Hyperemesis Gravidarum - Morning Sickness

Hyperemesis is the medical term for excessive vomiting. It may be a symptom of conditions such as gastric flu or intestinal obstruction. When it occurs in pregnancy, it is known as hyperemesis gravidarum.

The etiology of hyperemesis gravidarum is not well understood. Hormonal causes related to human chorionic gonadotropin, estradiol, progesterone, adrenal hormones and pituitary hormones have been proposed, but currently there is no conclusive evidence implicating any specific substance. Psychological and social factors influence this disease, such as in unwanted pregnancies, although this syndrome is not limited to unwanted pregnancies. Young, unwed mothers whom are felt to have "sinned" and therefore harassed by their parents, are common sufferers of this syndrome. Remarkable improvement with hospitalization is often noted in such cases, with rapid relapses once released to the home environment. Hysterical and immature personalities can predispose one to this condition.

Morning sickness is the nausea and vomiting that affects 50 percent to 90 percent of all expectant mothers during the first few months of pregnancy. Hyperemesis gravidarum probably develops because of an oversensitivity of the vomiting center in the brain to the hormonal changes produced by the placenta and fetus during pregnancy, but it may also be of psychological origin. The vomiting causes dehydration and should be treated in a hospital with intravenous infusions of glucose, antinauseant drugs, and sedation.

The term "morning sickness" can be deceptive because for some women, it can come at any time of day. Typically, it starts 4 to 6 weeks after conception and usually resolves spontaneously by the 16th week. Some women may have symptoms beyond the first trimester, and a few may have symptoms throughout their entire pregnancy.

Recommendations for Relief of Morning Sickness, Gastric Distress, Nausea and Vomiting:

  • Eat small meals throughout the day so that you're never too full or too hungry.
  • Avoid rich, fatty foods.
  • Avoid foods with smells that bother you.
  • Stay our of the kitchen while food is being prepared if food odors provoke nausea.
  • Eat more carbohydrates (plain baked potato, white rice, dry toast).
  • Eat saltine crackers and other bland foods when you feel nauseous.
  • Replace fluids and salt lost by vomiting by consuming broths, ginger ale, Gatorade, Jell-O or apple juice.
  • Drink fluids between meals, rather than with meals.
  • Chew foods thoroughly and eat slowly.
  • Rest after meals, but try to avoid reclining or lying down immediately after eating. Attempt to keep your head slightly elevated.
  • Antacids, such as Maalox or Mylanta, may be taken as directed to control gastric upset.
  • Avoid caffeine, alcohol and tobacco.
  • Unless otherwise prescribed, take non-aspirin preparations with food for pain control.
  • If swallowing medications in the form of tablets becomes problematic, crush them and mix with apple sauce prior to ingestion.
  • The iron in prenatal vitamins can bother some women. If you think your morning sickness is related to your vitamins, talk with your doctor and he or she may change your vitmains.
  • Wearing "acupressure" wrist bands, which are sometimes used by passengers on boats to prevent sea sickness, may help some women who have morning sickness. You can buy the bands at boating stores or travel agencies, such as the AAA Auto Club.

Anti-emetic medication appears to reduce the frequency of nausea in early pregnancy. There is some evidence of adverse effects, but there is very little information on effects on fetal outcomes. Of newer treatments, pyridoxine (vitamin B6) appears to be more effective in reducing the severity of nausea. The results from trials of P6 acupressure are equivocal. The results of the trial using adrenocorticotropic hormone to treat hyperemesis gravidarum show no evidence of benefit. Ginger may be of benefit, but the evidence so far is weak.

See also:Motion Sickness

The herbs and nutrients mentioned above reflect the major nutritional supplements that may help the condition. Please do remember however that nutritional supplementation is an adjunct to medical treatment and in no way replaces medical treatment.

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