Nausea

Nausea is often followed by vomiting but usually clears up after two or three days without any need for treatment. If it continues for several days or you have repeated bouts, it might be a symptom of an underlying condition — this could be physical or psychological. 

Nausea can be caused by conditions affecting your brain, gallbladder, liver, pancreas, oesophagus, small intestine or stomach. Diagnosing the underlying cause of persistent nausea can, therefore, be difficult. 

In all cases, nausea is ultimately triggered by stimulation of a part of the brain called the vomiting centre. The vomiting centre causes the sensation of nausea and coordinates the act of vomiting. 

Nausea is not painful but the symptoms are uncomfortable. Nausea can be felt in your chest, upper abdomen, back or throat. Other symptoms of nausea, such as headache, fatigue and loss of appetite, are common. 

Other nausea symptoms include: 

• Abdominal pain
• Diarrhoea
• Dizziness or light-headedness
• Fever
• Passing gas
• Vomiting or feeling that you want to vomit

Many conditions can cause you to feel sick. If you also have diarrhoea and vomiting, you may have gastroenteritis (an infection of your stomach and bowel caused by a bacteria or virus), food poisoning or a virus such as norovirus.

If you also have a headache and a high temperature, you may have the flu.

Feeling sick often accompanies the intense headache of a migraine, along with vomiting and light and/or sound sensitivity.

It is also common to have nausea in the early weeks of pregnancy, although some women experience nausea into their third trimester. 

Other common causes of nausea include:

Digestive system conditions

• Heartburn and gastro-oesophageal reflux disease (GORD) — when some of your stomach contents pass back up into your gullet, causing a burning sensation that triggers nausea after eating
• Indigestion
• Irritable bowel syndrome (IBS) 
• Stomach ulcers — eating stimulates the production of stomach acid, which can irritate your ulcer, causing a burning sensation that triggers nausea 

Motion sickness and seasickness

This can happen during a bumpy ride on any vehicle. Your inner ear, which is responsible for your balance, sends signals to your brain which do not sync up with the signals your eyes send to your brain. This can cause dizziness, nausea and/or vomiting.

Inner ear conditions

Your inner ear is responsible for your balance and awareness of your position and orientation in the world around you. Consequently, conditions that affect your inner ear can disrupt your balance, making you feel dizzy and nauseous. 

Conditions include inner ear infections, such as labyrinthitis, and benign paroxysmal positional vertigo (BPPV), which is caused by loose debris in your inner ear. 

Intense pain

Extremely painful conditions eg pancreatitis, gallstones and kidney stones can cause nausea.

Certain medications

Certain medications, including chemotherapy, radiotherapy and general anaesthetics, can cause nausea as a side effect. 

Recent surgery 

You may experience nausea as a side effect of general anaesthesia. However, recent surgery can also cause nausea due to dehydration, taking medication post-surgery on an empty stomach and eating too much too soon after surgery. 

Other nausea causes

Nausea can also be caused by conditions affecting your: 

• Brain eg meningitis
• Gallbladder eg gallstones
• Intestines and stomach — this includes: 
• Bowel obstruction
• Femoral hernia
• Hiatus hernia
• Inguinal hernia
• Umbilical hernia
• Liver eg liver failure or liver cancer
• Pancreas eg pancreatitis
• Oesophagus 

Anxiety and stress, drinking too much alcohol or eating too much food can also cause nausea. In women, nausea can also be caused by premenstrual syndrome (PMS) and/or period pain.

COVID-19 and nausea

The most common symptoms of COVID-19 are a dry cough, fever, loss of smell and taste and tiredness. Other symptoms include: 

• Breathlessness or difficulty breathing
• Chest pain
• Chills
• Headaches
• Muscle aches
• Runny nose and/or sore throat

However, nausea is also a symptom of COVID-19 and the virus can cause other gastrointestinal symptoms often before you develop respiratory symptoms. These symptoms include:

• Diarrhoea
• Vomiting

Other accompanying symptoms and possible causes

Other symptoms associated with your nausea can give you a clue to the underlying cause. For example: 

• Diarrhoea or vomiting suggests you may have food poisoning or norovirus 
• Dizziness suggests you may have labyrinthitis or vertigo
• Headache or fever suggests you may have an infection eg flu
• Headache and sensitivity to light or sound suggest you may have a migraine
• Heartburn or bloating after eating suggests you may have acid reflux

However, you should not self-diagnose. If you are worried, you should always see your GP. 

With most bouts of nausea, you will stop feeling sick after a few hours to a few days. However, you should see your GP if your nausea continues, you are frequently nauseous or you are losing weight without trying.

To diagnose the cause of your nausea, your GP may examine your stomach and discuss how you feel. You might be asked to have blood and/or urine tests. If you are a woman, you might be asked to take a pregnancy test.

Your GP may refer you to a consultant for further investigations, diagnosis and treatment.

Nausea is rarely serious but it can occasionally be a sign of a heart attack. Seek medical assistance immediately if you suddenly feel nauseous and have:

• Chest pain
• Intense headache
• Pain or a burning sensation radiating down your left arm, jaw or neck
• Shortness of breath
• Sweating

Nausea can also be a sign of an infection, such as meningitis, so you should also seek medical assistance immediately if you have nausea and any of the following symptoms: 

• Confusion
• Difficulty breathing
• Severe headache
• Stiff neck

It is also necessary to seek medical advice for nausea if you suspect that you have ingested a poisonous substance or if you are dehydrated.

If you have nausea and have not been able to eat or drink for over 12 hours, or still have nausea after 24 hours of taking over-the-counter anti-nausea medication, see your GP.

If there is no improvement in how you feel after a few days, you should see your GP. They may prescribe anti-nausea medication and, if needed, will recommend treatment for the underlying cause of your nausea. 

If your nausea is a side effect of medication, your GP or consultant may prescribe a different medication or change your dosage. 

If you have morning sickness nausea or are pregnant and have nausea, you should always get advice from your midwife or GP before taking any medication.

If your nausea is caused by motion sickness eg when sitting at the back of the car, you can try sitting in the front. If your nausea occurs when travelling by sea, you can apply a scopolamine patch (anti-seasickness patch). You can also try over-the-counter medications, such as dimenhydrinate or an antihistamine.

If your nausea is caused by GORD, you can take stomach-acid reducers to relieve your GORD symptoms, which may, in turn, relieve your nausea. Similarly, if your nausea is caused by intense pain, taking painkillers may help relieve your nausea.

Home remedies

There are several changes you can make to ease your nausea symptoms yourself. You can try: 

• Doing something to distract yourself and not lying down straight after eating
• Drinking peppermint or ginger tea
• Eating small, frequent meals and eating slowly
• Getting some fresh air
• Sipping cold, preferably sour drinks — water, ginger water and lemon water can all help; drinking lemon juice can also help but drinking too much too quickly can worsen nausea
• Wearing loose clothing that does not put pressure on your stomach or waist

Try to avoid: 

• Cooking or eating foods with strong odours
• Eating fried, greasy or spicy food — bland food will be much easier on your digestive system
• Eating quickly
• Having a large drink with your meals
• Nausea triggers — this includes: 
• Flickering lights — this can trigger a migraine
• Heat and humidity 
• Strong odours eg perfume and certain foods
• Travelling by sea