How to tackle morning sickness in pregnancy

Pregnancy is a time of joy for many women, who often look forward to completing the journey and giving birth to healthy babies at the end of nine months.

Though fulfilling, the journey is not always smooth. Pregnancy causes a lot of physical and emotional changes in a woman’s body due to the increased production of hormones like oestrogen and progesterone.

Some of the changes include fatigue, forgetfulness, weight gain, mood swings, anxiety or depression, weight gain, protruding belly, enlarged breasts, stretch marks and hair loss. Others are symptoms like nausea, vomiting and constipation.

These symptoms are mostly referred to as ‘morning sickness’ because most women experience them in the morning, can also occur at any time of the day. They may be mild or severe, as well as short-term or long-term in affected women.

Whichever the case, the symptoms cause a lot of discomfort for pregnant women and can significantly impact their quality of life, particularly during early pregnancy.

If left untreated, severe nausea and vomiting can cause dehydration, decreased urination, loss of appetite and unintentional weight loss that can harm the baby. At this point, many women usually require hospitalisation to deal with the condition.

Despite its common occurrence during pregnancy, the main cause of morning sickness remains unknown in the healthcare fraternity. Nevertheless, past studies have indicated that the increased levels of the pregnancy hormones — oestrogen and progesterone — could be responsible for the problem.

Scientists note that the enhanced production of these hormones during pregnancy could be causing disruptions in the balance of good bacteria, which keep people healthy and bad bacteria that cause diseases.

Since they mostly reside in the gut, an influx in the bad bacteria is believed to disrupt the digestive system, leading to unwanted symptoms like nausea, vomiting and constipation that affect women during pregnancy.

Guided by this theory or line of thought, a scientist from the US-based University of California Davies School of Medicine, sought to find out if the consumption of probiotics — substances containing good bacteria that naturally occur in the body, could help address this problem.

These probiotics can be found in yoghurt and other types of fermented foods. They are also available as food supplements usually taken in the form of tablets.

The results of this first of its kind study, which was recently published in the Nutrients Journal, show that probiotics can indeed help women to tackle pregnancy-related nausea, vomiting and constipation.

Based on the study, these probiotics increase the production of good bacteria in the stomach, which helps in suppressing the disease-causing ones, thereby leading to a healthy and well-functioning digestive system that guards against morning sickness.

“The cause of nausea and vomiting during pregnancy is unknown to this date. Various theories have been proposed, but none of them is conclusive,” said Albert Liu, the lead author for the study and professor of obstetrics and gynaecology at the Davis School of Medicine.

Based on his experience with patients that he attended to, Dr Liu said nausea, vomiting and constipation during pregnancy can significantly diminish the quality of patients’ lives.

“Once nausea and vomiting during pregnancy progress, they can become difficult to control, and sometimes the patient even needs to be hospitalised,” he said.

“Over the years, I’ve observed that probiotics can reduce nausea and vomiting and ease constipation. It’s very encouraging that the study proved this to be true. Probiotics have also benefited many of my other patients who weren’t in the study,” said Dr Liu.

During the study, 32 participants were asked to take probiotic capsules that were available over-the-counter and mainly contained a type of good bacteria known as lactobacillus. The researchers asked them to observe their symptoms during this period, which they did 535 times throughout the 16-day duration of the study.

The findings of the study showed that taking probiotics significantly reduced constipation and the number of hours participants felt nauseous or vomited by 16 percent and 33 percent respectively.

It also significantly improved symptoms related to the quality of life such as fatigue, poor appetite and difficulty maintaining normal social activities.

“It would be interesting and important to further test whether probiotics can reduce nausea and vomiting caused by chemotherapy in cancer patients,” she said.

Other ways of preventing or lessening morning sickness symptoms include avoiding triggers such as strong odours, excessive fatigue, spicy foods and foods high in sugar.

From faecal specimens taken from study participants, the researchers found that women with morning sickness symptoms had low quantities of bacteria that carry an enzyme known as bile salt hydrolase which generates bile acid that usually helps with nutrient absorption in the gut.

The intake of probiotics helped to increase the amount of this bacteria hence decreasing the levels of nausea and vomiting among affected women.

Another finding was that affected women also had high levels of two bacteria in the gut (Akkermansia and Akkermansia muciniphila) at the beginning of the study that were associated with more vomiting.

At the end of the study, their vomiting had decreased as the probiotics they took significantly reduced the quantities of these two harmful bacteria in their gut.

According to the study, the consumption of foods with probiotics increased vitamin E levels in the body. And this was linked to decreased levels of vomiting.

The researchers noted that the study provided key insights on the impact gut bacteria has on the function of the digestive system during pregnancy.

“This explains why we are what we eat, and why the bacteria we harbour in our gut has a huge impact on our health. They affect the digestive system as well as skin health and neurological function,” stated Liu.

Although the findings of the study are intriguing, the researchers caution that due to the small sample size of participants, further studies will be needed to confirm the effects of the probiotics.

“Our previous work showed the benefits of probiotics in preventing liver inflammation. The current study might be one of the first to show the benefits of probiotics in pregnancy,” said Dr Yu-Jui Yvonne Wan, another author of the study from the Department of Public Health Sciences at the University of California, Davis.

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