What are the symptoms of colic in pregnant women?

The physical constitution of pregnant women is quite special during pregnancy, and it is very likely that some small problems will cause big troubles. Pregnant women are prone to intestinal colic during pregnancy, and the intestinal colic of pregnant women cannot be ignored. This is mostly caused by inflammatory diseases of the gastrointestinal tract. Intestinal colic in pregnant women can cause abdominal pain, as well as persistent pale face, abdominal pain and bloating, heavy diarrhea, cramps between the legs, and cold feet and abdomen. You need to go to the hospital for examination as soon as possible to avoid the risk of miscarriage.

Symptoms and signs

The patients are mostly between 40 and 59 years old, and are more common in women.

1. Postprandial pain Postprandial pain in the upper or middle abdomen is the main clinical manifestation of chronic mesenteric ischemia. It usually occurs within 30 to 45 minutes after a meal, with abdominal cramps or dull pain that lasts for several hours. Patients eat less due to fear of pain. The pain may manifest as dull pain or severe abdominal pain, radiating to the back. A small number of patients experience persistent pain, similar to the persistent rest pain caused by lower limb ischemia. In addition, the severity of abdominal pain is related to the amount of food eaten and the fat content of the food.

2. Gastrointestinal disorder: About 1/3 of patients with abdominal pain also experience nausea, vomiting, and abnormal bowel movements, which start with constipation and then develop into diarrhea. The frequency and duration of occurrence gradually increase. These symptoms are not characteristic and are related to the affected blood vessels and the site of ischemia in the digestive tract. When the celiac artery is affected, there are often nausea, vomiting, and abdominal distension. Involvement of the superior mesenteric artery manifests as postprandial abdominal pain and weight loss. Involvement of the inferior mesenteric artery manifests as constipation, occult blood in the stool, and ischemic colitis.

3. Weight loss The eating-pain connection quickly leads to anorexia in the patient, followed by rapid and severe weight loss which is the hallmark of this disease. As intestinal ischemia progresses, intestinal malabsorption syndrome may develop, leading to further weight loss and the appearance of large amounts of foamy stools, indicating that the stools are rich in fat and protein.

4. Physical signs: The patient may have significant weight loss. A bruit may be heard in the upper abdomen, which is caused by a narrowed aorta or other visceral arteries.

Pathological etiology

The celiac artery, superior mesenteric artery, and inferior mesenteric artery are the nutrient vessels of the gastrointestinal tract. The collateral circulation between them can provide sufficient blood supply to maintain the vitality and function of the affected intestine. Therefore, most isolated SMA chronic occlusions are asymptomatic. However, when the second blood vessel also has insufficient blood supply, the relatively ischemic intestine cannot meet the increased blood supply required for food intake. This is the cause of the typical "eating pain" of colic.

The main cause of the gradual occlusion of visceral arteries is atherosclerosis. Arterial angiography and autopsy have found that the incidence of chronic mesenteric ischemia caused by arteriosclerotic occlusion in the elderly population is on the rise. Hypertension and smoking are the main risk factors for arteriosclerotic occlusive disease.

Less common lesions include compression of the celiac artery by the celiac ganglion, dilated aortic pseudoaneurysm or isolated aneurysm, thromboangiitis obliterans, or periarteritis nodosa involving the celiac artery. There is a rare condition called medial arcuate ligament syndrome, which is caused by the high origin of the celiac artery, or the normal origin of the celiac artery but the low position of the ligament, which compresses the celiac artery and partially occludes it.