Nausea: causes, care and when to get help

Nausea is a feeling of sickness that can come from the stomach, inner ear, brain, medicines or many medical conditions.

You may have an unsettled stomach, reduced appetite, extra saliva, sweating, or the sense that you might vomit. It can be brief or continue in waves, and may occur with abdominal discomfort, headache, dizziness, diarrhoea or fever.

Seek urgent medical assessment for nausea with severe or worsening abdominal pain, chest pain, confusion, a severe headache, a stiff neck, trouble breathing, vomiting blood, black stools, or signs of dehydration such as very little urine and marked dizziness. Get prompt advice if vomiting prevents you from keeping fluids down, or if nausea follows a head injury.

Nausea has many possible causes, and the order below is not a ranking. Digestive causes include acid reflux, gastritis, gastroenteritis, food poisoning, gallstones, hepatitis A and pancreatitis. Motion sickness and altitude sickness can affect balance signals. Migraine can bring nausea with light sensitivity or headache, while heat exhaustion and hypoglycaemia can cause sweating, weakness or shakiness.

A clinician will ask when symptoms began, what brings them on, whether vomiting occurs, recent food or travel, medicines, pregnancy possibility, alcohol use and accompanying symptoms. Examination may include checking hydration, temperature, abdomen, balance and neurological signs. Depending on the pattern, tests can include urine testing, blood tests, a pregnancy test, stool testing or imaging.

Small frequent sips of water or oral rehydration fluid can help replace losses. Choose bland foods when you feel able, and avoid alcohol, heavy meals and strong smells if they worsen symptoms. A clinician may recommend an anti-sickness medicine or treat the underlying problem, such as reflux, migraine, infection, low blood glucose or gallbladder disease. Do not stop prescribed medicines without advice.

Notice your personal triggers, including particular foods, travel, heat, skipped meals or migraine warning symptoms. Eat regular meals if low blood glucose is a concern, take breaks from heat, and use food hygiene when preparing or storing food. For travel-related nausea, face forward, focus on a stable point outside and discuss preventive medicines with a pharmacist or clinician before a journey.