Why Do I Get Nauseous

We’ve all had the urge to throw up now and then. Whether it’s when we’re travelling or just finished a meal, nausea is an unpleasant feeling we all wish would go away soon. So, why do we experience it in the first place?

Nausea is the body’s natural reaction to either ingestion of harmful substances and toxins or disturbance in regular bodily functions. Nausea usually subsides on its own, but it can linger on in serious illnesses.

Therefore, prompt treatment and diagnosis are vital. This article covers everything you need to know about nausea. From its causes and symptoms to its treatment and prevention. So, stick around to find out more.

Causes of nausea

The most common causes of nausea are:

• Gastrointestinal disorders 

Nausea and vomiting are common symptoms of digestive tract diseases like - peptic ulcer and gall bladder disease, gastroesophageal reflux disease, intestinal bowel obstruction, pancreatitis, and appendicitis. Abdominal pain also occurs in the latter two.

• Medicines

Nausea and vomiting are side effects of - NSAIDs, chemotherapy drugs, antibiotics, anti-diabetic and anti-gout drugs, immunosuppressants, opiates, and oral contraceptives. 

• Food poisoning

Nausea occurs when contaminated or spoiled food is consumed. Food poisoning-induced nausea subsides on its own.

• Pregnancy

Pregnant women experience regular nausea and vomiting episodes called morning sickness. It can occur throughout the day. It usually starts during the first trimester and subsides around the 16 – 20th week of pregnancy. 

• Motion sickness

Movement of any means of transport triggers the balance organs of the inner ear, which, in turn, activates the vomiting centre, thus causing nausea and vomiting while travelling. 

• Infections

Systemic viral and bacterial infections cause nausea since they affect the stomach along with the rest of the body. Nausea occurs in inner ear infections like Labyrinthitis due to activation of the vomiting centre (Cleveland Clinic - Causes of Nausea),² (MSD Manual - Nausea),³ (NHS Inform - Nausea)^.4.1

The less common causes of nausea are:

• Brain or CNS diseases

Migraines, brain tumours and haemorrhages, severe head injuries, and infections like meningitis and encephalitis activate the vomiting centre in the brain causing nausea.  

• Metabolic disorders

Nausea and vomiting occur in metabolic diseases like diabetes, severe liver and kidney failure, Addison’s disease, hyperthyroidism, diabetic ketoacidosis, hypercalcaemia, hyper and hypoparathyroidism, and uraemia. 

• Psychological problems

Nausea and vomiting are either triggered intentionally in bulimia or occur unintentionally in cases of child nausea in response to distressing situations.

• Cyclic vomiting syndrome

It's a rare disorder marked by severe vomiting episodes at varying intervals. It usually starts in childhood and can persist till adulthood. In contrast, people with chronic nausea have vomiting episodes weekly for 6 months.^1,3

Other causes of nausea are:

• Stress and anxiety disorders
• Alcohol and substance abuse
• Heart attacks and heart failure
• Food allergies
• Overeating
• Starvation^1,2

Signs and symptoms of nausea

Besides the urge to vomit, other common symptoms of nausea are:

• Loss of appetite
• Excessive sweating
• Retching
• Stomach pain
• Uneasiness in your chest, stomach, and the back of your throat (Stanford Health Care - Nausea).⁵

Nausea and vomiting usually do not indicate serious illnesses and subside within a day or two. However, prolonged vomiting results in dehydration. Children are more prone to dehydration as they cannot notice and report its symptoms.

Signs of dehydration to watch out for are:

• Increased thirst
• Fatigue and weakness
• Dry lips and mouth
• Sunken eye.
• Rapid breathing and heart rate
• Confusion
• Dark urine and little to no urination (Cleveland Clinic - Nausea and Vomiting)⁶,(Mayo Clinic - Nausea and Vomiting).⁷

Management and treatment for nausea

Nausea can be relieved with these simple home remedies if no underlying conditions are present:

• Drinking beverages like ginger ale or chamomile tea to soothe the stomach
• Eating bland foods like rice, bananas, and plain bread
• Avoid spicy, greasy, and processed foods that irritate the stomach
• Avoid caffeinated, carbonated, and alcoholic beverages
• Eating slowly and consuming small meals
• Avoid mixing hot and cold foods
• Periodically drinking water to prevent dehydration
• Refraining from physical activity after meals and resting in either a sitting or propped-up position
• Taking over-the-counter medications like antacids and pink bismuth^5,6

Vomiting can be controlled by taking clear liquids like water, broth, weak-sweetened  tea, fruit juices (excluding orange and grapefruit due to their acidity), and popsicles. Sugar-containing drinks help settle the stomach and replenish blood sugar levels.

