Deal With Chronic Unexplained Nausea

Nausea is an unpleasant feeling in your stomach that is associated with the urge to vomit. The sensation of chronic nausea doesn't always lead to throwing up, but it makes you feel like you're on the verge of it. Chronic unexplained nausea can have many causes (gastrointestinal disease, chronic infection, vertigo, constant anxiety, food allergies), but they're not as obvious to diagnose as more common triggers, such as food poisoning, pregnancy or the stomach flu. Even if your doctor can't diagnose your chronic nausea, there's a number of ways to deal with it regardless of the cause.

Steps

Dealing with Chronic Nausea at Home

  1. Take a pregnancy test. The definition of chronic nausea is different to many people, with some thinking it must last for more than a week to qualify, whereas others say more than a month. Pregnancy is a very common cause of nausea (called morning sickness) that can last for a few weeks or sometimes even longer. If you're a sexually active female and feeling nauseous in the morning for a week or more, buy a pregnancy test from the pharmacy and check.
    • Morning sickness is much more common during the first trimester (3-month period) of pregnancy, although in rare cases it can last the entire 9 months.
    • The main treatment for morning sickness is to avoid triggers, which may include stuffy rooms, odors, heat, humidity, noise, and visual and physical motion.
    • If you are pregnant and your nausea persists for more than a few weeks, make an appointment with obstetrician for advice.
  2. Check the side effects of your medications. Another very common cause of unexplained chronic nausea, especially among the elderly, is medication. Virtually every prescription and over-the-counter medication can trigger nausea as a side effect, but the most common offenders are chemotherapy drugs, painkillers (especially opiates), antidepressants (SSRIs) and antibiotics.[1]
    • Read the list of side effects for your medications and see if your nausea is associated with taking any of them.
    • Research your medication(s) on the internet to see if other people are having trouble with unexplained nausea.
    • Ask your doctor about reducing your dosage or changing to a different type of medication with similar actions.
  3. Cut down on alcohol consumption. Although drinking alcohol is firmly ingrained in our culture as an appropriate social activity, the reality is that ethanol is toxic to people and can cause numerous negative symptoms, including nausea. Sometimes it's from drinking too much and getting dizzy ("bed spins") or "hung over" the next morning, but if your nausea is chronic then you may be allergic to alcohol. See if you can connect having a drink with feeling nauseous.
    • If it does seem to be caused by alcohol, you need to cut back or stop drinking alcohol altogether.
    • Some races of people are more susceptible to feeling sick / nauseous after drinking alcohol because they lack the enzymes to break down and process ethanol. Asians and Native Americans are most notable.[2]
    • Switch to non-alcoholic beer, virgin cocktails or grape juice instead of wine if you still want to be social and go to bars/lounges with your friends.
  4. Eat bland whole foods. Regardless of the cause of your nausea, eating fatty, fried and/or spicy food will generally make it worse. As such, eat bland whole foods that are low in fat and higher in fiber, such as whole wheat bread, bran cereal, and fresh fruits and veggies.[3] Furthermore, chew slower and eat smaller, more frequent meals.
    • If you really have trouble keeping food down, nibble on plain crackers and toast throughout the day.
    • If you can eat small meals, focus on lean fish, chicken breast, rice, boiled potatoes and bread. Veggies are fine too, but avoid ones that can cause gas and make nausea worse — such as cauliflower, cabbage and onions.
    • It's recommended that you wait about six hours to eat solid foods after you throw up. Sip on some diluted chicken or beef broth while you wait.
  5. Watch for food allergies. Food allergies often go undiagnosed and can be a cause of chronic nausea and stomach upset. The most common foods that trigger allergic reaction in people are: eggs, fish, cow's milk (and related dairy products), peanuts, walnuts, soy products, shellfish (shrimp, crab, mussels) and wheat.[4] Be more aware of how you feel within a few minutes of eating certain foods.
    • Try an elimination diet (removing foods one by one) and see if that cures your nausea.
    • Other allergy symptoms to look out for include: swelling in your face, lips and/or throat, congested nose and sinuses, itchy skin, hives, headache, brain fog and difficulty breathing.
    • If you think you might have a food allergy, get tested by a nutritionist or allied health professional who is trained in allergy testing.
  6. Avoid strong odors. In addition to avoid eating fatty, spicy and fried foods, you should also avoid smelling them as strong odors often cause nausea to get worse. Other strong odors to avoid include perfume/cologne, cigarette smoke, body odors, onions, garlic and curry.[3] Avoid restaurants until you feel better and prepare more meals at home. Avoid the food courts and perfume counters when shopping in malls.
    • Wearing a surgical mask or applying some menthol rub to your nostrils may reduce the impact of strong odors while you're outside your home.
    • Other triggers of nausea to be aware of in your home and other places include: high heat, humidity and flickering lights.
  7. Keep hydrated. Chronic, low levels of dehydration are much more common than you might think, especially in warm and humid climates. The vast majority of people drink plenty of beverages, but they are often loaded with caffeine and processed sugar, which can promote loss of water from the body. Furthermore, your risk of more severe dehydration is high if your nausea is associated with chronic vomiting.[5]
    • Aim for approximately eight 8-ounce glasses of purified water each day — more if you're active and sweating a lot.
    • If you're having trouble keeping water down, take small sips or try sucking on ice chips.
    • Avoid beverages with caffeine, such as coffee, black tea, hot chocolate, colas and energy drinks.
    • Avoid milk if you're lactose intolerant. Symptoms of bloating, abdominal cramps and diarrhea will make your nausea worse.
    • If you're losing fluid from vomiting and/or diarrhea, then you also need to replace your electrolytes (mineral salts). As such, drink some diluted fruit or vegetable juice in addition to water.

