Nausea: Definition, Types, Causes, Symptoms, and Effects

Nausea Overview

Nausea is an uncomfortable sensation in the stomach that causes an inclination to vomit. Sometimes, the vomiting does occur, and sometimes, there is no vomiting, and the signs persist for many days. The inclination to vomit is often very severe, and treatment is needed. The type, severity and nature of the nauseous feeling experienced differ for different people and depend on the cause. It is either acute, a short-term response to a sudden trigger, or chronic, in which the symptoms continue for days and weeks. 

It is mostly a temporary sensation and is not a cause for concern. 

Many causes responsible for nauseous feelings are anxiety or stress, phobias, motion sickness, food poisoning, migraine, pregnancy, viruses like noroviruses (stomach bug or stomach flu) and influenza viruses (flu), some medications like beta blockers and hormonal contraceptives, cancer therapy, diseases of the digestive system like irritable bowel syndrome (IBS) gastroesophageal reflux disease (GERD) heartburn, cyclic vomiting syndrome etc., inner ear conditions like vestibular neuritis and labyrinthitis etc., eating disorders, thyroid diseases, overeating or eating spicy and high-fat food, painful conditions like kidney stones, gallbladder stones, pancreatitis, meningitis and ulcers. 

The symptoms of chronic nausea are poor appetite, the urge to vomit, profuse sweating, experiencing rapid and rhythmic contractions of the stomach muscles, ache and uneasiness in the throat, upper back, chest or stomach, weakness and saliva in the mouth. The intensity and duration of symptoms depend upon the cause. For example, the nauseous feelings of food poisoning persist for up to 48 hours, and the symptoms begin to improve within 24 hours in the case of stomach flu. If the symptoms persist for a week or more, it could be due to pregnancy and pregnancy testing is required. 

Self-care and avoidance of triggers are enough in many cases. Medical options like Meclizine, dimenhydrinate and liquid or chewable antacids, nutritional therapies, anti-anxiety drugs, etc., are useful in some severe situations. Some natural methods and home remedies like avoiding triggers, using nutritional strategies, proper hydration, avoiding spicy or fatty foods, avoiding strong and repulsive odours and adding peppermint and ginger to the diet are effective. Some non-conventional options like exercises, relaxation techniques and acupuncture have potential benefits.

What is Nausea?

The term' nausea' is derived from the Greek words ναυτια and ναυσια, which means the signs and symptoms of sickness. Many experts restrict it to a condition that develops just before the vomiting. However, it has a wide range of causes and symptoms and is classified as a separate condition by some health professionals. Merriam-Webster's medical dictionary defines nausea as stomach distress that causes the urge to vomit and distaste for foods. It is characterised by activities of the parasympathetic nervous system like a lower rate of respiration, pallor (lightening of colour of skin and mucous membranes), bradycardia (increased heart rate), salivation and diaphoresis (excessive sweating). The feelings are relieved by vomit.  

What does nausea feel like? 

Some people experience an intense and sudden urge to vomit; others experience a low-level chronic condition with mild dizziness and discomfort. Not all people experience vomiting. However, the patients thought that vomiting is likely to relieve them of the symptoms. The feelings experienced in pregnancy nausea differ from those experienced in non-pregnancy nausea. During pregnancy, nausea or morning sickness, the symptoms are worst at the start of the day and are accompanied by signs like anxiety, depression, vomiting and poor appetite. Some other accompanying signs are missed or delayed periods, changes in breasts, fatigue and tiredness, aches in the lower back, mood swings due to hormonal changes, headaches, food cravings or aversions and frequent urination. The feelings of non-pregnancy nausea are different, including headache, constipation, diarrhoea, cramping and stomach pain.  

What is the other term for nausea?

Depending upon the cause and nature of signs and causes, various other related terms are used for nausea. These include seasickness, airsickness, morning sickness, car sickness, altitude sickness, mountain sickness, indigestion, retching, emesis, gagging, motion sickness, stomach upsets, queasiness etc. While these terms are used interchangeably, it is important to note that they have different causes and medical contexts.  

How common is nausea?

Nausea is very common, particularly in pregnancy, and according to the National Institute of Health and Care Excellence, 35-91% (average 69.4%) of pregnant women experience nauseous feelings, particularly during the initial months of pregnancy. Most people experience mild (40%) to moderate (46%) symptoms, and just 14% experience severe symptoms.  

The major type experienced is acute nausea; chronic unexplained nausea is rare, with a prevalence of 0.6% (PLOS ONE, 2019). 

What are the types of nausea?

Based on the underlying causes and symptoms, nausea is of various types. Broadly, there are two types, i.e., acute or chronic nausea. The treatment and management depend upon the exact type and causes. Various common types are;

1. Acute nausea: It appears suddenly and stays for a short duration. Factors like side effects of medications, viral infections, motion sickness, food poisoning, etc trigger it. 
2. Chronic nausea: It is a recurrent and persistent type of nausea and last for weeks to months. It is caused by long-term conditions like gastroesophageal reflux disease (GERD), psychological issues like depression and anxiety, kidney diseases and migraines.
3. Cyclic nausea: It is a type of nausea that occurs recurrently in cycles. It is experienced in cyclic vomiting syndrome (CVS) and causes rapid and severe attacks of nausea that persist for days. Cyclic nausea is characterised by sudden onset and intense symptoms.
4. Refractory nausea: It is a type of nausea that responds poorly to the standard treatments, and the symptoms continue despite repeated and ongoing treatments. It occurs during cancer chemotherapy, chronic medical conditions, side effects of some medications that are used on a long-term basis, different neurological conditions and gastrointestinal obstructions.
5. Psychological nausea: Psychological or psychogenic nausea is caused by psychological factors without medical or physical causes. It is experienced in several psychological conditions like anxiety, depression, panic attacks, generalized anxiety disorder (GAD), stress, eating disorders, phobias and post-traumatic stress disorder (PTSD). It results from mind-body interactions and requires many lifestyle interventions and psychological therapies.

Acute nausea 

It is a type of nausea that has a sudden onset, and the synonyms begin to decline after a sharp rise. It doesn't last longer, and the symptoms disappear without any treatment with mild care. Acute nausea is the most common type and develops in response to various events and triggers. The causative triggers are heavy alcoholism, food poisoning, taking higher doses of certain drugs like opioid painkillers, antidepressants and certain antibiotics, the sudden withdrawal of drugs, early pregnancy, infections in the digestive system, i.e., stomach, intestines and other organs, head trauma, stress and anxiety, gastroparesis (a situation in which stomach doesn't empty properly), and some diseases like adrenal deficiency and uremia. 

The nature and severity of signs and symptoms depend upon the causative trigger. In mild cases, there is just a painful stomach and poor digestion. Some people experience hypersalivation, pale skin and excessive sweating. In severe cases, other symptoms noted are problematic heart rate, cerebral haemorrhages, severe pressure in the brain, meningitis (swelling of tissues that surround the brain and spinal cord), seizures, migraine, inner ear problems causing issues with body balance, inflammation of kidneys, stomach, gallbladder, pancreas, appendix and other organs, heart attack, bowel or stomach ulcers and bowel twisting and blockage. The symptoms are person specific and vary from person to person. 

The history of signs and medical history is enough for a routine diagnosis. Sometimes, blood tests are required to diagnose infections and inflammation. Often, the symptoms go away without any treatment. However, if the symptoms persist and are severe, treatment is required. The goal of treatment is to treat the symptoms and lessens the severity of the condition. The following treatments are used;

Medications: The medications are used to calm the stomach and stop vomiting. Emetic drugs like apomorphine and cupric sulphate empty the bowels and stomach. Other medications, like antibiotics, antidepressants, etc., treat the causative factors. 

Fluid therapy: If nausea leads to severe vomiting, fluid therapy is necessary to replace the lost fluids and electrolytes. It is particularly required if the patient is unable to eat or drink. 

Nasogastric tube (NG): It is used in case of severe nausea and vomiting. The NG passes through the nose and throat and reaches the stomach. It is used to deliver patients nutrition, liquids, medicines and electrolytes. Sometimes, suction is applied to the tube to empty the stomach. 

Various precautions and preventive measures help to manage the severity and reduce the incidence. These include proper rest to reduce the activity level, drinking plenty of fluids to replace the lost fluids and prevent dehydration in case of vomiting, eating smaller meals, avoiding strong flavours and spices and reducing or eliminating the use of alcohol.

