breastfeeding.
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