Taking Natural Remedies for Chronic Nausea

  1. Drink herbal teas. Adding some herbal tea to your routine is not only a great source of uncaffeinated hydration, but some herbs may combat nausea by settling your stomach down or calming your nerves. For example, peppermint, spearmint and chamomile are herbs well known for their stomach soothing abilities.[6]
    • Herbs that may reduce anxiety/stress and make an impact on nausea include: chamomile, Valerian root, passionflower and kava.
    • You can buy these herbal teas at most grocery stores or buy the dried herbs directly and use them to make a herbal infusion.
    • Don't add boiling hot water to herbs as it can destroy some of the helpful compounds. Instead, add very warm water and let the herbs steep for about 15 minutes.
  2. Consume ginger products. Another traditional plant remedy popular for combating nausea is ginger. Ginger has some anti-inflammatory ability and is considered a carminative that reduces gas, bloating and abdominal pain — all of which can cause nausea.[6] Ginger can be consumed as an herbal tea, taken as capsules, or as a lozenge or chew.
    • Most commercial ginger ale doesn't contain real ginger, but some natural brands in health food stores do. Make sure to get rid of the fizz (carbonation) before drinking it.
    • Pickled ginger (the type that often comes with sushi) is another form that's tasty and fairly easy to find.
    • Take some form of ginger about 15–30 minutes before eating solid food in order to reduce the likelihood of nausea.
  3. Consider taking vitamin B6 supplements. The is some research that indicates supplementing with vitamin B6 (pyridoxine) can help reduce chronic nausea and vomiting, especially among women who are pregnant. The recommended dosages are 30mg of pyridoxine hydrochloride daily for up to five days consecutively.
    • Be aware that vitamin B6 supplements may not impact all causes of chronic, unexplained nausea, but it's affordable and worth a try in most cases.
    • Taking too much vitamin B6 (more than 100mg daily) can lead to nerve irritation and numbness/tingling in your limbs. Always keep daily doses under 50mg to be on the safe side.

