Q&A: What is causing my stomach pains at 19 weeks?

by Dr. Gerard M. DiLeo

I am having left upper abdominal pains for five days now. I am 19 weeks pregnant and this second trimester should be the greatest time of being pregnant. But I am feeling miserable, everytime when I start to do something in a standing or sitting position the nagging pain comes back in the upper quadrant of my abdomen at the border of my left rib cage. Only if I lay down with a warm pad on my belly do I have relief. But I can't lay down all the time, I have to work full time as a nurse. Please tell me what this pain is and what can I do about it?

If you had said your right upper abdomen, I'd be quick to blame your gall bladder. Mid upper abdominal pain goes along with gastritis or esophageal hernia. It's possible that these GI symptoms may radiate to the left side, but it's uncommon. The only thing on your left side is your spleen, but a problem with it would be disastrous very quickly, and by this time you're clear of that danger. I suppose angina is a possibility, but the positional relationship to the occurrences are agains that, too. It may be that as you use your intercostal muscles to help you breathe--normal as the fundus obtunds the diaphragm--that you've strained these muscles, and that could take weeks to cool down. You may have old scarring over your pleura, and the increased intercostal muscular activity is causing inflammation there as well. If you're going to have one quadrant hurt, the upper left is the most innocent. And also the most mysterious. Thankfully, this pain will probably resolve as mysteriously as it began, with no real answer ever.

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