Chronic nausea 

In chronic or constant nausea, symptoms like stomach upset and feelings of sickness and nausea last long. The American Family Physician (APF) describes chronic nausea as persisting for more than 1 month. It is due to a variety of causes. Some important causes are pregnancy (women feel constantly nauseous around the 9th week of pregnancy, a condition known as morning sickness), hyperemesis gravidarum (a severe nauseous condition in pregnancy that require hospitalization and causes a woman to lose 3-5% of her body weight), gastroparesis (a condition causing improper gastric emptying) and bowel obstructions. Some less common causes of constant nausea are food intolerance, peptic ulcers, irritable bowel syndrome (IBS), dyspepsia, gastroesophageal reflux disease (GERD), depression, anxiety disorders, eating disorders, constant migraine headaches, high intracranial pressure due to bleeding, a mass or blood clot in the brain, ear diseases like labyrinthitis and Meniere's disease, cancers in the brain or digestive system and long-term use of some medications like birth control pills, antivirals, antibacterials, nicotine, anticonvulsants, cardiovascular medications, gastrointestinal medications and the medications used to treat Parkinson's disease etc. 

The symptoms depend upon the cause, and some general symptoms common to all patients are fluctuations in skin temperature, troubled swallowing, rapid heartbeat, dizziness, lightheadedness and increased saliva production. Constant nausea for a long time causes malnutrition and dehydration due to poor thirst and appetite, and the patients need to speak to a doctor in case of heavy and constant vomiting, loss of appetite, poor concentration, weight loss, fatigue and poor wound healing. 

Treatment is based on causes and clinical signs and symptoms. Antiemetic drugs are used to stop vomiting and control nauseous feelings. These drugs include anticholinergics (e.g., Scopolamine), benzodiazepines (e.g., lorazepam and alprazolam), antihistamines (e.g., diphenhydramine), cannabinoids (e.g., dronabinol), butyrophenones (e.g., haloperidol and droperidol), phenothiazines (e.g., promethazine and chlorpromazine) and corticosteroids like dexamethasone. The doctors prescribe the drugs, and must be used as advised. Some of these drugs, like, benzodiazepines, cause dependence and must be used as advised, and the doctors don't recommend it for a long time. The patient must receive fluid therapy in case of frequent and heavy vomiting to avoid consequences like electrolyte imbalances and dehydration. Some home remedies like ginger powder, peppermint oil and vitamin supplements like vitamin B6 are useful. 

Prevention protocols are eating smaller meals, staying dehydrated, avoiding caffeinated drinks and cold, fatty and spicy foods, avoiding physical activities immediately after eating and using over-the-counter medications like Pepto Bismol and antacids.

Cyclical Nausea

Sometimes, nausea and vomiting occur repeatedly in cycles, a condition known as cyclic vomiting syndrome (CVS). The symptoms don't necessarily occur every day. However, they do last longer. The symptoms often appear without apparent cause, and every attack lasts hours to days. Some sudden and severe attacks need hospitalisation. It occurs irrespective of gender; sometimes, the symptoms persist for decades. The nature, severity and duration of symptoms are person specific. 

The exact cause is not known. However, some experts like RG Boles and JC Williams suggest that the mitochondria of the cells have a role. Mitochondria produce energy by breaking the nutrients, and sometimes, due to genetics, illnesses and exposure to toxins or drugs, the mitochondrial DNA goes abnormal, causing disturbances in the cellular metabolism. Some other factors involved are migraine headaches, imbalances of the autonomic nervous system, problems with the gastrointestinal nervous axis and hormonal imbalances. Panic attacks, anxiety and other types of emotional disturbances sometimes act as triggers. The other triggers are flu and respiratory infections, food allergies, menstrual cycle issues, motion sickness, physical exhaustion and prolonged fasting. 

The CVS causes a variety of symptoms like repeated and severe episodes of nausea, vomiting, retching, gagging or heaving, poor appetite, photosensitivity (sensitivity to light), pale skin, pain in the abdomen, fatigue, headaches, lack of interest in the talking, spitting or drooling, low-grade fever and diarrhoea. 

The case history, signs and symptoms, tests and ruling out other conditions are used for diagnosis. Once the cause is established, preventive and abortive therapy is used for treatment. An abortive therapy is very effective at the start of an attack and stops or lowers the intensity of the attack. The choice of treatment depends upon the stage of the cycle. In the initial stage (prodrome phase), the medications relieve abdominal pain, migraine, and lower stomach acid production. In the vomiting phase, the treatment focuses on treating anxiety and lowering the stomach's acid production. In case of severe vomiting, intravenous fluids are administered to prevent dehydration. In the recovery phases, supportive therapies are used to prevent future attacks. 

Some reports suggest that taking L-carnitine and coenzyme Q10 at recommended doses helps treat mitochondria abnormalities. Some severe and untreated CVS complications are dehydration, oesophagus and Mallory Weiss tear (a tear towards the lower end of the oesophagus). The prevention needs avoiding triggers like food additives or certain foods, taking proper sleep, lowering anxiety and stress and following the doctor's instructions for treatment and prevention.

Anxiety nausea

Anxiety is the body's response to stressful events and causes various physical and psychological symptoms, including nausea. During anxiety, the breathing and heart rate increases, causing a bout of nauseous feelings. The feelings like butterflies in the stomach before a job interview or a public presentation are common examples and pass out quickly. However, sometimes, it takes a more severe turn, causing prolonged sickness and vomiting or dry heaving. 

Several factors associated with anxiety are responsible. Anxiety triggers a freeze or fight or flight response as the body prepares to fight the crisis or to avoid it. Several hormones and neurotransmitters are released in response to stress that increases the heart rate, breathing and muscular tension and cause more blood supply to the brain. The resulting mechanisms influence the whole body, including the respiratory, reproductive, endocrine, cardiovascular and musculoskeletal systems. The effects on the digestive system cause symptoms like painful spasms, constipation, diarrhoea, bloating, stomachache, acid reflux, heartburn, nausea and vomiting. People having chronic digestive issues, like irritable bowel syndrome (IBS), are more likely to experience nausea in response to anxiety. Various responsible anxiety disorders are generalised anxiety disorder (chronic anxiety), social anxiety disorder, post-traumatic stress disorder (PTSD), phobias and panic disorders. 

Anti-anxiety medications e.g., alprazolam and lorazepam are prescribed for treatment that needs to be used long-term for better results. These are prescription medications and must be used as advised by the doctor. Anxiety and nausea are rarely cause emergencies, and some management techniques are likely to help. These include;

Stress and anxiety management: Patients must divert thinking to the present and ignore the future during an anxiety attack. A useful technique to distract from anxiety triggers is taking long breaths, listening to the favourite music, playing games, or counting backward from 100. After some time, the body becomes normal. 

Preventive measures: Some other techniques that help in the long run are regular exercises, eating well-balanced and healthy diet, taking proper sleep, avoiding caffeine and alcohol, improving social mobility and practicing relaxing techniques like aromatherapy, breathing exercises and meditation. In chronic anxiety, the patients must consult the physician, who must refer them to the concerned professional for more help. 

During nausea, some tips like eating something, slowly sipping liquid, wearing a loose-fitting dress that doesn't disturb the stomach, avoiding sweet, greasy and fried foods, mixing cold and hot foods, avoiding intense physical activities after a meal and eating smaller meals rather than three bigger meals are helpful.

Refractory nausea

Refractory nausea is a type of nausea that doesn't respond to the standard treatments. It negatively influences the quality of life and results in more dangerous outcomes like dehydration if not managed properly. 

It is a more severe and persistent form and is due to several causes, e.g.,

• Gastrointestinal disturbances like gastroparesis or functional dyspepsia
• Radiotherapy or chemotherapy 
• Side effects of some medications like some antibiotics and opioids 
• Psychological issues like depression, stress and nausea
• Neurological issues like demyelinating disorders and increased intracranial pressure that disrupts the neurological ability to regulate nausea.

The major symptoms are a wave of intense and persistent nausea that is not responsive to anti-nausea and antiemetic drugs. In severe cases, some other signs accompany it, like dehydration, electrolyte imbalances and poor appetite. 

