Nausea: What do I need to know?

Overview

What is Nausea?

Sensation of discomfort in the stomach is given the term as Nausea. It can come along with the urge to vomit. Nausea is a frequent medical issue experienced by nearly all individuals irrespective of age group.

Nausea is a symptom of numerous health disorders, rather than a disease in itself.

Nausea vs Vomiting

Comparing Nausea and Vomiting

Food poisoning and stomach flu are two prevalent conditions that induce nausea and vomiting. Symptoms of nausea and vomiting caused by viral gastroenteritis typically improve within 24 hours. The duration of nausea and vomiting caused by food poisoning ranges from 12 to 48 hours.

Nausea

• Nausea is a feeling of stomach discomfort that is frequently associated with the tendency to vomit, although it doesn’t always lead to vomiting. Nausea is characterized by weakness, sweating, and excessive salivation. Vomiting often results from nausea.

• Nausea is caused by the stimulation of brain centers that control vomiting due to the annoyance of nerve fibers in the stomach or duodenum. Nausea can indicate a range of disorders, from minor to severe. Indigestion, motion sickness, and pregnancy are the most common causes that might cause nausea.

Vomiting

• While vomiting is an act of throwing up stomach contents. It can be voluntary or involuntary. Infections, intestinal immotility, bad food habits, dehydration can lead to vomitings.

• Vomiting is regulated by two separate brain centers ¹Nausea vs Vomiting| Researched based study from Nlm.nih.gov , namely the vomiting center and the CTZ ie. chemoreceptor trigger zone. Both these centers are placed in the medulla oblongata. The emetic process (contractions of muscle) is initiated and regulated by the vomiting center.

Causes

Causes of Nausea

Nausea is driven by two pathophysiological ²Causes| Researched based study from Springer.commechanisms, namely gastric electrical rhythm problems and gastric adaptation abnormalities.

Non-stomach pathophysiological entities such as uncommon GERD, small-intestinal bacterial overgrowth, and colonic dysfunction are discrete factors that can elicit nausea.

Lot of things can cause nausea such as:

Motion sickness

• Motion sickness is what causes people to feel queasy in cars, on ships, or in the air. The condition provokes symptoms such as sweating, nausea, and emesis. Preventive measures can be taken during travel to minimize the probability of getting sickness. There are medications that may stop nausea, such as the scopolamine patch.

Chemotherapy induced nausea

• Platinum-based chemotherapeutic agents, including carboplatin, cisplatin and oxaliplatin, are commonly used for cancer treatment. Nausea and vomiting are frequent anticipated adverse reactions of cytotoxic chemotherapeutic ³Causes| Researched based study from Cancer.gov agents used in cancer treatment.

It can be:

• Acute-Starts within 24 hours of initiating chemotherapy.
• Anticipatory-It is due to psychological factors that trigger nausea due to smell and view of the chemo room even before chemotherapy begins.
• Delayed-Starts after 24 hours of chemotherapy session.
• Refractory-This type of nausea doesn’t show any effects on antiemetic drugs.

Nausea and vomiting are common symptoms associated with brain, liver, and gastrointestinal cancers.

Postoperative nausea and vomiting

Postoperative nausea (PONV) and vomiting and post discharge nausea and vomiting (PDNV) ⁴Causes| Researched based study from Asahq.org are common and can cause significant distress to patients.

• Opioid analgesics commonly used for managing perioperative pain are a significant cause of postoperative nausea and vomiting (PONV) and post-discharge nausea and vomiting (PDNV).

• Opioids, such as morphine and fentanyl, are recognized independent inducers of nausea and vomiting.

Emesis with bacterial infections

Staphylococcus aureus and bacteria Bacillus cereus are prominent bacterial species associated with emesis.

• Staphylococcus aureus is capable of causing food poisoning through the ingestion of its enterotoxins, resulting in vomiting. Staphylococcus aureus is known to produce enterotoxins from the organism that are thought to act as inhibitors of the immune response in vivo.

• Bacillus cereus (B. cereus), which is most famous for producing vomiting and diarrhea after consuming reheating rice or other starchy meals.

Fluids in the brain and spine

• Nausea frequently accompanies migraine headaches, head trauma, brain neoplasms, cerebrovascular accidents, intracranial hemorrhage, and meningitis. It may be a glaucoma symptom brought on by stress on the nerves at the center of the eye. It is a neurological response that can be provoked by physical discomfort, intense emotional distress, or exposure to unpleasant stimuli.

