[32F] Pregnant with heartburn, nausea, and vomiting bile

Patient Description

A 32-year-old female, currently 28 weeks pregnant, is experiencing heartburn, nausea, and vomiting bile. She has been dealing with a burning sensation in the upper abdomen/chest, described as tightness and burning, with a severity of 6.5 out of 10 for heartburn and 7 out of 10 for chest pain. The symptoms have been persistent for the past 3 days. The patient has attempted to manage the heartburn with water and antacids without identifying specific food triggers. She has also been vomiting bile at least twice a day and has noticed a slight difficulty swallowing. Additionally, she has vomited a small amount of blood. The patient has a history of diabetes since 2007, managed with Basaglar and Imunjev insulin. She has a family history of GERD and IBS and takes Tylenol quick release and uses marijuana for sleep aid. She also has seasonal allergies. No other medications, supplements, or herbal remedies were reported.

Show More

Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be contributing to your symptoms:

  • Gastroesophageal Reflux Disease (GERD): This condition occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus, causing heartburn and other symptoms. Pregnancy can also exacerbate GERD symptoms due to hormonal changes and pressure from the growing fetus.

    • Treatment typically involves lifestyle changes and over-the-counter medications. If these don't help, prescription medications or even surgery might be necessary.
  • Peptic Ulcer: These are sores that develop on the lining of your stomach, upper small intestine or esophagus. The most common symptom of a peptic ulcer is burning abdominal pain, which you've described. Vomiting of blood can be a sign of a bleeding ulcer.

    • Treatment typically involves medications to decrease stomach acid. If an ulcer is caused by a bacterial infection, antibiotics may be necessary.
  • Gallstones: These are hardened deposits in the gallbladder that can cause a sharp, crampy pain in the right upper part of your abdomen. Pregnancy increases the risk of gallstones due to increased estrogen levels.

    • Treatment may not be necessary if the gallstones aren't causing symptoms. If they are, surgery to remove the gallbladder may be necessary.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

Here are some steps you can take to alleviate your symptoms:

  1. Avoid foods and drinks that trigger heartburn. Common triggers include fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.
  2. Eat smaller meals. Avoid overeating by eating smaller meals.
  3. Don't lie down after a meal. Wait at least three hours after eating before lying down or going to bed.
  4. Elevate the head of your bed. If you regularly experience heartburn while trying to sleep, put gravity to work for you. Place wood or cement blocks under the feet of your bed so that the head end is raised by 6 to 9 inches.
  5. Don't wear tight clothing or tight belts.
  6. If you smoke, stop. Smoking decreases the lower esophageal sphincter's ability to function properly.

What you should look out for

Seek immediate medical attention if you:

  • Experience severe chest pain or pressure, especially if it's combined with pain in the arm or jaw, or difficulty breathing. These could be symptoms of a heart attack.
  • Vomit large amounts of blood or if your vomit looks like coffee grounds.
  • Have bloody or black tarry stools.
  • Have difficulty swallowing.
  • Have persistent nausea or vomiting.
  • Have weight loss for no known reason.

Remember, it's important to consult with a healthcare provider for an accurate diagnosis and treatment.

Show More

1
 Hugs
0
 Comments

Save

9 mo ago


People Also Ask


What are common causes of heartburn during pregnancy?

Heartburn during pregnancy is often caused by hormonal changes that relax the lower esophageal sphincter, allowing stomach acid to flow back into the esophagus. Additionally, the growing uterus can put pressure on the stomach, exacerbating heartburn.


How can I differentiate between heartburn and a more serious condition like a peptic ulcer?

Heartburn typically causes a burning sensation in the chest and upper abdomen, often after eating. A peptic ulcer may cause more severe, persistent pain and can be accompanied by symptoms like vomiting blood or black stools. It's important to consult a healthcare provider for an accurate diagnosis.


What lifestyle changes can help manage GERD symptoms during pregnancy?

To manage GERD symptoms during pregnancy, try eating smaller meals, avoiding trigger foods, not lying down immediately after eating, elevating the head of your bed, and wearing loose clothing. Avoiding smoking and alcohol can also help.


When should I seek medical attention for vomiting bile and blood during pregnancy?

Seek medical attention if you experience severe chest pain, vomit large amounts of blood, have black tarry stools, or have persistent nausea and vomiting. These could be signs of a more serious condition that requires prompt medical evaluation.

No comments yet

Be the first one to comment

Share your feedback

All Stories


Experiencing symptoms?

Our AI will conduct a medical interview and assess what might be happening. You can also make a post afterwards.

Share your feedback