The treatment depends upon the underlying cause and is often challenging due to the various issues involved. Antiemetics like dopamine antagonists, serotonin receptor antagonists and corticosteroids provide some relief. Prokinetic agents, e.g., metoclopramide, increase stomach contractions and help in some conditions like gastroparesis. Neurostimulation techniques like transcutaneous electrical nerve stimulation (TENS) and some implantable devices benefit by influencing the nervous pathways regulating nausea. Psychological support by the psychiatrist or family and friends is helpful in case of psychological causes. Some dietary modifications like eating smaller and more frequent meals, staying hydrated, using dietary supplements, e.g., vitamin B6 and avoiding triggers are helpful. 

Prevention is unsuccessful, especially with persistent causes like chemotherapy or psychological factors. Some helpful tips are identifying and avoiding triggers, strictly following the antiemetic protocols recommended by the healthcare provider, drinking enough liquids to maintain hydration and proper stress management. In refractory nausea, it is important to consult the doctor to diagnose causes and formulate treatment and prevention plans. 

What are the causes of nausea?

It must be remembered that nausea is not a disease but a symptom of other diseases. The following diseases and health conditions are associated with nausea. 

1. Motion sickness: Motion sickness is a condition in which the brain receives conflicting and often contradictory information from the sensory organs. It causes a lot of random responses and motions in the body and results in symptoms like dizziness, nausea and vomiting. 
2. Infections: Nausea is a symptom of various infectious like food poisoning, COVID-19, flu, gastroparesis, gastritis, inflammatory bowel disease (IBD), gastroesophageal reflux disease (GERD), celiac diseases, pancreatic diseases and gallbladder diseases etc., causing nausea, among other symptoms. 
3. Medications: Nausea is a side effect of many commonly used medications like chemotherapy drugs, opioids, dietary supplements like iron supplements, some OTC Pain killers like ibuprofen or aspirin, antidepressants, drugs containing neurotransmitters and some antibiotics. 
4. Pregnancy: Nausea (morning sickness) is a common condition experienced by 70-80% of pregnant women. Even though called morning sickness, the symptoms occur throughout the day and are characteristic of the first trimester of pregnancy. 
5. Medical conditions: Besides infections mentioned above, other conditions that cause nausea are ear issues like vestibule neuritis, labyrinthitis and Meniere's disease, hormonal changes related to contraception and pregnancy, endocrine disorders, thyroid diseases, and neurological conditions.
6. Anxiety or stress: Digestive and mental health are closely linked, and people having emotional health issues like stress and anxiety experience digestive symptoms, including nausea. Anxiety and phobias trigger panic attacks causing dizziness and nausea.
7. Overeating or fasting: Overeating and fasting both cause drastic changes in the levels of nutrients and glucose in the blood, causing nausea. Nausea is a symptom of low acid in the stomach, which is common with starvation. Overeating causes high pressure inside the stomach. It puts pressure on the internal organs, leading to nausea. 
8. Alcohol or drug use: Alcohol and drugs like MDMA, ayahuasca, prescription opioids, heroin and cocaine irritate the lining of the stomach, resulting in changes in acid production, discomfort and nausea. Chronic alcoholism and drug abuse often result in gastritis leading to the same consequences.

Motion Sickness 

Motion sickness is a condition in which conflicts occur between the brain and sensory organs. The brain cannot properly process the information sent from the sense organs like the skin, ears and eyes. It causes a person to become clammy, queasy and upset during various situations like in a boat, aeroplane and car and even in different social situations. The incidence rate depends upon the situation. For example, an earlier study in 1999 noted that 28.4% of public transport passengers experience motion sickness symptoms (Turner and Griffin, 1999). The most common start is at age 6, and peak symptoms are experienced around 9. 

It occurs when the body parts engaged in motion sensing, like inner ears, eyes, joints, and muscles, send conflicting information to the brain. The brain can't make sense of the conflicting information, resulting in confused reactions. For example, while driving, the muscles send information that the body is still, while the eyes and ears are sensing motion, and disconnection between these two messages confuses the brain. Important risk factors include virtual reality experiences, dangerous rides in amusement parks, reading a book during riding, nervous system diseases, drug abuse, and spending too much time in video games and movies.

 The symptoms occur as a surprise, which means the patient is perfectly normal at one time and experiences symptoms like rapid breathing, pale skin, vomiting and nausea, hypersalivation, loss of concentration, irritability, fatigue, dizziness and headaches at other times. 

Several treatment options are antihistamines used to treat allergies and are effective for symptoms of motion sickness and skin patches like scopolamine skin patches attached behind the ears some hours before an expected drive and are replaced every three days. The medications are prescribed only for adults. Some preventive measures are effective, like breathing in Lavender, ginger and mint scents, sucking candies containing ginger and peppermint, drinking plenty of fluids, eating low-fat and starchy foods and avoiding heavy meals, particularly acidic and spicy before travelling, avoiding smoking and alcohol, breathing in fresh air, avoiding reading a book or using phone or tablet during drive and using acupressure wristbands. 

Some precautions like sitting in the middle of the boat, choosing the window seat of the bus, sitting in the front seat in the car, choosing a forward-facing seat on the train and sitting in the wing section of the plane are effective. 

Infections 

Different infections associated with nausea are;

Stomach flu or food poisoning: The stomach and intestinal upsets caused by viral infections and food poisoning are common causes. The infections cause nausea, cramping, stomach pain, diarrhoea and vomiting. 

Bacterial and viral infections: Infectious agents like Rotavirus, Norovirus, Salmonella, Escherichia coli, flu viruses, coronavirus, etc., are involved. The coronavirus and flu cause symptoms like diarrhoea, vomiting, nausea, sore throat, runny or blocked nose, body aches, fatigue, headaches, cough, breadth shortness, loss of smell and taste and fever. 

Digestive disorders: Different digestive disorders like gastritis due to H. pylori infections, gastroparesis, GERD, IBD, celiac diseases, gallbladder infections and pancreatitis etc, cause nausea and related symptoms. Besides chronic nausea, digestive disorders cause symptoms like food intolerance, abdominal pain, constipation, diarrhoea, indigestion, belching and bloating. 

Inner ear infections: Some inner ear infections cause nausea and dizziness as the inner ear's vestibular system helps the body maintain balance and decide about its position. The conditions responsible are vestibular neuritis, Meniere's disease and labyrinthitis. 

The treatment of infections depends upon the cause, and mostly a long course involving medications and supportive care is necessary. Changes in lifestyle and dietary habits are helpful too. In the case of ear infections, the symptoms mostly improve automatically over time, and OTC medications for motion sickness help manage the symptoms.

Medications 

Medications are used to cure certain diseases. However, they cause some undesired side effects, including nausea. The medications causing nausea as side effects are antibiotics like cephalexin, clindamycin, erythromycin, levofloxacin etc., antidepressants like fluoxetine, escitalopram, citalopram etc., pain killers like ibuprofen or aspirin, food supplements like iron, folate, vitamin E,  C supplements, chemotherapy drugs and opioids analgesics. 

Such medications work by changing the chemical processes that regulate the interactions between the body and the brain. Sometimes, the medications influence the levels of neurotransmitters like dopamine and serotonin, resulting in nausea and vomiting. The nausea and related symptoms caused by the medications are short-lived. The symptoms start sometime after taking the medications and stop once the medications are stopped. Prevention needs the avoidance of causative medications, and the patients must consult the doctor for alternative medications.

Pregnancy 

Experiencing nausea and vomiting during pregnancy is known as morning sick. It affects more than two-thirds of women, particularly in the first trimester. Despite being labelled as morning sickness, the symptoms are experienced at any time of the day. The timing of onset varies; however, the most common start is around six weeks of gestation, and most women experience symptoms before nine weeks of pregnancy and begin to improve after 12 weeks of pregnancy. In rare cases, the symptoms persist throughout the pregnancy. 

The exact cause is not known; however, a combination of hormonal and physical factors is involved. The common factors are:

• Changes in metabolism during pregnancy
• Fluctuations in blood pressure
• Increased levels of hormones like oestrogen and human chorionic gonadotropin (hCG) 

Some factors that worsen the symptoms of motion sickness are warm weather, smelling or eating some foods, particularly if the patient is intolerant or allergic to such foods, being exhausted and having anxiety and stress. Its severe form is hyperemesis gravidarum, which causes severe dehydration, losing weight (10 pounds or more), and a vomiting frequency of 3 or more per day. 

The signs and symptoms are stomach upsets, poor appetite and vomiting. Some patients experience acid reflux, heartburn, motion sickness, hunger pangs, feeling something stuck in the throat and seasickness. Unmanaged and untreated cases cause low birth weight in babies as the baby is not getting proper nutrition.

