Explaining the severe “morning sickness” Kate Middleton is experiencing

TORONTO- The extreme level of nausea the Duchess of Cambridge is suffering from only happens to about two per cent of all women who are pregnant.

It is called Hyperemesis Gravidarum, a term of Greek and Latin origins that literally translates to “excess vomiting of pregnancy.”

“The vomiting is recurrent, and severe enough to cause weight loss of five per cent of the woman’s pre-pregnancy weight,” Global News medical contributor Dr. Samir Gupta said. In some instances, the illness is so bad that the woman requires intravenous fluids, as in the case with the Duchess of Cambridge.

Dr. Gupta said the illness tends to occur more commonly in first pregnancies, with younger women and in cases where the woman is carrying twins.

Research suggests that hormonal changes associated with pregnancy are likely to blame.

“For example, estrogen and progesterone do relax smooth muscle in the gut, and slow down stomach emptying,” said Gupta. “And women with a history of nausea and vomiting from estrogen–based medication are more likely to develop pregnancy-related nausea.”

On the other hand, Gupta said estrogen levels peak in the third trimester of pregnancy, whereas Hyperemesis is usually limited to the first trimester.

Another possible cause for nausea is the hormone hCG, which is the hormone detected by pregnancy tests. It peaks during the first trimester and tends to be higher in women with nausea and vomiting.

Five ways to manage nausea and vomiting caused by pregnancy

1. Rule out other causes
Just because nausea and vomiting from pregnancy is common, it doesn’t rule out other common causes, like gastroenteritis or gall bladder disease. Other causes should be suspected, particularly if it starts after week 10.

2. Dietary changes
The first step is to alter the diet and eating patterns to reduce the risk. This means eating slowly and smaller meals, to avoid a full stomach, but also more frequent meals to avoid an empty stomach, which can also aggravate nausea. Also eliminate foods which trigger reflux – including caffeine, spicy, fatty, and acidic foods.

3. Avoid triggers
Triggers are different for each woman, but examples include stuffy rooms, strong odors like perfume, heat, humidity, and physical motion.

4. Alternative therapies
These are commonly tried, especially because people try to avoid medications in pregnancy. For example acupuncture or acupressure of a specific region called P6, just above the wrist, is popular, and has been shown to be effective in some studies. Also, ginger was shown in a meta-analysis to be effective for nausea, though it didn’t reduce vomiting per se.

5. If you can’t keep hydrated, seek help!
The key is keeping hydrated, to protect both yourself and your baby. If you’re not taking in at least as much as you are putting out, then consult your doctor. Medications like vitamin B6, anti-histamines, and anti-emetics can be used, and in rare cases such as that of the Duchess, intravenous fluids and vitamin replacements may be required.