Stomach Issues During Early Pregnancy: Causes and Concerns

Gastric disease

Hello, doctor! I have a history of gastrointestinal issues and often experience stomach pain, approximately five days a week.
I have stocked up on various antacids.
I previously underwent tests (not an endoscopy), and the doctor diagnosed me with alcoholic gastritis, while a traditional Chinese medicine practitioner suggested I have a gastric ulcer.
However, I have not consumed alcohol for the past two years.
Over the past few months, I have experienced very little stomach pain.

Recently, I discovered that I am about four to five weeks pregnant.
Around this time, I have been experiencing severe nausea; if I don’t eat, I feel like vomiting, and if I do eat, I inevitably vomit.
For the past two days, the nausea has intensified to the point where I feel nauseous all day, and I occasionally experience dizziness.
Today, I even vomited blood.
What could be the cause of this? Since last year, I have been taking good care of my stomach, and the frequency of my previous symptoms has significantly decreased.
Recently, I have been eating regular meals and avoiding any irritating foods, so why has this suddenly occurred?
I am scheduled for a surgical abortion next week, and I am currently unable to eat and have been vomiting blood.
I am very scared and wondering if I might have some illness.

Ling, 20~29 year old female. Ask Date: 2004/08/01

Dr. Hong Hongchang reply Internal Medicine

Based on your symptom description, the causes of upper abdominal pain may include peptic ulcer, erosive gastritis, pancreatitis, and gallstones.
Given your previous alcohol consumption habits, the likelihood of alcoholic gastritis or ulcer is quite high.
Additionally, since you are currently pregnant, experiencing morning sickness is common; however, the presence of blood in your vomit may indicate superficial mucosal damage or other hemorrhagic gastroenteritis.
It is recommended that you visit an obstetrics and gynecology clinic for further evaluation.

Reply Date: 2004/08/01

More Info

Experiencing gastrointestinal issues during early pregnancy is not uncommon, especially for those with a pre-existing history of stomach problems. Your symptoms of severe nausea, vomiting, and the presence of blood in your vomit are concerning and warrant immediate medical attention.
Firstly, it's important to understand that pregnancy can significantly alter your gastrointestinal system due to hormonal changes, particularly the increase in human chorionic gonadotropin (hCG) and progesterone. These hormones can slow down digestion, leading to symptoms such as bloating, nausea, and vomiting, commonly referred to as "morning sickness." However, if you are experiencing severe and persistent vomiting, it may indicate a condition known as hyperemesis gravidarum, which can lead to dehydration and electrolyte imbalances.

The presence of blood in your vomit is particularly alarming. This could be due to several reasons, including:
1. Esophageal irritation: Frequent vomiting can irritate the lining of the esophagus, leading to small tears or bleeding.

2. Gastritis or ulcers: Given your history of alcohol-related gastritis and possible ulcers, the stress of pregnancy and the increased acidity from vomiting could exacerbate these conditions, leading to bleeding.

3. Other gastrointestinal issues: There may be underlying conditions that have not been diagnosed, which could be contributing to your symptoms.

Given that you are scheduled for a surgical procedure next week, it is crucial to address these symptoms immediately. I recommend that you contact your healthcare provider or go to the emergency room to discuss your symptoms, especially the vomiting of blood. They may perform diagnostic tests, such as blood tests or imaging studies, to determine the cause of your symptoms and ensure that you are stable before your procedure.

In the meantime, here are some general recommendations for managing nausea and vomiting during pregnancy:
1. Stay Hydrated: It's essential to maintain hydration, especially if you're vomiting frequently. Sipping on clear fluids like water, broth, or electrolyte solutions can help.

2. Small, Frequent Meals: Eating small amounts of bland foods throughout the day can help manage nausea. Foods like crackers, toast, or bananas may be easier to tolerate.

3. Avoid Triggers: Identify and avoid foods or smells that trigger your nausea.

4. Ginger and Acupressure: Some women find relief from nausea using ginger tea or acupressure wristbands.

5. Consult Your Doctor: If over-the-counter remedies are not effective, your doctor may prescribe medication to help control nausea and vomiting.

Lastly, regarding your concerns about the impact of your gastrointestinal issues on your pregnancy, it is essential to communicate openly with your healthcare provider. They can provide personalized advice and support to ensure both your health and the health of your baby are prioritized during this time. Remember, your well-being is crucial, and addressing these symptoms promptly is vital for a safe and healthy pregnancy.

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