Some medications like doxylamine and vitamin B6 supplements are used; both are available OTC. Another useful medication is Diclegis® which is a slow-release pill. Sometimes, antiemetics, antihistamines and anticholinergics are used. The obstetrician must prescribe the medications. Acupuncture and acupressure wristbands have shown potential usefulness. 

Some dietary and lifestyle changes help manage morning sickness. The dietary changes like eating toast and crackers in the morning, avoiding skipping meals and eating smaller meals, avoiding fatty and spicy foods, and adding more bland foods like eggs, applesauce, baked potato, dry toast, rice and bananas, using protein-rich foods like peanut butter, nuts, cheese and yoghurt, drinking a lot of fluids, avoiding caffeinated drinks, taking snacks during a long journey, chewing ginger candies and using ginger tea are effective.

Some useful lifestyle changes are taking iron supplements only at bedtime or as asked by the healthcare provider, avoiding flickering lights and strong odours, taking proper sleep and rest, maintaining proper room ventilation, smelling pleasant and fresh odours like mint, organs and lemon, avoiding lying down after a meal and rinsing the mouth after a vomit to wash away acid from the teeth. 

Medical conditions

Besides the infections mentioned above, several medical conditions that cause nausea are ulcers in the lining of small intestines and stomach, migraine headaches, meningitis (infections of protective layers around the brain and spinal cord), liver cancer, liver failure, ear infections, heart attacks, intestinal blockages, benign paroxysmal positional vertigo (BPPV), kidney stones, gallbladder stones, eating disorders, food allergies, severe pains associated with kidney and gallbladder stones, excessive use of drugs like marijuana, intestinal blockages, tumours, appendicitis and poisoning.

The severity of nausea depends on the condition responsible. The treatment needs the identification of causes. Some home remedies like taking proper rest, dietary changes to feel better, drinking plenty of fresh water and clear fluids, remaining still, and using over-the-counter medicines like dimenhydrinate and prescription medications like scopolamine patches are effective. In case of poisoning, caffeine-coloured or dark blood comes in the vomit and emergency medical assistance is needed. Signs of dehydration, stiff neck, high frequency of vomiting, severe pain and low urination frequency are the signs that need immediate attention.

Anxiety or stress 

Anxiety is the body's emotional response to stressful events and causes various physical and psychological symptoms. The symptoms like nausea, butterflies in the stomach and sickness occur. However, these symptoms are temporary and regress after the stressful event. In severe conditions, the digestive disturbances become too severe, requiring a person to spend too much time in the bathroom. During anxiety, a freezing or fight or flight mechanism that prepares the body for an emergency is triggered. It results in a rush of hormones and neurotransmitters that cause muscular tension, increased heart and breathing rate, increased blood flow toward the brain and low blood flow towards the digestive organs. The effects on the digestive system cause symptoms like painful spasms, diarrhoea, constipation, vomiting, nausea, acid reflux, heartburn, bloating and stomachache. 

The management of nausea due to anxiety and stress needs the management of both nausea and stress. To manage stress, the patient must focus on the present, give off the past, take deep and long breaths, and distract from stressful events. Some useful anxiety coping strategies are eating a healthy diet, spending a few minutes regularly on exercises, avoiding caffeine and alcohol, remaining socially active by spending more time with family and friends, aromatherapy, breathing exercises and working on mindfulness techniques. To manage or avoid nausea, the precautions like taking smaller meals regularly, staying properly hydrated, limiting the use of caffeine and alcohol, avoiding greasy and heavy foods, eating some dried bread or plain crackles, sipping water slowly, self-calming, avoiding mixing cold and hot foods and avoiding excessive physical activities immediately after a meal.

Overeating or fasting

Nausea due to overeating or fasting is an uncomfortable and unpleasant sensation that often results in vomiting. It occurs because consuming a large amount of food overwhelms the digestive system. Too much eating, particularly of heavy, greasy and fast foods, results in indigestion and gastro-oesophageal reflux disease, causing nausea, among other signs. Fasting causes several issues resulting in nausea, e.g., hypocalcemia, a prolonged lower calcium levels in the blood and ketosis, i.e., high levels of ketone bodies in the urine and blood. Both conditions cause nausea. 

The signs of nausea due to overeating are a feeling of discomfort and fullness in the stomach, bloating, belching and excessive gas production in the stomach. During fasting, signs like dizziness, lightheadedness, fatigue, weakness and excessive hunger are noticeable. 

The treatment and prevention depend upon the cause. In case of nausea due to overeating, proper resting in a comfortable position to allow the stomach to digest food, avoiding lying down for 2-3 hours after a meal, remaining properly hydrated, eating foods in smaller portions rather than three bigger meals, chewing the food thoroughly to make it easily digestible and avoiding triggering foods are effective. 

In case of nausea due to fasting, the treatment and preventive protocols are breaking the fast slowly and gradually using easily digestible foods like soup, yoghurt and fruits, staying poorly hydrated to replenish the lost fluids and avoid dehydration, using balanced diets containing healthy fats, carbohydrates and proteins to break the fast and continuously monitoring the blood glucose levels are important and effective measures.

Alcohol or Drug Use

Nauseous feelings are among the symptoms of alcoholism, drug addiction and withdrawal from addictive substances. It mostly results in vomiting and, in some cases, creates a sense of vertigo. Taking drugs like opioids without prescriptions and doctors' guidelines often cause nausea. It causes the destabilisation of body systems and stomach sickness. 

Different people have different levels of resistance to alcohol and drug abuse. Generally speaking, the risk is there for drug abuse, including heroin, cocaine, marijuana, MDMA, prescription opioids, ayahuasca etc. Pain in the stomach after drinking alcoholic beverages or taking drugs is a sign of gastritis, the inflammation of the stomach that causes the nauseous condition. Excessive alcoholism (more than 14 standard drinks per week or four in a single day for men and more than seven drinks per week or more than three in a single day for women) results in several issues, including nausea (National Institute on Alcohol Abuse and Alcoholism). The other signs of nausea due to alcohol and illicit use of drugs are depression, confusion and fast or difficulty breathing, lethargy, decreased urine production, diarrhoea, abdominal pain, dry mouth, dizziness and faintness. In severe cases, the conditions like nervous breakdown, confusion, chest pain and dehydration occur. 

The patients need to consult the healthcare provider for drug addiction treatment, and it needs the involvement of doctors, family and friends and personal commitment on the part of the patient to leave the drug. 

Preventive measures like stopping drug abuse, limiting alcohol use to safe levels, staying properly hydrated throughout the day, taking proper rest, avoiding activities that cause severe symptoms, eating easily digestible bland foods like rice, bananas, toast and crackers, avoiding spicy, greasy and heavy foods, avoiding triggers like some foods, certain environment and smells, using over the counter medications like antacids, adding ginger to the diet in the form of ginger supplements, ginger candies or ginger tea, practising relaxing techniques like deep breathing and seeking professional help whenever needed.

What are the symptoms of nausea?

All types of nausea are difficult to describe. Patients experience different types and severities of symptoms and have different experiences. Some common symptoms experienced in all types of nausea are;

