Nausea

Nausea

Definition

Nausea is a feeling of queasiness in the stomach. It is usually associated with the feeling that one might vomit.

What is going on in the body?

Nausea is a feeling that almost everyone has had at some point in their lives. It can be caused by many different conditions, ranging from pregnancy or exercising too much to infection or cancer. Determining the cause of nausea is not always easy.

Risks

What are the causes and risks of the condition?

The list of conditions that can cause nausea is very long. It is best broken down into general categories. These include:
  • a viral or bacterial infection in the digestive tract, spread from person to person through the community or by food poisoning
  • an infection in another part of the body, such as the flu or an ear infection known as acute otitis media
  • pregnancy
  • alcohol
  • gastroesophageal reflux
  • peptic ulcers
  • problems with balance and equilibrium, such as motion sickness
  • anxiety and other psychological conditions
  • certain drugs, such as antibiotics, narcotics, cancer chemotherapy, oral contraceptives, and pain medications
  • disease processes involving the abdomen, such as appendicitis, gallbladder disease, gallstones, kidney stones, hepatitis, pancreatitis, or bowel inflammation
  • a blockage in the stomach, bowels, or esophagus, the tube that connects the mouth to the stomach. Esophageal atresia is an example of this type of blockage.
  • systemwide conditions, such as poorly controlled diabetes, headaches, cancer, chronic renal failure, heart attacks, being overly tired, overexerting oneself, and hormone or salt imbalances
  • birth defects in the digestive tract, such as a poorly formed stomach or intestine. These may include duodenal atresia, pyloric stenosis or imperforate anus.
Other causes are possible. In some cases, no cause can be found.

Prevention

What can be done to prevent the condition?

Prevention is related to the underlying cause. For example, avoiding alcohol can prevent nausea from drinking too much. Medications can help with the nausea caused by traveling. If the nausea is due to morning sickness during pregnancy, eating crackers and avoiding fatty foods can help. There are many other examples of prevention depending on the specific cause.

Diagnosed

How is the condition diagnosed?

People can diagnose nausea on their own. A healthcare professional can help a person figure out the cause of the nausea. The first step is a history and physical exam. In some cases, this may be all that is needed to diagnose the cause. In other cases, many other tests may be needed. Blood, urine, and x-ray tests are commonly done.

Long Term Effects

What are the long-term effects of the condition?

Nausea itself has no serious long-term effects, though it may be distressing and prevent sleep and other activities. The underlying cause may be very serious, however. For example, cancer is a rare cause of nausea that can lead to death. If vomiting occurs with the nausea, dehydration and salt imbalances may occur.

Other Risks

What are the risks to others?

Nausea itself is not contagious and poses no risk to others. In some cases, nausea is due to an infection that may be contagious.

Treatments

What are the treatments for the condition?

Treatment is directed at the underlying cause. For example, if the cause is gastroesophageal reflux, medications can be given to treat the reflux. If the cause is appendicitis, surgery is needed to remove the appendix.
Medications are also available to treat nausea if the cause cannot be treated or avoided. For example, people who need chemotherapy to treat cancer are often given drugs to reduce nausea before chemotherapy begins.
Some drugs that may help reduce nausea are available over-the-counter, such as Pepto-Bismol, Emetrol or diphenhydramine (i.e., Benadryl). For morning sickness, over-the-counter medications such as pyridoxine (vitamin B6), diphenhydramine (i.e., Benadryl), dimenhydrinate (i.e., Dramamine) and doxylamine (i.e., Unisom Nighttime Sleep Aid) can be used when approved by your doctor or pharmacist.
Others antinausea medications are more powerful, such as promethazine (i.e., Phenergan), prochlorperazine (i.e., Compazine), ondansetron (i.e., Zofran) or dronabinol (i.e., Marinol), and require a prescription.

Side Effects

What are the side effects of the treatments?

All medications have possible side effects. For example, diphenhydramine makes many people sleepy. Pepto-Bismol can turn the stools black. Other drugs can cause allergic reactions, diarrhea, or other side effects. Specific side effects depend on the medications used. Surgery can be complicated by bleeding, infection, or an allergic reaction to anesthetic or pain medications.

After Treatment

What happens after treatment for the condition?

If the underlying cause can be found and treated, the nausea should stop. If the cause cannot be found or cannot be treated, drugs to reduce nausea may help. For example, some people may need narcotics to control pain, but the narcotics make them nauseous. In this case, drugs to treat nausea can be given at the same time as the pain medications.

Monitor

How is the condition monitored?

People with nausea can monitor it themselves and judge how well it is responding to treatment. The underlying cause of nausea may need further monitoring and treatment by a healthcare professional.

Sources

Conn's Current Therapy, 2000, Rakel et al.

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