Stomach pain during pregnancy

Many pregnant women will find themselves having stomach pain in the second trimester, especially at night when the symptoms of stomach pain will become more severe, which will affect their sleep quality. Long-term insomnia is very bad for the health of pregnant women, so they should go to the hospital as soon as possible for gastric juice analysis and serological testing. These two tests can determine the cause of their illness.

1. Gastric juice analysis

Determining the basal gastric secretion (BAO) and the maximum acid secretion (MAO) and peak acid secretion (PAO) after the histamine test or pentagastrin test to determine the gastric acid secretion function is helpful for the diagnosis of chronic atrophic gastritis and guiding clinical treatment. In chronic superficial gastritis, gastric acid is usually normal, while in extensive and severe chronic atrophic gastritis, gastric acid is decreased.

2. Serological testing

In chronic atrophic gastritis, serum gastrin is often moderately elevated because lack of gastric acid cannot inhibit G cell secretion. If the lesion is severe, not only the secretion of gastric acid and pepsinogen will decrease, but also the secretion of intrinsic factor will decrease, thus affecting the decrease of vitamin B12; serum PCA is often positive (more than 75%).

3. Gastrointestinal X-ray barium meal examination

With the development of digestive endoscopy technology, upper gastrointestinal tract radiography is rarely used in the diagnosis of gastritis. When using double contrast imaging with barium gastrointestinal irradiation to display the fine structure of the gastric mucosa, atrophic gastritis may show that the gastric mucosal folds are relatively flat and reduced.

4. Gastroscopy and biopsy

Gastroscopy and pathological biopsy are the main methods for diagnosing chronic gastritis. Superficial gastritis is often most obvious in the gastric antrum, and is often characterized by a diffuse increase in mucus on the surface of the gastric mucosa, with grayish white or yellowish white exudates. The mucosa at the lesion site is red and white or mottled, resembling measles-like changes, and sometimes with erosion. The mucosa of chronic atrophic gastritis is mostly pale or grayish white, or red and white, with the white area sunken; the wrinkles become thinner or flat, and due to the thinning of the mucosa, purple-blue submucosal blood vessels can be seen; the lesions can be diffuse or mainly in the gastric antrum. If accompanied by proliferative changes, the mucosal surface is granular or nodular.

The biopsy specimens were examined pathologically to determine chronic superficial gastritis, chronic atrophic gastritis, intestinal metaplasia, and dysplasia. A rapid urease test on biopsy tissue may be performed.