1. Feeling queasy or dizzy: Feeling dizziness and queasiness in a nauseous condition are very common and are related to the development of conditions like vestibular migraines, motion sickness, low blood pressure, inner ear problems, side effects of some medications, morning sickness due to pregnancy, stress and anxiety and benign paroxysmal positional vertigo (BPPV). It is a common sign and sometimes needs medical assistance.
2. Sensation of wanting to vomit: Having a heavy urge to vomit in nausea is the natural response by the body to get rid of the toxins or other substances causing nausea. The vomiting centre in the brain is activated by the nausea triggers, which activate the gastrointestinal tract and muscles involved in the vomiting process. Several factors responsible are emotional issues, pregnancy, inner ear diseases and engulfing some toxic substances that irritate the stomach lining.
3. Upset stomach: Stomach upsets are very common during nausea and are due to several factors like food poisoning, gastrointestinal irritation, eating quickly or overeating, bacterial and viral infections, acid reflux, the side effects of some medications, motion sickness, pregnancy and various emotional factors. Stomach upsets could be due to various other factors that must be investigated.
4. Loss of appetite: The body reduces appetite to reduce the entry of more toxic substances responsible for nauseous conditions. The risk is particularly high if nausea is due to stomach upsets, food aversions, and intolerances. It is a temporary issue that sometimes worsens, leading to weakness and dehydration.
5. Excessive saliva production: Sialorrhea or hypersalivation occurs as the body tries to limit the exposure to nausea-causing chemicals, irritants and toxins within the walls of the stomach and intestines. It is due to the activation of the autonomic nervous system, gastrointestinal irritation and the use of some medications that cause hypersalivation. It is generally harmless but compromises the quality of life, and severe hypersalivation must be consulted with a doctor.
6. Sweating or clammy skin: Excessive sweating and clammy skin occurs as a part of physiological responses by the body to the nauseous condition. The symptoms occur as the autonomic nervous system reacts to the changes of vomit and discomfort. The sympathetic nervous system activation activates the fight or flight response to prepare the body for emergencies that result in sweating. The symptoms are not mostly severe, but persistent signs that interfere with the quality of life must be discussed with the doctor.
7. Rapid heartbeat: Heart palpitations or a rapid heartbeat is another physiological response of the body to the nauseous condition. It occurs due to the activation of the sympathetic division of the autonomic nervous system in response to stress and discomfort. It is a normal and temporary response by the body and is rarely a cause of concern. However, it is a sign of other health issues like heart disease and must not be ignored. 
8. Weakness or fatigue: Weakness and fatigue during nausea are the consequence of various physiological responses by the body to stress and discomfort. Activation of the sympathetic nervous system diverts the attention towards a fight or flight response and away from leisure activities like eating and drinking, causing reduced food intake, poor digestion and absorption and weakness over time. If the nausea results in vomiting, the loss of nutrients and water from the body causes dehydration, poor energy levels and electrolyte imbalances. Medical assistance is needed in severe cases. 
9. Headache or lightheadedness: Lightheadedness or headache during nausea is attributed to various factors like the activation of the nervous system to handle the stress situation and the resulting change in the blood pressure, dehydration, blood pressure fluctuations, hormonal changes during pregnancy, migraine headaches, emotional stresses and the side effects of some medications.
10. Diarrhoea: Diarrhea is a sign of gastrointestinal infections and disturbances. Several causes of nausea are associated with gastroenteritis and diarrhoea, e.g., food poisoning, irritation of the lining of the stomach and intestines, anxiety and stress, and medical conditions, e.g., IBS, food allergies and intolerances. Untreated and continuous diarrhoea causes dehydration and loss of electrolytes, leading to further complications.

Feeling queasy and dizzy

Dizziness and sickness are common signs of nausea due to various factors. Both are often the first sign to appear and result from underlying medical conditions like motion sickness during pregnancy, use of medications, anxiety, food poisoning, migraine, inner ear conditions, dehydration, bacterial and viral infections and gastrointestinal disturbances. Treatment depends upon the underlying causes. Some common options are using OTC anti-nausea medications, avoiding food additives and other foods that trigger the signs, and staying hydrated and resting properly. The medications must be used after consulting a healthcare provider. Prevention, too, depends upon the cause. General preventive measures include:

• Avoiding nausea triggers
• Managing stress and anxiety
• Avoiding contaminated and spoiled food
• Maintaining good hygiene

The severity and duration of signs depend upon exposure to risk factors and various individual factors, and the signs last anywhere between a few minutes to hours. It is mostly a mild discomfort; however, in severe and untreated cases, it severely impacts daily life and needs medical assistance.

Sensation of wanting to vomit 

The sensation of wanting to vomit is due to the attempt by the body to get rid of harmful substances that are causing the symptoms of nausea. It lasts as long as the triggering agent is there and occasionally results in vomiting. Various responsible causes are infections, gastrointestinal disturbances, inner ear infections, motion sickness due to pregnancy, anxiety, side effects of anti-anxiety medications, and other related factors. Treatment depends upon the cause. In the case of mild and uncomplicated cases, just resting and staying away from the triggers is enough. Some other useful measures are drinking cold and clear liquids, eating bland and light foods like plain bread and saltine crackers, eating smaller meals, avoiding mixing hot and cold foods and avoiding physical activities immediately after eating. 

OTC anti-nausea medications and consultation with the doctor are necessary in severe and complicated cases. General preventive measures are the same as for otter causes, i.e., identification and avoidance of triggers, stress management, avoiding contaminated and spoiled food and maintaining good hygiene. The severity and duration depend upon the exposure to risk factors and multiple individual factors. It occasionally lasts minutes to hours and resolves earlier in case of vomiting. The severity ranges from mild to intense, depending upon the exposure risk factors. 

Upset stomach

Stomach upsets are the common causes of nausea and result in vomiting or nausea. Stomach upsets result from various nausea-associated factors like certain medical conditions, use of medications, motion sickness due to nausea, food poisoning, bacterial and viral infections, and emotional disturbances. Treatment depends upon the cause. Avoiding triggers and taking proper rest and home remedies are effective in milder cases. In complicated and severe cases, anti-nausea medications like Scopolamine, Dimenhydrinate, Promethazine and Meclizine are needed. In severe cases, it becomes necessary to consult the healthcare provider for more appropriate care and prevention. 

Following general hygiene protocols, managing stress and anxiety, avoiding triggers, and avoiding spoiled and contaminated food are useful for prevention. The severity and duration of symptoms are highly variable, ranging from mild and easily manageable to severe conditions requiring medical help. The signs last hours to days, depending on exposure to risk factors and treatment and care protocols.

Loss of appetite

Appetite is lost in almost all infections in the body due to the release of inflammatory chemicals that influence the brain's appetite centre and the side effects of medications. In the case of a nauseous condition, underlying medical conditions like stress and anxiety, use of medications, gastrointestinal disturbances and bacterial and viral infections cause loss of appetite. It is either partial or complete, resulting in accompanying signs like weakness, dehydration, and weight loss. 

Treatment depends upon the cause and options like antiemetic drugs Aprepitant, Dolasetron, Rolapitant etc. and nutritional and lifestyle changes are useful. The prevention needs avoiding triggers, like greasy, heavy and spicy foods, practising stress management techniques and opting for a healthy lifestyle. If a person is experiencing a persistent loss of appetite with nausea, it is important to consult the healthcare provider for guidance and treatment.

Excessive saliva production

Sialorrhea or hypersalivation occurs during nausea and is an attempt by the body to lower the risk of contact between the walls of the digestive system and mouth and the harmful agents and to expel the agents out. Several factors responsible are gastrointestinal disturbances like inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and gastro-oesophageal reflux disease (GERD), use of certain medications like Clozapine, Ketamine, Potassium Chloride, Pilocarpine etc., pregnancy in combination with morning sickness, throat and mouth infections and various neurological conditions like traumatic brain injury, cerebral palsy, Parkinson’s disease and stroke. 

Treatment of hypersalivation is easy, and several measures like the use of antiemetic drugs to treat nausea, antibiotics to treat the underlying infections, taking alternative medications in case of hypersalivation due to side effects of medications and occupational or speech therapy in case of drooling due to stress and anxiety are effective. For prevention, the root cause must be eliminated. Some options, e.g., avoiding nausea triggers and maintaining good oral hygiene, are helpful. The severity and duration of signs are person specific and depend upon many factors. Consulting the healthcare provider is important for recommendations and personalised treatments. 

Sweating or clammy skin 

Sweating and the resulting clammy skin occurs as a part of nervous responses to the situation. The autonomic nervous system is responsible for maintaining the physiological balance and preparing the body for emergencies by triggering a fight or flight mechanism. It boosts the heart rate, metabolism and breathing, resulting in sweating and clammy skin. Some gastrointestinal infections cause fever and sweating. For pregnant women, the development of nausea during travels, flights and boat trips results in severe stress causing sweating without any other causes. Treatment involves addressing the root cause of nausea and other health conditions. 

Some useful options are resting properly in a cool and comfortable environment, drinking a lot of water and clear fluids to maintain hydration, practising relaxation techniques for anxiety and stress management and using OTC or prescription antiemetics to relieve nausea. Prevention needs avoiding the triggers, managing the unavoidable risk factors, and opting for a healthy lifestyle and nutrition. The severity and duration of symptoms are variable and depend upon exposure to risk factors and many personal factors. In the case of chronic and refractory conditions, it is important to consult the doctor to identify the cause and get treatment.