GERD

• Muscular ring between the stomach and the esophagus weakens, which leads to Gastroesophageal reflux disease. This can result in an upsurge of stomach contents and subsequent nausea. The predominant manifestation of GERD is heartburn, often accompanied by bad breath, a sour or bitter oral taste, emesis, trouble swallowing, and dental erosion, among other symptoms.

Problem in Inner ear

• Nausea may be associated with vertigo, a sensation of spinning, movement, or falling while at rest. Benign positional vertigo, Motion sickness, viral infections of the inner ear and certain brain tumors can trigger nausea.

Hypoglycemia

• A low blood sugar level frequently causes nausea.

Alcohol consumption

• Alcohol intoxication and withdrawal, including hangovers, can induce nausea.

Anesthesia

• It is the state of temporary loss of sensation or consciousness, induced by the administration of drugs. Postoperative nausea is a common occurrence during the emergence from anesthesia.

Food allergies and poisoning from food

• Food poisoning occurs when contaminated food contains bacteria that produce toxins causing symptoms such as nausea and cramping in the abdomen.

Pancreatitis

• Pancreatitis is characterized by pancreatic inflammation. The pancreas secretes digestive enzymes, which may result in digestive issues.

Anxiety disorders

• This is another common cause of recent nausea. Anxiety can have a prolonged duration and disrupt one’s daily functioning. The presence of symptoms such as decreased breathing rate, agitation, fatigue, slow heart rate, insomnia, irritability, among others, can have an impact on digestive function and result in nausea.

Lack of Sleep

• Sleep deprivation heightens the chances of health issues, including mood disturbances, gastrointestinal symptoms (such as abdominal pain, gas, diarrhea, constipation, nausea, and vomiting), and headaches.

Pregnancy-Related Nausea

• Nausea is a commonly reported symptom during pregnancy. Approximately 70% of pregnant women face nausea during the initial stages of pregnancy. It is normal for nausea to begin between 4-8 weeks of pregnancy. It ends between 13 and 14 weeks. However, it could begin sooner and go on longer.

• The term “morning sickness” ⁵Causes| Researched based study from Nlm.nih.gov is commonly used to describe nausea experienced during pregnancy, which may mislead women to assume that it only occurs in the mornings.

Pregnancy sickness worries

• In case of chronic and intense nausea and vomiting, medical consultation is advised for additional recommendations beyond the aforementioned treatments. Nausea during pregnancy may indicate a potential issue requiring attention, despite its common occurrence.
• Hyperemesis Gravidarum is a pregnancy-related medical condition that results in nutrient loss.
• Molar pregnancy is characterized by the formation of abnormal uterine tissue growth.

Symptoms

Symptoms of Nausea

Frequent nausea is characterized by a sensation of discomfort or illness in the stomach and dizziness.

The following are the prevalent indications of nausea:

• Lightheadedness.
• Fatigue
• Visual impairment.
• Sweating.
• Excessive accumulation of saliva in the oral cavity.
• The desire to vomit.

Chronic nausea is a condition that is difficult to articulate, but its symptoms may include:

• Experiencing persistent nausea.
• Loss of appetite.
• Excessive perspiration.
• Experiencing discomfort in the chest, upper abdominal region, or throat.
• Retching refers to involuntary, rhythmic contractions of the respiratory and abdominal muscles.

What are the strategies for preventing vomiting after experiencing nausea?

• Grapefruit juices (which are overly acidic), clear juices and popsicles might help in avoiding vomiting. Sugar-containing beverages exhibit superior stomach-soothing properties compared to non-sugar-containing fluids. Assume a seated or reclined position with support. Physical activity can trigger nausea and thus result in vomiting.

• Restrict snacking and avoid pairing sugary snacks with non-diet carbonated beverages. It is advisable to avoid concurrent consumption of food and engagement in play activities by children.

Diet

Dietary options for reducing Nausea

Consuming food during nausea can be challenging. The maintenance of adequate hydration and electrolyte equilibrium is of the utmost importance in the management of nausea. Certain foods have anti-nausea properties and promote wellness.

Optimal Foods for Nausea Relief are:

• Apples
• Banana
• Ginger
• Lemon
• Chilled edibles
• Rice
• Mint
• Water and clear beverages

Apples

• Fiber in apples helps in the quicker removal of toxins from the body. Additionally, fiber lowers and eases digestion, which could assist in easing nausea. A fiber-rich diet might actually make you feel more queasy, so exercise caution if you consume too much of it.

