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What Morning Sickness and Ulcers May Have in Common

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Oct. 17, 2000 -- Helicobacter pylori, the 'bug' that causes many peptic ulcers, may also be the cause of some of the awful bouts of nausea and vomiting that pregnant women know as "morning sickness." That, at least, is what a team of researchers from Ponce School of Medicine in Puerto Rico believe they have found.

But other experts in gastrointestinal diseases are not so convinced, saying it is unlikely that H. pylori is behind what many women consider to be one of the first -- and most unpleasant -- symptoms of pregnancy.

Nilda Santiago, MD, clinical investigator, and Alvaro Reymunde, MD, associate professor at Ponce School of Medicine, tell WebMD that 83% of women referred to a hospital clinic for treatment of severe morning sickness symptoms tested positive for H. pylori.

Several years ago, the infection was shown to be the major cause of stomach ulcers. Currently, patients presenting with ulcers are routinely tested for H. pylori, says Reymunde. If the test is positive, the patients receive antibiotic treatment that wipes out the infection, which in turn allows the ulcer to heal.

In the study presented at the 65th annual scientific meeting of the American College of Gastroenterology in New York, Santiago and Reymunde reported that they also tested a near equal number of pregnant women who reported no morning sickness to determine if H. pylori was present in the blood of those women as well. Both groups of women were in their first three months of pregnancy.

"Only 7% of the healthy controls tested positive for H. pylori," Santiago tells WebMD.

Philip O. Katz, MD, chief of gastroenterology at the Graduate Hospital in Philadelphia, tells WebMD that the study by Santiago and Reymunde is "provocative," but he said he has strong reservations about the findings.

For example, he says, "the prevalence numbers on both ends are surprising." The prevalence of H. pylori in the women without morning sickness is "surprisingly low, while the prevalence in the symptomatic group is surprisingly high." On average, about 20% to 40% of healthy people are carrying silent H. pylori infections -- meaning they have no symptoms, he says, explaining therefore that "finding a prevalence of just 7% is surprising."

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