Rapid heartbeat 

Rapid heartbeat or tachycardia is having a heart rate higher than 60-100 beats per minute. In nauseous condition, it occurs due to several factors like stress and anxiety and the resulting activation of the fight or flight response due to the activation of the sympathetic nervous system, dehydration due to chronic and heavy vomiting, use of certain medications like aspirin, epinephrine etc., and pain and gastrointestinal infections. Treatment must address the root cause and manage the factors like nausea. It involves resting properly, drinking much water to avoid dehydration, practising relaxing techniques for anxiety and stress, OTC and prescription antiemetics to relieve nausea, beta-blockers, and other related drugs to manage the heart rate. 

Prevention needs avoiding nausea triggers, maintaining proper hydration, managing stress and opting for a healthy lifestyle. The severity and duration of signs are person specific. The heart rate is an immediate response to the triggers, and if signs like chest pain accompany it, it is likely a sign of heart disease, and the patient must consult the doctor for diagnosis and treatment.

Weakness or fatigue

Experiencing weakness and tiredness is the culmination of issues accompanying nausea and associated risk factors. The causes include dehydration due to nausea and vomiting and the resulting loss of water and electrolytes, gastrointestinal disturbances that cause poor appetite and poor absorption of nutrients from the body and diarrhoea, bacterial or viral infections that cause weakness as the body struggles to fight off the infections, side effects of certain medications that cause dry mouth and anorexia, underlying medical conditions like chronic diarrhoea, thyroid diseases and anaemia. For treatment, the underlying cause must be treated first.

The useful measures to take are taking proper rest to allow the body to recover, drinking water to maintain hydration, consuming smaller meals instead of heavier ones, OTC and prescription medications for nausea and treatment of underlying conditions. Prevention needs adequate rest, staying hydrated, a balanced diet, and managing stress and anxiety. The severity and duration of signs is variable and depends upon multiple factors. The body needs many days to recover the previous strength, and supportive therapies are required to smooth the journey.

Headache or lightheadedness

Headaches and lightheadedness are the consequences of different factors accompanying nausea, like dehydration and the resulting loss of water and fluids, hypoglycemia due to inadequate food intake, improper digestion, migraine, inner ear infections like labyrinthitis and vertigo and side effects of medications. The underlying cause must be addressed for treatment, and the symptoms must be managed as and when they occur. 

General preventive measures like taking proper rest, maintaining hydration status, preferring smaller meals over heavier ones, antiemetics for nausea, and treating any other associated health issues are effective. For prevention, techniques like avoidance of triggers, maintaining hydration status, managing stress and taking a proper diet are very important. The severity and duration of signs are very person specific and depend upon many factors. The signs must last up to an hour in milder and uncomplicated cases. In case of prolonged signs, it is necessary to consult a healthcare provider.

Diarrhoea 

The occurrence of diarrhoea with nausea is a sign of accompanying gastrointestinal infections. Various digestive system conditions, like bacterial, viral and parasitic infections, cause both diarrhoea and nausea. The other factors are food poisoning, gastrointestinal conditions like IBD, IBS and GERD, side effects of medications, anxiety, stress and other related causes. Treatments are used to address the underlying cause and manage the symptoms. Options like staying hydrated, taking proper rest, using easy-to-digest and bland foods, using antiemetic drugs to manage and treat nausea and OTC and prescription medications for diarrhoea are very helpful.

The prolonged and complicated cases result in dehydration and weight loss. Preventive protocols like taking a balanced diet, managing stress, avoiding contaminated and spoiled food and practising good oral, hand and food hygiene are effective. The severity and duration of signs are highly variable, and in most uncomplicated cases, the signs must last a maximum of a few days. Persistent and refractory diarrhoea, particularly of high frequency, needs emergency care. Fluid therapy is sometimes necessary to replenish the lost water and electrolytes.

What are the short-term effects of nausea?

Although nausea is a sign of other health issues, it has several short-term and long-term effects. Some short-term effects of nausea are; 

1. Feeling dizzy, uncomfortable and queasy: The first and the most common symptom of nausea is a discomforting sensation in the throat and upper abdomen that causes uneasiness and queasiness as if the vomit is coming. 
2. Stomach discomfort and upsets: Nausea is often a consequence of stomach issues like indigestion, cramps, bloating and stomachache, and different signs accompany the nauseous feelings. 
3. Drooling or excessive saliva production: Due to various nausea risk factors, the body triggers various protective responses, e.g., excessive saliva production, to limit the contact between the agents and body surfaces. Consequently, the patients feel uncomfortably high saliva levels in the mouth and drooling in the children. 
4. Uneasiness and discomfort: The risk factors of nausea and the nauseous condition cause uneasiness and discomfort. As a result, the patients feel agitated, restless and distressed. 
5. Clamminess and excessive sweating: Nausea causes an emergency in the body. The body responds to the emergency by activating the sympathetic division of the autonomic nervous system, which results in high metabolism, respiratory and breath rate and sweating. 
6. Lightheadedness and dizziness: Nausea often involves blood pressure fluctuations and inner ear conditions. Both influence a person's self-perceptions and cause lightheadedness and dizziness. The inner ear has a role in maintaining body balance. 
7. Food aversions and poor appetite: As a result of nausea, the body limits the appetite to reduce the entry of new food that has the potential to make the situation worse. The patients start disliking previously liked foods, and a prolonged poor appetite results in weight loss and weakness.
8. Belching or burping: During nausea, excessive gas is often trapped in the digestive tract, like in the intestines and stomach, which causes belching or burping. 
9. Poor concentration: Nausea causes poor concentration or loss of concentration. It occurs as the body is focused on the signs of nausea and distress. The discomfort due to nausea makes it difficult to focus on routine tasks. 
10. Shallow and rapid breathing: Sometimes, shallow and rapid breathing occurs in nausea. It is related to emotional stress and anxiety. It is among the signs of heart disease and must be reported to the doctor, as just nausea is not enough to cause prolonged signs. 

What are the long-term effects of nausea?

As an independent condition, nausea causes several long-term effects too. The type, nature and severity of long-term effects depend upon the underlying cause. Here are some long-term effects;

1. Malnutrition: Nausea causes loss of appetite. Persistent and long-term nausea and the resulting loss of appetite for long time results in nutritional deficiencies. 
2. Weight loss: As a sequel of poor appetite and nutritional deficiencies, the body starts losing water, fat and proteins, resulting in weight loss. The unintentional weight loss often becomes very severe, and 5-7% of weight loss causes extreme emaciation and weakness. 
3. Dehydration: It is a less common sign as the patient is asked to drink more water. However, if the nausea is accompanied by heavy vomiting, the resulting high amount of water loss is not compensated by drinking water, and the signs of dehydration, like dry and sunken eyes, increased heartbeat, and dry and dry skin, start developing. Emergency fluid therapy is done to replace the fluids lost. 
4. Increased frequency of gastrointestinal disturbances: Although nausea is a consequence of gastrointestinal disturbances, having severe nausea for a long time contributes to increased severity of conditions like peptic ulcers, gastritis and acid reflux.
5. Emotional distress: Being at a higher risk of nausea or suffering from long-term nausea makes a person emotionally very delicate, causing depression, anxiety and distress. Emotional sighs influence the overall quality of life. 
6. Sleep disturbances: Having persistent nausea due to any cause disrupts the normal pattern of sleep, and sleep is often disrupted in the middle of the night. As a result, the signs of sleep deprivation develop in patients with long-term nausea.
7. Social and workplace issues: Long-term nausea severely limits productivity, performance and reliability. It influences social interactions as a person is emotionally and physically deemed less reliable. 
8. Poor quality of life: Chronic nausea and its associated negative signs like discomfort and stomach upsets negatively influence the quality of life. The patients are often deprived of enjoyable foods and activities like hiking, trails and boat trips. The dislikeness for foods often reaches the levels of food intolerance. 
9. Increased healthcare requirements: Patients with long-term nausea and exposure to risk factors need routine medical checkups and treatments to manage the long-term signs. All such factors increase healthcare costs. 
10. Weakness and fatigue: The outcome of nausea, its associated factors and their negative outcomes cause poor health, weight loss, physical exhaustion and weakness. 

How does nausea affect general health?

Nausea has various negative effects on overall health—the discomfort and fear of vomiting cause stress, anxiety and depression that causes poor quality of life. Nausea occurs due to various issues like psychological issues, pregnancy, motion sickness, gastrointestinal disturbances, migraines and infections, all of which cause multiple health issues. Nausea triggers complex physiological responses that especially involve the nervous and gastrointestinal systems. The protective mechanisms are activated to protect the body, resulting in low appetite and nutritional deficiencies. Therefore, severe and prolonged nausea results in weakness, dehydration, weight loss, and other negative health outcomes. 

