Nausea

Nausea may be accompanied by other symptoms depending on the underlying disease, disorder, or condition. Symptoms that frequently affect the digestive tract may also involve other body systems.

Nausea may accompany other symptoms affecting the digestive tract including:

• Abdominal pain

• Belching

• Diarrhea

• Gas

• Indigestion

• Vomiting

Nausea can also be caused by problems in body systems other than the digestive tract including:

• Body aches

• Dizziness

• Fatigue

• Fever and chills

• Flu-like symptoms

• Headache

• Yellow skin and eyes (jaundice)

If you think about it, nausea can occur in virtually any situation.

In some cases, nausea may accompany symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Symptoms that may indicate a serious or life-threatening condition include:

• Bloody or black stools

• Difficulty breathing

• Fainting or change in level of consciousness or lethargy

• Head injury

• High fever (over 101°F)

• Rapid pulse or rapid breathing

• Severe abdominal pain

• Severe headache or stiff neck

• Vomiting blood or black material (resembling coffee grounds)

Causes of nausea include infection, poisoning, malignancy (cancer), inflammation, uncontrolled diabetes, trauma, obstruction, and other abnormal processes within the digestive, nervous, reproductive, cardiovascular, or endocrine systems.

Nausea may arise from problems in the digestive tract including:

• Food intolerances or allergies

• Food poisoning

• Gallstones

• Gastritis and viral gastroenteritis

• Gastroesophageal reflux disease (GERD)

• Hiatal hernia

• Inflammatory bowel disease (Crohn’s disease, ulcerative colitis)

• Irritable bowel syndrome

• Kidney disease (kidney stones, kidney failure)

• Liver disease (hepatitis, cirrhosis, liver failure)

• Overeating or eating a high-fat meal

• Pancreatitis

• Peptic ulcer

Nausea can also be caused by problems in body systems other than the digestive tract including:

• Altitude sickness or motion sickness

• Cancer and chemotherapy treatments

• Concussion

• Electrolyte imbalance

• Exposure to smoke or toxic fumes or substances

• Heat exhaustion

• Medication side effects

• Meniere’s disease

• Migraine

• Pregnancy or morning sickness

• Stress or anxiety

• Type 1 or Type 2 diabetes

• Vertigo and labyrinthitis

In some cases, nausea may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting.

Call your doctor or poison-control hotline immediately or take the child to an emergency care facility if you suspect poisoning or drug ingestion.

• Appendicitis

• Bowel obstruction

• Brain hemorrhage

• Diabetic ketoacidosis

• Heart attack

• Increased intracranial pressure

• Intestinal blockage

• Kidney failure

• Liver failure

• Poisoning

• Sepsis

Nausea does not always lead to vomiting. Most causes of nausea are not serious and will usually resolve with home treatment. However, there are times when it is best to see your doctor.

Contact your doctor when nausea lasts for more than a week. For women, if there is any possibility of pregnancy, make an appointment with your doctor. Early and regular medical care during pregnancy is important for both you and your baby.

See a doctor promptly when:

• Episodes of nausea or vomiting recur for more than a month

• Nausea or vomiting occurs with unexplained weight loss

• Vomiting—not spitting up—in a baby less than two months old

• Vomiting lasts for more than 12 hours in infants, 24 hours in older children, and 48 hours in adults

Call 911 or go to your nearest emergency room for nausea and vomiting when:

• You also have a severe headache or abdominal pain.

• You are vomiting blood or a coffee ground-like material.

• You have not been able to keep fluids down for 12 hours.

• You have other symptoms, including chest pain, blurred vision, confusion, rectal bleeding, high fever, or stiff neck.

• You have signs of dehydration, including excessive thirst, dark-colored urine, urinating less than normal, headache, skin that remains raised after pinching it, or dizziness, lightheadedness or fainting.

• Your child has signs of dehydration, including dry mouth and tongue, irritability, no tears with crying, no wet diapers for three hours, skin that stays tented when pinched, or sunken eyes cheeks, or soft spots.

To diagnose your nausea, your doctor may ask you several questions including:

• When did the nausea start?

• How long have you had nausea? How often does it occur?

• Is the nausea constant or intermittent?

• Does vomiting occur with the nausea?

• What, if anything, seems to make the nausea better or worse?

• Do you have any other symptoms, such as fever, diarrhea or headache?

• Have you lost weight?

• Have you recently traveled outside the country or been around anyone who is sick?

• What other medical conditions do you have?

• What medications do you take?

Your doctor will perform a physical exam that includes feeling your abdomen. Your doctor will also look for signs of dehydration. Depending on the results and your answers to the questions, your doctor may recommend tests. This could include blood tests, urinalysis, or imaging exams of the abdomen, such as ultrasound or CT (computerized tomography) scan.

It is not always possible to diagnose an underlying cause or condition. If the problem persists and your provider is unable to determine a cause, seeking a second opinion may give you more information and answers.

Treating nausea is not always necessary. It depends on the cause and your comfort. For simple causes of nausea, such as indigestion, over-the-counter (OTC) treatments are available. This includes antacids, various acid blockers, and bismuth subsalicylate (Pepto-Bismol). There are also OTC antihistamines that can help control nausea, including dimenhydrinate (Dramamine) and meclizine (Antivert). However, women who may be pregnant should not take any nausea medicine without consulting a doctor first.

Prescription medicines are also available to treat nausea and prevent vomiting. The need for these medications depend on the cause of nausea. They can be extremely helpful for certain causes, such as cancer chemotherapy.

There are several nausea remedies you can try at home to relieve and prevent it including:

• Avoiding alcohol, caffeinated beverages, and spicy or fried foods

• Drinking small amounts of clear, cold, sweet liquids, including ginger ale and non-citrus juices, frequently

• Eating small, frequent meals of cold or room temperature, bland foods, such as crackers, plain bread, rice, or chicken soup, slowly

• Keeping away from strong odors, including cooking smells

• Sitting or reclining instead of lying flat and avoiding physical activity

If you get nausea due to motion sickness, talk with your doctor about strategies to prevent it and manage it.

Alternative or complementary treatments can be very useful for preventing and controlling nausea. Many of them do not use drugs at all, but rely on a mind-body connection. These strategies can be especially helpful for causes like cancer treatments. Alternative treatments include:

• Acupuncture

• Biofeedback, which teaches you how to gain conscious control over physical processes

• Guided imagery

• Music therapy

• Relaxation techniques, such as breathing exercises, meditation, and progressive muscle relaxation

• Systematic desensitization, which teaches you how to reduce anxiety-related problems, such as nausea

Essential oils and some herbs and plants may also help relieve nausea. This includes ginger, peppermint, lemon and chamomile. While teas and aromatherapy with essential oils are generally safe, talk with your doctor before taking a supplement for nausea.

Left untreated, nausea can lead to serious complications including:

• Dehydration due to a decreased desire to drink or ability to hold fluids

• Poor nutrition due to a decreased desire to eat