One or two ounces of these fluids can be given about 30 minutes after vomiting and should gradually be increased later. Oral medicines that upset the stomach should temporarily be put on hold till vomiting has ceased. Wait for about 6 hours after a vomiting episode to have solid foods.^3,6,7

Vomiting and nausea accompanied by other symptoms or associated with diseases, radiation therapy, surgery, and drugs require additional treatments such as:

1. Medications

Medicines are prescribed depending on the severity of symptoms. Anti-emetics and antihistamines relieve mild to severe nausea and vomiting, postoperative nausea, morning sickness, and motion sickness. Anti-anxiety drugs, dopamine antagonists, and corticosteroids also alleviate nausea symptoms.^1,5

2. Nutrition therapy

It involves selecting foods that are least likely to trigger nausea and taking nutritional supplements and vitamins to relieve the adverse effects of persistent vomiting, especially in starved or malnourished individuals.^1,5

3. Oral rehydration

Oral rehydration solutions replenish the mineral stores and bodily fluids of people with frequent vomiting episodes, severe dehydration, and electrolyte imbalances. These solutions are only for people who can tolerate taking fluids by mouth.^3,5

4. Total parenteral nutrition

Special fluids given as nutritional support are directly injected into a vein through a catheter. This helps people with persistent vomiting and when the stomach cannot absorb nutrients from food ingested by the mouth.^1,5

5. Tube feeding -

Specially formulated liquids are delivered directly to the stomach through a PEG (percutaneous endoscopic gastrostomy) tube. This works best in people with a healthy gut. It also has lesser side effects than the parenteral route.^1,5

Nausea and vomiting can also be relieved with alternative therapies like:

• Ginger supplementation - Studies have shown that eating ginger helps alleviate nausea and vomiting. Ginger can be consumed as ginger tea, ginger biscuits, or ginger ale.  Ginger supplements can also be taken only after consulting a pharmacist or doctor
• Acupuncture and hypnosis can also relieve symptoms resistant to medications.^1,4

FAQs

How common is nausea

Nausea and vomiting are common side effects seen in adults and children. It’s estimated that 2-3% of the world’s population will experience one vomiting episode each month.^1,6

These side effects are mainly seen in 80% of cancer patients undergoing radiation therapy or chemotherapy (according to the National Cancer Institute) (Nausea and Vomiting in Cancer)

and pregnant women in their first trimester (50-90% experience nausea and 25-55% experience vomiting).^6,8

How can I prevent nausea

You can prevent nausea by:

1. Eating right

• Have small meals throughout the day instead of large ones thrice a day
• Eat slowly and do not skip meals
• Stay clear from foods that are hard to digest, fried, and strong-smelling
• Rest and stay upright after eating
• Eat bland foods like crackers, toast, and cereal in the mornings
• Snack on high-protein foods like cuts of lean meat or cheese at night
• Consume food at room temperature

1. Drinking sufficient water

• Avoid drinking water during meals. Instead, drink water between meals
• Drink at least 6-8 ounce glasses of water daily to prevent dehydration
• Frequently sip water throughout the day, rather than drinking large quantities at once

Other ways to prevent nausea include reducing triggering odours like air fresheners, perfumes, food smells, and smoke, wearing loose-fitting clothes that do not cling to your stomach and waist, and staying away from stuffy rooms and flickering lights (NHS - Nausea).^6,7,9

When should I call my doctor for nausea

You should consult your doctor if:

• Nausea lasts for more than a week
• Vomiting occurs continuously for more than 1-2 days
• Vomiting occurs along with diarrhoea and lasts for more than a day
• You’re unable to hold down fluids
• The vomit is green and smells of faeces
• Severe weight loss occurs
• Symptoms of moderate and severe dehydration are seen

Immediate medical attention is needed if the following symptoms are seen:

• Severe constant pain and soreness in the abdomen
• Distended/ Swollen abdomen
• Severe chest pain
• Blood in vomit that looks like coffee granules
• Sudden and severe headaches
• Stiff neck, lethargy, confusion, and decreased awareness
• Rapid breathing rate and pulse
• Vomiting with a fever over 101 F^4,6,7

Severe chest pain accompanied by breathlessness and radiating pain to the arms, back, neck or jaw warrants emergency medical attention as these symptoms indicate a heart attack.⁹

You should also contact your doctor if you have other diseases like diabetes or cancer. Frequent vomiting lowers blood sugar levels in diabetic patients and hampers cancer patients’ nutritional intake and mental health.^4,8

Summary

Nausea is an uneasy feeling that usually resolves with time. However, it could also be a symptom of mild to serious illnesses, poisoning, and altered bodily function. Therefore, prompt diagnosis and treatment are required, especially if underlying diseases are present. Home remedies, medications, and alternative therapies can help relieve nausea and should be adopted based on the symptoms exhibited. Moreover, you can prevent nausea through healthy eating habits, regular water intake, and staying in a calm environment.