Priority 11 from the Hyperemesis Gravidarum PSP

UNCERTAINTY: How can symptoms of hyperemesis gravidarum, other than vomiting, be effectively treated? For example the nausea, excessive saliva, extreme sense of smell and fatigue. (JLA PSP Priority 11)
Overall ranking	11
JLA question ID	0090/11
Explanatory note	Not available for this PSP
Evidence	Some prevalance studies on ptyalism (excessive salivation) identified. No discussion of other symptoms in guidelines
Health Research Classification System category	Reproductive health and childbirth

Extra information provided by this PSP
Original uncertainty examples	Is there an effective treatment for ptyalism? ~ Is there anything to reduce the excess saliva that comes hand in hand with HG? ~ One of the most distressing symptoms of HG for many women is the heightened sense of smell. Is there a medical way to target that symptom in particular? ~ The sickness and nausea is obviously a big part of HG. But how do we treat the less talked about effects including extreme tiredness, no energy, headaches, dizziness, breathlessness, confusion, being unable to stand/endure movement or motion/listen to conversations/music without feeling like you are going to be sick or faint? ~ How can the other symptoms be reduced (i.e. smell sensitivity, excessive saliva, extreme fatigue, recurring UTIs). ~ Is there a way to control the extreme sensitivity to smell, which causes so much agony? ~ Is there anything that can be done to dull the extremely heightened sense of smell that a lot of HG patients suffer with? As I honestly think it would have helped with the severity of the constant nausea in my case.
Submitted by	Patients x 34 ~ Healthcare professionals x 2 ~ Carers x 2 ~ Offspring x 3

Extra information provided by this PSP

Original uncertainty examples

Is there an effective treatment for ptyalism? ~ Is there anything to reduce the excess saliva that comes hand in hand with HG? ~ One of the most distressing symptoms of HG for many women is the heightened sense of smell. Is there a medical way to target that symptom in particular? ~ The sickness and nausea is obviously a big part of HG. But how do we treat the less talked about effects including extreme tiredness, no energy, headaches, dizziness, breathlessness, confusion, being unable to stand/endure movement or motion/listen to conversations/music without feeling like you are going to be sick or faint? ~ How can the other symptoms be reduced (i.e. smell sensitivity, excessive saliva, extreme fatigue, recurring UTIs). ~ Is there a way to control the extreme sensitivity to smell, which causes so much agony? ~ Is there anything that can be done to dull the extremely heightened sense of smell that a lot of HG patients suffer with? As I honestly think it would have helped with the severity of the constant nausea in my case.

Submitted by

Patients x 34 ~ Healthcare professionals x 2 ~ Carers x 2 ~ Offspring x 3

PSP information
PSP unique ID	0090
PSP name	Hyperemesis Gravidarum
Total number of uncertainties identified by this PSP.	65 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	9 October 2019