At 28 weeks of pregnancy, the abdomen feels bloated and painful, as if overfull.

At 28 weeks of pregnancy, a bloated and painful abdomen resembling the feeling of overeating may be caused by physiological factors, but pathological causes such as chronic gastritis or acute gastroenteritis cannot be ruled out. Treatment should be based on the underlying cause. The specific analysis is as follows:

1. Physiological Factors

At 28 weeks of pregnancy, women have entered the third trimester. As gestational age increases, the uterus gradually enlarges. This expansion can stretch surrounding tissues, leading to a sensation of bloating and discomfort. This is considered a normal physiological phenomenon. Typically, no other abnormalities occur in the body, and special treatment is not required.

2. Pathological Factors

1) Chronic Gastritis
Chronic gastritis is a common digestive system disorder characterized by inflammatory changes in the gastric mucosa. It can impair normal digestion and lead to abdominal bloating. Treatment may include medications such as omeprazole enteric-coated capsules, lansoprazole enteric-coated tablets, or colloidal bismuth pectin capsules, taken under medical supervision.

2) Acute Gastroenteritis
Acute gastroenteritis develops rapidly and often presents with symptoms such as bloating and abdominal pain. Medications such as montmorillonite powder, lactase tablets, or compound probiotics like Bacillus subtilis and Enterococcus faecalis granules may be prescribed to help speed recovery.

Besides the above conditions, other possible causes include chronic pelvic pain syndrome, uterine contractions, or gastric ulcers. Since pregnant women are a special population, self-medication should be avoided. If any discomfort occurs, it's important to seek timely medical evaluation and treatment at a qualified hospital to prevent adverse effects on fetal development due to inappropriate medication use.