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See our main pregnancy advice page and our diarrhoea page.
The majority of women will feel queasy or nauseated during the early part of pregnancy. Others may first know they are pregnant because their sense of smell or taste changes so that certain foods such as coffee or fish trigger very unpleasant salivation and nausea, with or without actual vomiting. This has a fancy name called ‘ptyalism’. Women make saliva at a rate of knots and feel the need to keep spitting it out.
Certain obstetric situations make severe vomiting more likely, such as a molar pregnancy, which is when the placental tissue has become abnormal, or a twin pregnancy. An ultrasound scan will look for these situations.
Nine months is a long time, and a pregnant woman is no more and no less likely than anyone else to get a tummy upset during that time. If she travels, she should take particular care to avoid travellers’ diarrhoea as dehydration could have more serious consequences for her and her baby. Attention to food hygiene, meticulous hand-washing, and drinking only bottled water in exotic places is undoubtedly the most important way of preventing travellers’ diarrhoea. Prompt use of rehydration sachets to keep the body chemistry healthy is strongly advised. Loperamide to slow diarrhoea is completely safe during pregnancy. Medicine to reduce the nausea and vomiting which relates specifically and only to the hormonal changes of pregnancy does not respond well to traditional anti-sickness medicines, and following the tragedy of thalidomide, women and doctors are understandably reluctant to use medicine in this circumstance. Ciprofloxacin is safe during pregnancy although best avoided in the first 12 weeks. Azithromycin which is best for travellers’ diarrhoea in SE Asia is also safe, but best avoided in the first 12 weeks.
Women with very severe vomiting, whether pregnancy induced (hyperemesis) or related to food-poisoning or a gut virus such as Norovirus, may need hospital admission for intravenous fluids. In extreme cases of hyperemesis, intravenous feeding may be necessary, together with vitamin replacement and possibly treatment with high dose steroids. If hyperemesis has happened to someone once it is likely to recur.
There is one specific cause of diarrhoea which is important in pregnancy called listeriosis, which is a bacterium which is caught from pre-prepared foods such as pate, pre-packed sandwiches, smoked salmon, and unpasteurised cheeses such as brie. This is why pregnant women are advised to avoid eating these foods. The bacteria may also be passed on through contact with the stools of infected animals or human carriers. So again the importance of good food and hand hygiene is important.
Good clear advice, thank you
I had this during my second pregnancy whilst on holiday in Sardinia (chicken) and it was very frightening – I shall make sure I shall remind my daughter (who I was 10 weeks pregnant at that time) when she get’s pregnant to be super careful whilst travelling ..
very useful and reassuring Julian
I’ll tell my daughter about this and urge her not to travel during the first 12 weeks.