Ginger

• The most pungent components of ginger are gingerols and shogaols. They are responsible for the spice, anti-inflammatory, and antiemetic qualities as well as its taste and smell. It is effective particularly in cases of morning sickness and chemotherapy-induced nausea and vomiting.

Clear beverages include water

• Slowly sipping ice water is a reliable method for easing nausea. The sole limitations for utilizing this faucet-accessible substitute are extreme cold sensitivity or dental sensitivity.

Applesauce and protein-rich meals

• Soft, low-fiber foods such as tofu, farina, and mashed potatoes are easily digestible and require minimal effort from the gastrointestinal system. Try to eat hard-boiled eggs, chicken breast and Greek yogurt.

Mint

• Peppermint is recognized for its calming effects and significant impact on the digestive system. It minimizes intestinal spasms, diminishes bloating and diarrhea, and addresses nausea.

Chilled edibles

• Suitable options for cold foods comprise Jell-O, creamy ice cream, chilled fruits, yogurt, pudding, and frozen ice pops.

Broths

• The body holds on to more liquids than solid meal components. Thus, in the state of nausea, liquid absorption by the body is facilitated. They also maintain the body’s hydration and electrolyte balance. Consuming chicken broth can decrease nausea.

Rice

• Bland, starch-rich food is recommended for consumption during nausea. Bland foods exhibit a mild taste.

• Bland foods are non-irritating to the stomach. Furthermore, they offer caloric intake and also reduce gastrointestinal discomfort. They aid in replenishing lost nutrients resulting from vomiting and diarrhea.

Bananas

• Banana consumption stimulates gastric mucus secretion. Gastrointestinal tract can be soothed by ingesting bananas. Additionally, it aids in replenishing the body’s potassium levels that may be depleted as a result of vomiting following nausea.

Lemons

• Lemons possess neutralizing acids that generate bicarbonates, which help in easing nausea. Therefore, lemon juice and lemonade are recommended beverages for this purpose.

Foods to avoid when nauseous:

Individuals experiencing nausea should avoid consuming the following food category:

• Foods that are greasy, fried, or fatty
• Sugary Foods-Excessive consumption of sugary food causes gastrointestinal distress by drawing water into the digestive tract. It induces nausea in the individual.
• Citrus juices like orange juice isn’t a good choice if you’re feeling queasy. The potent odor and tangy taste of oranges may potentially induce nausea.
• Spicy foods-The stomach secretes endogenous acidic contents. Excessive consumption of spices leads to an increase in both acids. It causes gastric irritation and consequent nausea. Aggravated ulcers cause severe pain, nausea, ⁷Diet| Researched based study from Nlm.nih.gov and abdominal discomfort.
• Odorous Fruits-Various stimuli, including drugs, chemicals, abdominal pain, motion, and psychic factors, can activate the brain region responsible for regulating nausea.
• Alcohol increases gastric acid secretion. It delays gastric emptying. Either of such circumstances can result in abdominal discomfort, nausea, and emesis.

Treatment

Treatment of Nausea

Antiemetics are some names for the drugs that are used to treat nausea.⁸Treatment| Researched based study from Uptodate.com

The following medications are frequently prescribed:

Chlorpromazine, perphenazine, levomepromazine

• These medications function through dopamine inhibition in the brain. Antiemetic drugs are beneficial in managing nausea induced by certain cancers, radiation, and opiate medications like morphine and codeine.

• Prochlorperazine, marketed under the brand name Stemetil®, is a commonly prescribed medication for nausea. This treatment is effective for various common causes of nausea such as vertigo, ear disorders, and pregnancy-related sickness.

Cinnarizine, Cyclizine, and promethazine

• These medications are classified as antihistamines. Antihistamines inhibit H1 receptors in the emetic center. They are used for the management of ear disorders and also motion sickness.

Nabilone

• It is a synthetic cannabinoid. It has been used for the treatment of nausea and vomiting. It is commonly prescribed to individuals undergoing chemotherapy.

Hyoscine

• The medication functions through the inhibition of acetylcholine, a neurotransmitter in the brain. It is effective for treating nausea resulting from ear disorders and motion sickness.