Recurrent and chronic nausea affects mental well-being too. Nausea and its associated conditions cause sleep disturbances. Disturbed sleeping patterns have multiple health outcomes, e.g., impaired mental functioning, daytime sleepiness, poor immunity, mood changes, weight gain and increased risk of diseases like heart diseases, diabetes and mental health conditions (Sleepfoundation.org). The dietary and lifestyle changes required to manage nausea and the medications used to manage the signs cause several side effects. For example, antiemetics cause side effects, e.g., constipation, dizziness and headache. In short, the influence of nausea on health outcomes is multifaceted and understanding these effects is very important to control the feelings.

How does nausea affect men's health?

Nausea influences both the physical as well as mental health of men. It is the symptom of other health conditions like anxiety, stress, medication side effects, and digestive issues. So, it accompanies the negative consequences of all these issues. The issues like loss of appetite result in malnutrition and dehydration, causing weak immune weakness and fatigue. Poor immunity means a person is at higher risk of infections and diseases. Nausea, particularly the chronic one, influences men's mental health as constant dizziness and discomfort associated with nausea cause depression, anxiety and poor quality of life. 

Poor performance at school and workplace and low self-esteem negatively influence relationships and sexual life leading to frustration and social isolation. Often, nausea is a warning sign of serious health issues like cancers, chronic gastrointestinal issues and liver diseases; thus, men experiencing persistent nausea must seek medical and psychological support. Managing nausea requires many nutritional and lifestyle changes, like giving off certain foods and taking some medications regularly, all of which ultimately influence the life of men. 

How does nausea affect women's health?

The effects of nausea on women's health are particularly severe as women have to face issues like hormonal changes, menstrual cycle changes, pregnancy, menopause, miscarriage and abortion in addition to the usual causes, i.e., stress, anxiety, medicine side effects and gastrointestinal disturbances. The most important and common type of nausea in women is the morning sickness experienced during the first trimester of pregnancy. Although it is considered normal and not a medical emergency, having persistent nausea for weeks causes issues like weight loss, fatigue and dehydration, which has implications for the health of both the mother and child. Hormonal changes during pregnancy and various menstrual cycle stages cause nausea that causes depression and fear. It is, however, short-lived and resolves as the causes subsides. Morning sickness is, however, just a nuisance and has no long-term negative consequences for pregnancy. Nausea and vomiting during pregnancy are associated with a lower risk of miscarriage (Weigel and WEIGEL, 1989). 

Nausea due to gastrointestinal issues like IBS and GERD causes severe symptoms that negatively influence nutritional intake and daily activities. Nausea occurring due to psychological issues like anxiety and stress causes sickness. The female tends to avoid triggers, including social settings. The psychological effects of chronic nausea are particularly severe, causing irritability, frustration, relationship issues due to social isolation and poor performance at school or the workplace. The management of nausea needs various nutritional and lifestyle changes that influence the quality of life. Women experiencing nausea must consult healthcare professionals to avoid physical and psychological health consequences. 

How does nausea affect mental health?

Nausea is a very distressing situation and has various mental health implications. It is due to various issues like gastrointestinal disturbances, medicine side effects, anxiety and stress, all of which cause emotional disturbances. Having persistent and refractory nausea causes frustration and disrupts daily life, and the feelings like anxiety and stress levels are elevated. All these factors combine to cause mental health issues in the long run. Refractory nausea that is not responsive to the treatments interfere with social life, workplace performance and relationships resulting in helplessness, irritation and frustration.

The fear of experiencing nausea and related symptoms at events and other social settings causes fear, and the person tends to withdraw from such events. Nausea disrupts sleep patterns and causes insomnia, sleep deprivation and other sleep disorders. Given the importance of sleep for mental well-being, it causes negative changes in mood and cognitive functions. To avoid these issues, seeking medical and psychological support is important.

How does nausea being diagnosed?

For proper and comprehensive treatment, accurate diagnosis is needed. The diagnosis of nausea typically involves history taking, physical examination, laboratory tests, imaging tests, and endoscopy. In most cases, the cause is easily identified, such as pregnancy, ingestion of toxins, etc. Sometimes however, it indicates health issues like cancer, acute gastroenteritis, meningitis, compilations of diabetes, peptic ulcers, acute hepatitis, intestinal obstructions and the inflammation of internal organs etc., like stomach flu due to bacterial and viral infections. These issues need separate diagnoses, and the following tests are helpful.

Medical history: The history of signs and symptoms helps in diagnosis. The points to be noted are the onset of symptoms (whether abrupt or slow), the timing of onset of symptoms (irregular, continuous, a few hours after the meal, during or after eating or before breakfast), the nature of the vomit (odorous or odourless, partially digested or undigested), the volume of the vomit, location and severity of the abdominal pain and the presence of any associated symptoms or findings (American Family Physician, 2007). 

Physical examination: The physical examination looks for signs of dehydration, infections, and other visible abnormalities. Examining the abdominal region is important; e.g., a tender and distended abdomen suggests bowel obstructions. Likewise, the neurological examination helps determine any central causes. 

Blood tests: Various blood tests indicate the causes of nausea. For example, a complete blood count detects the presence of infections and anaemia, kidney function tests, liver function tests, and electrolytes level tests help detect the cases like kidney and liver diseases and dehydration, and albumin tests help detect nutritional deficiencies. 

Radiographic testing: The supine or upright abdominal radiograph diagnoses any mechanical obstructions in the digestive organs. 

Gastric emptying test: A small amount of radioactive material and advanced imaging techniques are used to study the material flow from the stomach to the intestines after a meal. Any blockage in the flow of the content is a sign of obstructions or cancerous growths inside the stomach that is causing nausea. 

Autonomic function tests: Various tests like ultrasonography, sweat testing and breathing tests are used to evaluate the health of the autonomic nervous system, the part of nervous system that controls the digestive system. The tests are useful to detect any issues in processing nervous responses to nausea. 

Oesophageal manometry: During oesophagal manometry, a small tube is inserted into the oesophagus through the nose. The test helps the doctor to judge muscle contractions and pressures in the oesophagus and any obstructions in that part of the digestive system. 

Gastroduodenal manometry: During gastroduodenal manometry, a small flexible tube having a tiny camera and different instruments is passed to the oesophagus through the mouth. Besides providing visual imagery of the inside of these organs, it provides information about the frequency and strength of smooth muscle contractions in the stomach and small intestines.

Wireless capsule gastrointestinal system (capsule endoscopy): During capsule endoscopy, a pill (SmartPill®) that contains a wireless information system is ingested. The information system and the attached computer programs detect the pressure, pressure changes, temperature and acid levels in the gastrointestinal system. The motility test provides information about the motility and emptying time of the small and large bowel and stomach. The SmartPill® is made of indigestible materials; the stomach acids and intestinal enzymes cannot digest or degrade it and ultimately pass out with bowel movements.

Who is at risk of nausea?

Everyone is at risk of developing nausea. However, some people at higher risk are those with gastrointestinal diseases, migraines, food poisoning, psychological and emotional issues, motion sickness, pregnant women and patients undergoing chemotherapy treatment. The frequency and severity of the symptoms vary from person to person. Various gender and age-related factors influence the risk of nausea. The women are more likely to experience as they experience various risk factors that are unique to them only, like hormonal changes during adolescence, menstrual cycle changes, pregnancy and menopause.

How to stop feeling Nauseous?

Nausea is an unpleasant sensation, and it is natural to look for ways to stop or manage it. Besides the medications used for different types and symptoms, here are some remedies which help improve the signs and are easy to follow and cheap.  

