NVP Counselor
Date: 2004-01-23

Question:
I used your very helpful service during my first pregnancy and was helped by Caroline Maltepe. In fact, you were the only people who took me seriously and actually wanted to help. I shall ALWAYS be grateful.

I live in London England (although I am Canadian) and took Diclectin from week 10 (I was home for the Xmas holidays and someone told me about Mother Riska and Diclectin) all the way through my pregnancy, as my nausea never really went away. It did not solve the problem, although it made life more manageable by about month 5. My husband and I would like to have a second child and I have the following questions:

a) does Diclectin only come in oral form? If so, what is the solution for taking it early on when I might not be able to keep it down?

b) is it safe to take it before I get pregnant, so that there is already an amount built up in my system once i become pregnant? How long ahead of time can I take it?

c) would it help to also take Vitamin B6 before getting pregnant? If so, how far ahead should I start and what does is recommended?

d) is there anything else I can do to prepare/lessen the virulence of the nausea? it has been suggested to me that certain studies indicate that helicobacter pylori infection can be associated with more severe sickness. Do you know anything about this? Can I get tested for this infection?

If these questions are too long, I am happy to call the helpline. Please just let me know.
Kind regards

Answer:
We are delighted that we could make a difference in your first pregnancy. Thank you for your kind words. As for your questions ...

a: Diclectin comes only as the oral delayed release pill. In order for it to be effective, we suggest that women who are vomiting (and likely to vomit up the Diclectin tablet), use 50 mg of rectal gravol (dimenhydrinate) approximately 30 minutes before they take their Diclectin. It may only be necessary to do this the first few times you use Diclectin. If vomiting persists even with the gravol, other treatments might be considered. Please see our treatment algorithm posted on this website under Updates - February 2002.

b: As prevention we usually suggest that women take a B6 supplement (e.g., 25 mg, three times daily). Optimum timing ahead of pregnancy has not been established.

c: H. Pylori bacteria has indeed been reported in some women who exhibit severe vomiting that resembles the symptoms of hyperemesis gravidarum. If those severe stomach symptoms do not repond to any of the NVP/HG treatments, a test for H. Pylori might be indicated. If positive, the treatment for is different than treatment for NVP.