Ondansetron and Palonosetron

• These medications function by inhibiting serotonin (5-HT) in both the gastrointestinal tract and the central nervous system. Serotonin (5-HT) induces nausea in both the gastrointestinal and central nervous systems. These medications are effective in managing chemotherapy-induced nausea and vomiting.⁹Treatment| Researched based study from Nlm.nih.gov

Metoclopramide

• This medication exerts its effects directly on the gastrointestinal tract. It alleviates nausea by promoting gastric emptying and accelerating gastrointestinal transit. It is commonly employed for individuals experiencing gastrointestinal disorders or migraine headaches.

Domperidone

• This medication acts on the chemoreceptor trigger zone (CTZ).

Aprepitant and Fosaprepitant

• Newer medications function by inhibiting a chemical that stimulates neurokinin receptors in the body, thereby inducing nausea. They are typically administered to individuals undergoing a specific form of chemotherapy.

Acupuncture

• It has also been found to be useful to alleviate nausea using acupuncture, particularly in cases of seasickness and chemotherapy side effects.⁶Treatment| Researched based study from Sciencedirect.com

Tips to deal with pregnancy induced Nausea

• Reduce the amount of fluids you consume with your meals and instead sip on them in between courses.
• Swap out richer, creamier items for drier, basic ones like white rice, dry bread, or a plain baked potato.
• Getting a good night’s sleep; when you feel tired, pay attention to your body and lay down.
• If you’re feeling queasy, try sniffing some ginger or lemons, or have a glass of ginger ale or lemonade.
• Vitamin B6 has been shown to help lessen nausea and vomiting, so you may want to discuss taking a supplement with your doctor.
• Stay away from anything that tastes or smells awful and makes you sick.
• opt for smaller portions of meals instead of eating one large meal.

Home remedies

Home remedies for Nausea

There are a lot of home remedies to improve nausea. Some of them most effective ones are:

Chamomile tea

• Chamomile is a great medicinal herb used from ancient times. It is proven to decrease nausea and vomiting.
• You can make this tea by boiling some leaves of chamomile in water. Now strain the tea in a vessel after boiling it. Let it cool. Add honey for your taste and sip it to relieve nausea.

Mint

• Mint is regularly used to add flavor in different food items. Mint has gastric relaxant features. It is also used for aromatherapy.
• Sipping mint tea may alleviate the symptoms of nausea.

Baking soda

• Also known as sodium bicarbonate, is a potential remedy to suppress nausea.
• In a glass of warm water add ½ teaspoon of baking soda. Stir it and let the solution mix properly. Drink it to relieve nausea.

Ginger

• It is a widely used herbal remedy for various medical issues. It has anti-vomiting effects.
• You can either put ginger in your food or make ginger lemon tea to decrease nausea.

Cardamom

Also known as spice Queen, it is a great remedy for different stomach illness because of its relaxing properties.

There are different ways of using cardamom for nausea:

• Add cardamom powder to a warm glass of water. Now gargle with this water to relieve nausea immediately.
• Mix finely powdered cardamom, along with fine jaggery to make it a small lump. Put this pill in your mouth while traveling. It is a greatly beneficial remedy for people with motion sickness.

Clove

Every Indian kitchen has this widely used aromatic herb also known as lawanga.

• Take some cloves and grind it. Now mix this powder with some honey and make it a thick paste. This paste is licked to relieve nausea.
• You can also bite on some cloves to decrease nausea.
• Add cloves to your regular teas to reduce nausea.

Complications

What are the complications associated to Nausea?

Nausea accompanied by vomiting can cause dehydration. Children are at a higher risk of dehydration, especially when experiencing nausea, vomiting and diarrhea. When caring for an ill person, it is important to monitor for symptoms of dehydration and nausea, such as:

• Dry mouth.
• Dry and flaky lips.
• Sunken eyes.
• Tachypnea or tachycardia.
• Reduced urination frequency and a depressed fontanelle in kids.

Promptly notify your physician if you encounter the subsequent symptoms in conjunction with nausea:

• Acute abdominal pain.
• Fever accompanied by emesis.
• Hematemesis.
• Severe headache or cervical rigidity.
• Fatigue
• Confusion

Outlook

The outlook

Managing nausea and vomiting is crucial as it can result in significant loss of fluids and nutrients from the body. Dehydration, electrolyte imbalances, lack of appetite, malnutrition, and a decreased quality of life are possible consequences of this.

The easiest method to manage nausea and vomiting is to stop it before it starts. It may be possible to ease nausea by distracting oneself with audio, visual, or video media.