Getting Treatment for Chronic Nausea

  1. Ask your doctor about anti-nausea medication. If natural and home remedies don't impact your nausea, and your doctor is unable to figure out the underlying cause, then taking anti-nausea medication may be a good option.[7] Over-the-counter types such as Dramamine might work, but stronger ones need a prescription from your doctor.
    • Commonly prescribed anti-nausea drugs include: prochlorperazine (Compazine), granisetron (Kytril), ondansetron (Zofran), perphenazine (Trilafon), metoclopramide (Reglan), and thiethylperazine (Torecan).[8]
    • Cannabinoids (derived from the chemical THC in marijuana), such as dronabinol (Marinol), may also be useful for combating nausea.
    • Be aware that these drugs all come with their own potential side effects, which may include high blood pressure and difficulty with muscle control. Speak with your doctor at length about the side effects of any anti-nausea medication
    • If severe nausea prevents you from either taking pills or holding them down, then ask your doctor about suppositories.
  2. Consider short-term antibiotics. If your doctor (and other specialists) are unable to diagnose your chronic nausea, then it may be worth experimenting with a short course (a week or two) of antibiotics. Chronic low-grade bacterial infections are often difficult to diagnose and frequently trigger bouts of nausea, especially if they're gastrointestinal infections. Ask your doctor about the pros and cons of taking antibiotics.
    • Antibiotics are notorious for causing nausea, so there should be some evidence of infection before taking them.
    • Bacterial infections typically cause abnormal blood tests, such as a high white blood cells count, which indicates your immune system is fighting an infection.
    • Viral stomach infections can cause nausea also, but antibiotics are only effective against bacteria.
    • Erythromycin is an example of an antibiotic your doctor may prescribe. It is used to promote the passage of food from the gut to the intestines. The window for this antibiotic to be useful in treating nausea is very narrow, and if you take it for too long it may increase abdominal pain.
  3. Try acupressure treatments. Acupressure involves putting sustained pressure on specific spots on your body to trigger certain physiological reactions. It's the same principle as acupuncture, but without the needles. Research indicates that there's a point located on the wrist (called the P6 point) that, if pressed, can reduce nausea.[9] Most research has been done on pregnant women, but the P6 point may work for other causes also, such as motion sickness and anxiety.
    • You can locate a trained acupuncturist in your area, although watching some videos on how to locate and stimulate P6 may work also.
    • Pressing the P6 point on either wrist for between 30-60 seconds may be enough to significantly reduce your nausea. If not, try massaging the point for about five minutes.
    • Look for special bracelets online designed to stimulate the P6 point for long periods of time, which is may help when combating sea sickness or nausea related to pregnancy.
  4. See a chiropractor. Another type of alternative treatment that can significantly impact unexplained nausea is a chiropractic spinal adjustment. If the joints, nerves or muscles of your upper neck are irritated, it can throw off your balance just enough to cause mild dizziness and nausea. A chiropractic neck adjustment can realign spinal joints and reduce upper neck tension, which causes the related nausea to quickly fade away.
    • Most chiropractors will want to take an x-ray of your neck before adjusting it to make sure the treatment is safe.
    • You will often hear a relatively painless popping or cracking sound with chiropractic adjustments, so don't think anything is breaking.
    • Although one treatment is sometimes enough, you'll likely need between 3-5 treatments to fix an upper neck issue.



Tips

  • Too much exercise or activity and not getting enough rest can make your nausea worse.
  • Even if standard blood tests come back normal, consider seeing an endocrinologist to get your hormones checked. Hormone imbalance can trigger nausea.
  • The BRAT diet (bananas, rice, applesauce and toast) can be very helpful for not triggering nausea.
  • Traveling in cars, buses trains and taxis may make your nausea worse. If you have to go somewhere by car, insist on being the driver — you may feel less nauseous.
  • Some patients have chronic nausea that is not responsive to anti-nausea medication.Cognitive behavior therapy and treatment with antidepressants may be in order for these types of patients.

Warning

  • Have your doctor examine you if you're suffering from chronic nausea that you can't self-diagnose at home.

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Sources and Citations

  1. ↑ http://www.pharmacytimes.com/publications/issue/2008/2008-08/2008-08-8642
  2. ↑ http://www.ncbi.nlm.nih.gov/pubmed/2937417
  3. ↑ 3.0 3.1 http://www.mayoclinic.org/symptoms/nausea/basics/when-to-see-doctor/sym-20050736
  4. ↑ http://www.medicalnewstoday.com/articles/8624.php
  5. ↑ https://my.clevelandclinic.org/health/diseases_conditions/hic_Nausea_and_Vomiting
  6. ↑ 6.0 6.1 http://www.rd.com/health/wellness/stomach-soothers/
  7. ↑ http://www.aafp.org/afp/2007/0701/p76.html
  8. ↑ http://www.projectinform.org/publications/nausea/
  9. ↑ https://www.mskcc.org/cancer-care/patient-education/acupressure-nausea-and-vomiting
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