Nausea Overview
Nausea is the sensation of an urge to vomit, nausea can be acute and short-lived, or it can be prolonged. When prolonged, it is a debilitating symptom. Nausea is an uneasiness and discomfort of the stomach and the sensation of wanting to vomit, that often comes before vomiting. Nausea can be a precursor to vomiting the contents of the stomach. Vomiting is the forcible voluntary or involuntary emptying “throwing up” of stomach contents through the mouth.
Nausea (and vomiting) can be psychological or physical in origin. It can originate from problems in the brain or organs of the upper gastrointestinal tract (esophagus, stomach, small intestine, liver, pancreas, and gallbladder). Nausea may also be caused by diseases of many organs outside of the gastrointestinal tract. Therefore, the diagnosis of the cause of prolonged nausea may be difficult. All stimuli that cause nausea work via the vomiting center in the brain, which gives rise to the sensation of nausea and coordinates the physical act of vomiting.
Nausea symptoms are frequently difficult for people to describe, nausea symptoms are not painful but very uncomfortable feelings that are felt in the chest, upper abdomen, or back of the throat. Nausea has many causes and can often be prevented. When you are nauseated, you may feel weak and sweaty and notice a lot of saliva in your mouth. Nausea often leads to vomiting. Most of the time you do not need to worry about nausea and vomiting, but they can be signs of other illnesses.
Two common causes of nausea and vomiting are stomach flu and food poisoning. Nausea and vomiting from viral stomach flu will usually start to improve within 24 hours. Nausea and vomiting from food poisoning may last from 12 to 48 hours. Nausea can also be a side effect of some types of cancer therapy.
In population studies, more than 50% of adults reported at least one episode of nausea, and more than 30% of adults reported one episode of vomiting within the preceding 12 months, with women reporting more episodes of nausea than men.
Causes of Nausea
Nausea is a non-specific symptom, which means that it has many possible causes. Nausea can stem from a variety of causes. Some people are highly sensitive to motion or to certain foods, medications, or the effects of certain medical conditions, all these things can cause nausea. Following are the common causes of nausea described below.
Nausea is not a disease itself, but can be a symptom of many disorders related to the digestive system, including:
- GIT Infections
- Inflammatory Bowel Disease (IBD)
- Gastroesophageal reflux disease (GERD)
- Pain
- Peptic ulcer disease
- Food poisoning
- Diet
- Problems with nerves or muscles in the stomach that cause slow stomach emptying or digestion (gastroparesis)
- Discomfort in the upper stomach that is not related to an ulcer (non-ulcer dyspepsia)
- A condition that occurs when nerves and brain signals prevent food from passing along the digestive tract, even though there is no physical blockage (bowel obstruction)
- Problems with the area of your brain that controls the digestive processes (autonomic dysfunction)
- Fainting
- Low blood sugar
- Lack of Sleep
- Motion Sickness
- Migrane Headache
- An abnormal change in heart rate when you change your posture (postural orthostatic tachycardia syndrome)
Nausea is a side effect side effect of many medications including chemotherapy, or morning sickness in early pregnancy. Nausea may also be caused by anxiety, disgust and depression. Problems in certain areas of the body, or the entire body, such as cancer or infection, and some medications can also lead to nausea. Issues in these body regions commonly cause nausea:
- Abdominal or pelvic organs
- Balance centers in your inner ear
- Brain or spinal fluid
Signs and Symptoms of Nausea
Nausea symptoms are frequently difficult for people to describe. Nausea symptoms are not painful but very uncomfortable feelings that are felt in the chest, upper abdomen, or back of the throat.
Nausea symptoms can be difficult to describe, most people experience:
- Feeling like you are about to vomit
- Dizziness
- Lack of appetite
- Profuse sweating
- Repeated rhythmic contractions of respiratory and abdominal muscles that happen without your control (retching)
- Stomach ache, abdominal pain
- Uneasy feeling in your chest, upper abdomen, or back of your throat
- Vomiting
- Headache
- Fever
- Diarrhea
Gas - Lightheadedness
- A general feeling of being sick to one’s stomach
Other causes of nausea include side effects from medications pain, pregnancy and morning sickness, sea-sickness, viral infection, alcohol toxicity, and disease of the brain, esophagus, stomach, gallbladder, liver, pancreas, and intestine.
Diagnosis of Nausea
Diagnosis of nausea often can be made when the health care professional takes a careful history and performs a physical examination of the patient. Any tests that need to be ordered will be based on the information from the patients history and physical exam, and sometimes no further testing is required to make the diagnosis.
Laboratory tests and X-rays may be ordered to assess the stability of the patient and not necessarily to make the diagnosis. For example, a patient with food poisoning may need blood tests ordered to measure the electrolytes (minerals) and other chemicals in the body, since the patient may lose significant amounts of sodium, potassium, and chloride from the body from persistent vomiting and diarrhea.
Urinalysis may be helpful in assessing hydration status. Concentrated, dark colored urine is usually associated with dehydration because the kidneys try to preserve as much water as possible in the body. Ketones in the urine are also a sign of dehydration.
Treatment of Nausea
Treatment for nausea depends on the cause
Taking medications to address nausea’s underlying cause can help as well. Many pharmacologic medications are available for the treatment of nausea. There is no medication that is clearly superior to other medications for all cases of nausea. The choice of antiemetic medication may be based on the situation during which the patient experiences nausea. Examples include stomach-acid reducers for GERD or pain-relieving medications for intense headaches, etc.
There are varieties of anti-nausea medications (antiemetics) that your doctor may prescribe. These drugs can be administered in different ways depending upon your ability to take them. Medications are available by pill, liquid, or tablets that dissolve on or under the tongue, by intravenous or intramuscular injection, or by rectal suppository.
Nausea and vomiting are often made worse when you are dehydrated, resulting in a vicious cycle. Nausea makes it difficult to drink fluid, making the dehydration worse, which then increases nausea. Intravenous fluids may be provided to correct this issue and break the cycle.
If dehydration is present due to loss of fluids from severe vomiting, rehydration with oral electrolyte solutions is preferred. Keeping hydrated can help to minimize dehydration after your nausea subsides. This includes taking small, frequent sips of clear liquids, such as water or an electrolyte-containing beverage. If this is not effective or possible, intravenous rehydration may be required. Medical care is recommended if the patient cannot keep any liquids down, has symptoms more than 2 days, is weak, has a fever, has stomach pain, vomits more than two times in a day or does not urinate for more than 8 hours.
When you begin to reintroduce food, it’s helpful to stick to the bland low fiber foods or BRAT diet (bananas, rice, applesauce, and toast) until your stomach is more settled.
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