1. Don't lie down after a meal or compress the stomach. Both activities cause the gastric juices to rise and increase the uncomfortable sensations. Avoid unnecessary movements and reclining while the upper body is elevated. 
2. Keep the room or sitting area well-ventilated or sit before a fan. It helps to remove harmful gases and helps feel better. It diverts the attention away from the nauseous feelings. Moreover, fresh air has a soothing effect. 
3. Apply a cold compress. The nausea is often due to high temperature, and applying a cold compress, particularly at the back of the neck, helps ease the symptoms. 
4. Practice mindfulness and relaxation techniques like medication. These techniques help calm the mind and relieve the symptoms. The research has noted that adding a few hours of medication to the daily treatment plan for some weeks causes significant improvement in the clinical outcomes related to nausea and vomiting in patients undergoing anticancer chemotherapy. The techniques help a person to shift the mind away from the triggers. Watching the television or reading a book during a nausea attack is useful. 
5. Drink plenty of fluids and stay hydrated. Nausea is among the consequences of dehydration and causes dehydration if drinking or eating is reduced. Sipping water or some other clear fluid throughout the day is useful during a queasy feeling. Fruit juices or fruit slices in the freshwater are comforting too. 
6. Practice deep breathing, as it is among the most useful meditation and relaxing techniques. It helps relieve the symptoms of stress-induced nausea. A useful procedure is to breathe slowly through the nostrils while the mouth is closed, holding the breath for a few seconds, then breathing the air out. The cycle must be repeated as long as the symptoms of nausea are there. 
7. Add ginger to the diet plan as it is one of the most effective nausea-relieving remedies. The research has found it useful in managing the symptoms of nausea, particularly during chemotherapy and pregnancy (Integrative Medicine Insights, 2016). Various methods to use it are ginger tea, ginger candies, or just eating a small slice of fresh ginger. Ginger tea is prepared easily at home from fresh and peeled ginger. 
8. Add lemon to the diet as it helps digestion and improves nausea symptoms due to digestive illnesses. It contains nitric acid that soothes the stomach and helps digest food. A good practice is to squeeze the fresh lemon into medium-cold water and sip it continuously throughout the day. It improves bowel movements and helps relieve nausea symptoms due to constipation. However, too much lemon juice overstimulates the bowel, worsening symptoms. The lemon scent is helpful to relieve symptoms, too, and using freshly cut lemon or lemon essential oil for smelling is useful. Lemon inhalation aromatherapy effectively manages nausea and vomiting in pregnancy (Iranian Red Crescent Medical Journal, 2014).
9. Use chamomile tea as it has soothing effects due to the presence of apigenin, a flavonoid that helps in anxiety-induced nausea, and its soothing effects cause a person to sleep during a nauseous person. 
10. Add peppermint oil to the diet. Studies have found that peppermint helps to relieve symptoms of nausea, anorexia and vomiting in breast cancer patients undergoing chemotherapy. Various methods to take it in are peppermint oil, tea or capsules. Peppermint tea is available at grocery stores. Similarly, inhaling the pepper oil is helpful too. 
11. Take vitamin supplements, particularly vitamin B6 supplements. The studies have compared the effects of vitamin B6 supplementation with ginger and have found that taking 30-100 mg of vitamin B6 in 2-3 divided doses for some weeks is useful. Diclegis, a combination of doxylamine, an antihistamine and vitamin B6, is approved for treating pregnancy-induced nausea. The results are, however, mixed, and taking too much vitamin B6 often causes nausea.
12. Take over-the-counter nausea medications to help relieve the synonyms. These medications are known as antiemetics, and some useful examples are Pepto Bismol, Emetrol®, Gravol®, Dramamine® and Nauzene®. During pregnancy, OTC medicines must be used after consulting the doctor.
13. Eat bland and easily digestible foods. A useful concept is the BRAT diet, which contains bananas, rice, applesauce and toast. Avoid dairy products, dried foods and high-fibre foods. Small amounts of some foods like hard-boiled eggs, saltines, scrambled eggs, noodles, plain pasta and mashed or baked potatoes are effective.
14. Avoid carbonated soft drinks. Although some traditional sources recommend using carbonated beverages for stomach issues, the scientific evidence is otherwise. Carbonated drinks cause bloating and worsen the symptoms of nausea triggers like GERD. The results are, however, mixed, and more studies are needed. If carbonated drinks are to be used, they must be diluted with water before use.

What are the treatments for nausea?

Nausea and related conditions need personalised treatments tailored to the individual needs that address the underlying physical, emotional and neurological causes. A combination of different treatment options is often employed for better results. Some common treatment options are, 

1. Medications: Anti-anxiety and anti-nausea medications (like antacids and antiemetics) are recommended to help relieve the symptoms. Some preparations are available over the counter, and others need a doctor's prescription. 
2. Nutritional therapy: Nutritional therapies are specialised for individual patients with gastrointestinal diseases and help avoid nutritional deficiencies. The nutritionists find and recommend foods that don't trigger the nausea symptoms and advise about nutritional management. Sometimes, tube feeding and fluid therapy are done to avoid malnutrition in dehydration.
3. Rehydration therapy: The rehydration solutions are taken orally to help replenish lost fluids and minerals and treat or prevent dehydration. It is urgently needed in case of high vomiting frequency. 
4. Tube feeding: If the body cannot get desired nutrients from the food taken through the oral route, tube feeding is recommended. It delivers formulated nutritional liquids directly into the stomach through the percutaneous endoscopic gastrostomy (PEG) tube. 
5. Parenteral nutrition: Sometimes, the desired nutrients are directly delivered into the vein through total parenteral nutrition using a spaghetti-like thin catheter. It is needed if the stomach has lost its functioning and the intestines need time to heal and absorb the desired nutrients. 
6. Surgical treatments: Surgical procedures remove and treat some causes, like canners or blockages in the digestive system. The choice of surgical methods depends upon the nature of the illness responsible for nausea.

Is nausea treatable?

Yes, most causes of nausea are treatable. For mild and uncomplicated cases, taking rest, using home remedies and OTC medications like antiemetics and antacids are very effective. In severe and persistent cases, consultation with healthcare providers is needed for more focused treatment. As it is a sign of various other illnesses, treatment, management and prevention of the underlying causes are very important for better clinical outcomes. It is very rarely a medical emergency. 

How long does it take for nausea to go away?

The duration of nausea varies depending on the underlying cause. For example, the nausea associated with pregnancy (morning sickness) starts before the 9th week of pregnancy, and the symptoms mostly go away by the 14th week. For a minority of women, the symptoms continue for months after it and even continue till the birth of a baby, and it is due to the co-occurrence of other factors like nutritional factors, infections, genetic predisposition etc. In the case of more acute causes like stomach flu, the improvement is noticeable within 24 hours and even earlier in the case of more robust treatment and care. Sometimes, it lasts up to 48 hours or more in severe issues like food poison. 

Nausea is more short-lived in case of some causes like motion sickness and lasts for just a few minutes to hours and ends as soon as the motion sickness ends. In the case of viral gastroenteritis, nausea lasts for days to weeks until the virus leaves the body after completing its cycle and once the immune system has gained sufficient momentum. Nausea due to a migraine lasts for just a few hours and ends as soon as the migraine subsides. In the case of chronic conditions like IBD, IBS and GERD, nausea becomes chronic and continues for a long and needs persistent management. Nausea due to side effects of medicines lasts as long as the causative medications are used. The durations are just for guidelines, and the exact duration depends on many personal factors and management and treatment protocols used.

When should you be concerned about nausea?

Nausea is a sign of a variety of conditions. So, any nausea, particularly the persistent and refractory, must not be ignored. Immediate medical care and attention are needed if nausea results in severe vomiting and there are other signs, e.g., faecal material or faecal odour in the vomit, bleeding from the rectum, stiff neck, high fever, confusion, blurred vision, severe cramping and abdominal pain and chest pain. Some other signs that need immediate attention are,

• There is a severe and persistent headache after nausea and vomiting
• There are signs and symptoms of dehydration like lightheadedness and dizziness while standing, dark-coloured urine, painful urination, infrequent urination, dry mouth and excessive thirst
• The vomit is of green colour, has blood or has a resemblance to the coffee grounds
• The vomit lasts more than 12 hours for infants, 24 hours or more for babies and more than 48 hours for adults]
• The bouts of nausea and vomiting last more than a month
• The unexplained and heavy weight loss accompanies the nausea and vomiting.

Are Nauseous and vomiting the same?

No, both nausea and vomiting are very closely related but distinct conditions. The vomiting occurs after nausea, and many times, both occur together. Nausea causes an urge to vomit, and when the urge becomes too severe, the vomiting results. Vomiting or emesis is the forceful expulsion of digestive contents from the mouth, particularly the stomach. It is a protective mechanism that allows the body to eliminate harmful materials that are potentially dangerous for the body. The nauseous condition develops before vomiting; however, not everyone with nausea experiences vomiting. Both conditions have similar causative factors, signs and symptoms and similar treatment and prevention protocols.