Differential Diagnosis for Cough, Colds, Epigastric Pain in Pregnancy

Single Most Likely Diagnosis

• Gastroesophageal Reflux Disease (GERD): This condition is common in pregnancy due to increased intra-abdominal pressure and relaxation of the lower esophageal sphincter, which can cause epigastric pain. Coughing can exacerbate GERD symptoms.

Other Likely Diagnoses

• Viral Gastroenteritis: Although more commonly associated with diarrhea and vomiting, some viral gastroenteritis cases can present with epigastric pain. The cough and cold symptoms could be coincidental or part of a viral syndrome.
• Pregnancy-Related Hypertension: While not directly causing cough and colds, pregnancy-related hypertension can lead to epigastric pain due to liver capsule distension (in the case of preeclampsia with HELLP syndrome). However, this would typically be accompanied by other symptoms such as high blood pressure and proteinuria.
• Urinary Tract Infection (UTI): UTIs are common in pregnancy and can cause abdominal pain, which might be perceived as epigastric. However, UTIs typically present with dysuria, frequency, and urgency.

Do Not Miss Diagnoses

• Pulmonary Embolism (PE): Although less likely, PE is a critical diagnosis to consider, especially if the cough is new or worsening, and there are other risk factors for thromboembolism (e.g., immobilization, family history of clotting disorders). Epigastric pain could be referred pain from the diaphragm.
• Placental Abruption: This condition involves the premature separation of the placenta from the uterus and can cause severe abdominal pain, which might be described as epigastric. It's a medical emergency, especially if accompanied by vaginal bleeding.
• Appendicitis: While the pain of appendicitis typically localizes to the right lower quadrant, in late pregnancy, the appendix can be displaced upward, potentially causing epigastric or right upper quadrant pain. The presence of cough and colds would be coincidental.

Rare Diagnoses

• Pancreatitis: This condition can cause severe epigastric pain and is more common in pregnancy due to gallstones. However, it would typically be associated with more severe symptoms such as nausea, vomiting, and significant abdominal tenderness.
• Cholecystitis: Inflammation of the gallbladder can cause right upper quadrant or epigastric pain. While not directly related to cough and colds, it's a consideration in the differential diagnosis of abdominal pain in pregnancy.