Nausea – Causes, Symptoms and Treatment

What is Nausea?

Nausea is an unpleasant, often wave-like sensation in the upper abdomen or throat that is frequently accompanied by the urge to vomit. It is not a disease in itself but rather a symptom that can point to a wide variety of underlying conditions. Nausea can be short-lived and harmless, but it can also indicate a serious medical condition that requires professional evaluation.

Causes

The causes of nausea are diverse and can be grouped into several categories:

Gastrointestinal Causes

• Gastrointestinal infections (e.g., viral or bacterial gastroenteritis)
• Food poisoning
• Gastritis (inflammation of the stomach lining)
• Peptic ulcers or gastroesophageal reflux disease (GERD)
• Irritable bowel syndrome

Medications and Substances

• Chemotherapy for cancer treatment
• Antibiotics, pain relievers (e.g., ibuprofen, aspirin)
• Alcohol or drug misuse

Pregnancy

Nausea is especially common during the first trimester of pregnancy, often referred to as morning sickness. It is triggered by hormonal changes, particularly a rise in the hormone hCG (human chorionic gonadotropin).

Neurological and Psychological Causes

• Migraine headaches
• Vertigo and balance disorders (e.g., Meniere's disease)
• Motion sickness (kinetosis)
• Anxiety disorders and severe stress

Other Causes

• Cardiac conditions (e.g., a heart attack can present with nausea)
• Kidney or liver disease
• Thyroid disorders
• Postoperative nausea and vomiting following anesthesia

Symptoms and Associated Signs

Nausea rarely occurs in isolation. Common accompanying symptoms include:

• Vomiting
• Dizziness or lightheadedness
• Increased salivation
• Pallor and sweating
• Abdominal pain or stomach cramps
• Loss of appetite
• Rapid heartbeat (in some cases)

Diagnosis

Because nausea is a symptom rather than a standalone condition, the diagnostic process focuses on identifying the underlying cause. A healthcare provider will begin with a thorough medical history, asking questions such as:

• When does the nausea occur – in the morning, after eating, or in specific situations?
• Are there accompanying symptoms such as vomiting, pain, or fever?
• What medications are currently being taken?
• Is there a possibility of pregnancy?

Depending on the suspected cause, the following investigations may be conducted:

• Blood and urine tests
• Abdominal ultrasound
• Upper endoscopy (gastroscopy)
• Imaging studies such as CT or MRI for neurological concerns

Treatment

Treatment always depends on the underlying cause. The following measures may help:

General Measures

• Rest and relaxation
• Adequate fluid intake (water, herbal tea) to prevent dehydration
• Light, easily digestible foods (e.g., crackers, rice, bananas)
• Fresh air and an upright posture

Home Remedies

• Ginger (as tea or capsules) has demonstrated antiemetic properties
• Peppermint tea can have antispasmodic and soothing effects
• Acupressure at the P6 point (inner wrist) may help with motion sickness

Medications

For more severe or persistent nausea, antiemetic medications are used, such as:

• Dimenhydrinate (e.g., for motion sickness)
• Metoclopramide (MCP) for gastrointestinal nausea
• Ondansetron for chemotherapy-induced nausea and vomiting
• Domperidone to promote gastric emptying

When to See a Doctor

In most cases, nausea is harmless and resolves on its own. However, medical attention is recommended if:

• Nausea persists for more than 2–3 days
• Projectile or bloody vomiting occurs
• Severe abdominal pain or fever is present
• Signs of dehydration appear, such as dry mouth, dizziness, or significantly reduced urination
• Nausea occurs following a head injury
• Nausea is severe during pregnancy (hyperemesis gravidarum)

References

1. World Health Organization (WHO): Symptom Management Guidelines. Geneva: WHO Press, 2023.
2. Hasler WL. - Nausea, Vomiting, and Indigestion. In: Harrison's Principles of Internal Medicine, 21st Edition. McGraw-Hill Education, 2022.
3. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): Nausea and Vomiting – Overview and Treatment Options. U.S. Department of Health and Human Services, 2023.