Nausea is a feeling of discomfort that may make you feel as if you’re going to throw up. It is not a disease itself but rather a symptom of other conditions.
What is Chronic and Acute Nausea
Acute nausea occurs suddenly, gets worse quickly, and lasts a short time, usually a few days. It also often resolves on its own. The most common cause of acute nausea is viral gastroenteritis (often called stomach flu) or food poisoning.
Other causes may include medications, diabetic ketoacidosis, motion sickness, large amounts of alcohol, head trauma, and anxiety or stress.
Chronic nausea, on the other hand, lasts for long periods (over a month), during which time it may come and go. And given that it has many potential causes, a comprehensive history and examination is required for an accurate diagnosis. In some cases, both constant and acute nausea may occur together with vomiting.
Common Causes of Chronic Nausea
Some of the conditions linked to chronic nausea include:
Most women experience nausea and vomiting during pregnancy, especially in the first trimester. And although often referred to as morning sickness, it can occur at any time of the day.
You may experience mild nausea, where you temporarily feel nauseated and vomit 1-2 times a day. With severe nausea, you become nauseated for several hours and vomit more often.
Fortunately, nausea does not harm your unborn child and usually starts to resolve by the fourth month. In rare cases, pregnant women may experience a severe form of nausea called hyperemesis gravidarum that results in dehydration and weight loss. Hyperemesis gravidarum may require hospitalization.
Note: When treating nausea, doctors should consider pregnancy in women of childbearing age.
2. Gastrointestinal disorders
Nausea and vomiting are among the common symptoms of gastrointestinal disorders, such as:
- Gastroparesis: a condition that affects your stomach muscles, delaying gastric emptying hence interfering with digestion. Aside from nausea and vomiting, gastroparesis symptoms may include feeling full too quickly, bloating, abdominal pain, acid reflux, loss of appetite, and weight loss.
- Gastroesophageal reflux disease (GERD): a condition where your stomach contents, including stomach acid, persistently flow back into the esophagus. Symptoms may include heartburn, difficulty swallowing, regurgitation, nausea, and a bitter taste in your mouth.
- Peptic ulcers: these are open sores that develop on the lining of the stomach (gastric ulcers), the upper part of the small intestines (duodenal ulcers), or sometimes the lower esophagus (esophageal ulcers). The H. pylori bacterium and regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are common causes of peptic ulcers. Stomach pain is the most common symptom. You may also experience heartburn, nausea, bloating, feeling uncomfortably full, vomiting, dark tarry stools with visible blood, loss of appetite, and weight loss.
- Intestinal (bowel) obstruction: a gastrointestinal condition where your small or large intestines are blocked, preventing digested material from passing through. Symptoms may include severe abdominal pain, constipation, nausea, vomiting, and bloating. Bowel obstruction may be as a result of intestinal adhesions, colon cancer, inflammatory bowel disease (particularly Crohn’s disease), hernias, among other causes.
3. Neurological disorders
Neurological disorders are conditions that affect the central nervous system (CNS) and the peripheral nervous system (PNS). Some of these conditions may cause chronic nausea. These include:
- Migraine: a severe headache characterized by a throbbing pain, often on one side of the head. If you have a migraine, you’re also likely to experience nausea, vomiting, and light and noise sensitivity. It can last for several hours to several days. Migraines have various triggers, including stress, hormonal changes in women, excessive consumption of alcohol and caffeine, dehydration, certain foods like aged cheeses and processed foods, sleep deprivation or oversleeping, and exposure to sensory stimuli such as bright lights, strong smells, and loud noises.
- Increased intracranial pressure: ICP refers to growing pressure around the brain. Some of the causes behind this may include too much cerebrospinal fluid, brain swelling, brain tumor, blood pooling in the brain, meningitis, and stroke. Patients may experience headaches, blurred vision, nausea, vomiting, behavior change, reduced alertness, confusion, and speech or movement difficulties. ICP is life-threatening and, therefore, requires immediate medical attention.
Demyelinating disorders and labyrinthine disorders are other neurological conditions that could cause chronic nausea.
Chronic nausea can also be a side effect of drugs such as:
- Prescribed medications: nausea and vomiting are common side effects of many medications, such as chemotherapy drugs, narcotic drugs, nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics (e.g., erythromycin and Bactrim), Parkinson’s disease drugs, oral hypoglycemics (e.g., metformin), digoxin (nausea can occur even at therapeutic levels), and high dose vitamins.
- Illicit drugs: drugs such as marijuana, cocaine, and ecstasy have various health effects, including nausea.
- Alcohol: consuming alcohol increases the production of stomach acid and delays stomach emptying, both of which can lead to nausea or vomiting.
5. Psychiatric/Psychological/Mental disorders
You may also experience chronic nausea due to psychological disorders such as depression, anxiety disorders, eating disorders, and functional vomiting, i.e., unexplained nausea.
The treatment for nausea primarily involves relieving your symptoms and treating the underlying cause. To help control nausea and vomiting your doctor may prescribe any of various antiemetic drugs, such as:
- Diphenhydramine (Benadryl)
- Ondansetron (Zofran)
If you’re frequently vomiting due to nausea, it may lead to dehydration and electrolyte imbalance. To replace lost body fluids and electrolytes, your doctor may give you intravenous (IV) fluids.
Usually, nausea goes away on its own. However, there are measures you can take to help you stop feeling nauseous, such as:
- Getting plenty of fresh air
- Practicing deep breathing
- Eating a bland diet, i.e., foods that are easy to digest such as bread, crackers, rice, low-fat dairy products, cooked or canned vegetables, poultry, fish, and eggs
- Avoiding spicy, fatty, and fried foods
- Staying hydrated by drinking clear drinks such as water, carbonated drinks (e.g., ginger ale), lemonade, gelatin, and mint tea
- Eating smaller, more frequent meals but do not eat quickly
- Avoiding eating foods with strong odors; opt for cold foods rather than hot foods as they smell less
- Not engaging in activity soon after eating
- Taking over-the-counter (OTC), such as Pepto Bismol and motion sickness drugs like dimenhydrinate (Dramamine)
When to seek immediate medical attention
If you have nausea, see your doctor immediately if:
- You experience a sudden severe headache
- You are showing signs of dehydration, such as a dry mouth, excessive thirst, infrequent urination, and lightheadedness upon standing
- Your vomit contains blood or is green
- Your stool is black and tarry and has visible blood
If you’ve had bouts of nausea and vomiting for longer than one month, schedule an appointment with your doctor to get to the underlying cause and receive the proper treatment.References ⌵
- Andrew M., Nausea and vomiting in adults, September 2007.
- Amber J., Chronic or Acute Nausea, December 2019
- Sirisha Y., What causes constant nausea and how to treat it, May 2020
- Erica H., What are the Most Common Causes of Constant Nausea?, October, 2019
- Benjamin W., Melissa C., Nausea and vomiting definition and facts.