That queasy feeling. Ugh.
Feeling nauseous and not sure why?
As a board-certified family medicine doctor, I frequently see patients who say they are nauseous. Sometimes they are suffering from a viral infection, acid reflux or food poisoning. Other times, the cause is due to a chronic condition, such as gastroparesis or a neurological problem. Through my years treating patients for a variety of medication conditions that lead to nausea, here are some of the most common that cause people to feel as if their stomach is unsettled:
Acute Causes of Nausea
An acute condition means the problem came on suddenly and the symptoms worsen quickly.
Acute causes of nausea include:
Acid reflux. Some people may feel nauseous after a very large meal, or after eating spicy or saucy foods. Consider trying antacids, eating blander foods or eating smaller meals. Try not to lie down right after eating.
Alcohol and caffeine consumption. Drinking excessive amounts of alcohol can cause nausea and vomiting. People who only occasionally drink caffeine may feel nauseous when they have a cup of coffee. Caffeine withdrawal can also cause nausea.
Food poisoning. Most cases of food poisoning are caused by eating food contaminated with either bacteria or a virus, such as salmonella, listeria and E. Coli. In addition to nausea, symptoms may include fever, vomiting and diarrhea. (Learn about treating and preventing food poisoning)
Gastroenteritis, or the stomach flu, or another viral infection. In addition to nausea, symptoms may include a cough, runny nose, sneezing, stomachache, vomiting, diarrhea and fever. Antibiotics aren’t effective to treat viruses; rest and drink fluids.
Gallstones. Nausea is a common symptom of gallstones. A gallbladder attack occurs when gallstones block the bile ducts. In addition to nausea, symptoms of a gallbladder attack include pain in the upper right abdomen, fever, chills and vomiting. A low-fat diet is important for those with a history of gallstones. Try eliminating processed foods, fried foods and animal meats. Opt instead for lean proteins.
Medication side effects. Nausea may be a side effect of medications. Including pain medications, antibiotics, some blood pressure drugs, weight loss drugs, chemotherapy and medications administered after surgeries. Taking medication with food may help. If not, talk with your doctor about switching to a different medication.
Migraine headaches. People may feel nauseous before the headache starts or during the headache phase of a migraine. Ice packs, heating pads, naps and medications can help treat migraines – and ease nausea – once they start.
Pregnancy. Morning sickness is common during pregnancy, particularly in the first trimester. Sometimes, nausea is the first sign of pregnancy! Resting, eating blander foods and avoiding triggers can help ease morning sickness. Talk to your doctor if you want to try medications to combat nausea during pregnancy.
Any problem that affects the vestibular (balance) system. Air travel, going to a loud concert, some illness, and head injuries can disrupt our sense of balance and lead to nausea.
Still not sure what may be making you feel nauseous? Some people have chronic (lasting about four weeks or longer) conditions that may be leading to nausea.
Gastrointestinal conditions, such as untreated acid reflux, irritable bowel syndrome (IBS) and gastroparesis can all cause nausea. People with IBS may also have bloating, pain, constipation or diarrhea and appetite changes. People with gastroparesis – usually a complication of another illness, including diabetes – may have belly pain, bloating, vomiting and a feeling of fullness after eating only a little bit of food. Working with a primary care physician and/ or gastroenterologist can help patients manage these GI problems.
Neurologic conditions. Nausea can be a sign of vertigo, a condition in which people feel as if they or their surroundings are spinning. Nausea can also be a sign of a brain problem, including tumors. If nausea is accompanied by other neurologic symptoms such as dizziness, headaches, visual changes, feeling unsteady or weak, get checked by your doctor.
Endocrine or metabolic disorders. Nausea can be a symptom of hyperthyroidism or diabetes. A primary care physician and/ or endocrinologist can diagnose and treat these conditions.
Mental health conditions. Stress, anxiety and depression can lead to physical symptoms, including nausea. Mindfulness, meditation and other forms of stress reduction can help. If you need mental health support, please reach out for help.
Seeing Your Doctor
If you don’t know what is causing your nausea or if you are trying ways to feel better that aren’t working, reach out to your primary care physician. Also reach out if you are vomiting and showing signs of dehydration, such as decreased urination, have a fever above 100.4 degrees or are experiencing severe abdominal pain, vomiting blood or are lethargic. These symptoms are more serious and may require more urgent assessment. Getting an accurate diagnosis and treatment plan is vital to for your overall prognosis. If you are not sure, always reach out to your health care team for advice.