Chronic Nausea: Causes and Solutions for Persistent Discomfort

Chronic nausea and a persistent urge to vomit?

Since around the second year of junior high, I have had issues with my stomach, often feeling nauseous.
Now, in my third year of college, the situation has worsened, and it has gradually become a daily occurrence.
I feel nauseous even on an empty stomach, and after eating, I still experience nausea.
The frequency of nausea is high; I often recognize that I am hungry, but when food is in front of me, I have no appetite at all.
Sometimes I can eat a lot, while other times, I can only take one bite before losing my appetite completely.
In the morning, if I feel nauseous while brushing my teeth, I can't stop until I vomit some stomach acid.
I experience stomach pain less frequently, and when it does occur, it doesn't last long.
I usually avoid sweets and fried foods, and I am afraid to eat spicy food.
I also feel a bit scared about undergoing an endoscopy.

Murakami, 20~29 year old female. Ask Date: 2016/04/01

Dr. Lin Minghui reply Gastroenterology and Hepatology

There are many causes of long-term nausea and vomiting, including gastrointestinal diseases, peritoneal diseases, medications, infections, endocrine disorders, central nervous system diseases, psychiatric disorders, and inner ear imbalances.
If symptoms persist and there is weight loss or malnutrition, it is advisable to seek medical attention for appropriate examinations.
Wishing you good health.

Reply Date: 2016/04/01

More Info

Chronic nausea can be a perplexing and distressing condition, especially when it becomes a daily occurrence. Your experience of persistent nausea, which has escalated since your early teenage years, is concerning and warrants a thorough evaluation. There are several potential causes for chronic nausea, and understanding these can help guide you toward effective management and relief.

Possible Causes of Chronic Nausea
1. Gastroesophageal Reflux Disease (GERD): This condition occurs when stomach acid frequently flows back into the esophagus, leading to irritation and symptoms such as nausea, especially after eating. The fact that you experience nausea both on an empty stomach and after meals could suggest a reflux issue.

2. Gastroparesis: This is a condition where the stomach takes too long to empty its contents. Symptoms include nausea, vomiting, and feeling full after eating only a small amount of food. It can be caused by diabetes, certain medications, or idiopathic reasons.

3. Functional Dyspepsia: This is a common disorder characterized by chronic pain or discomfort in the upper abdomen, often accompanied by nausea. It can be triggered by stress, dietary habits, or gastrointestinal motility issues.

4. Anxiety and Stress: Psychological factors can significantly impact gastrointestinal function. Anxiety can lead to increased stomach acid production and altered gut motility, resulting in nausea.

5. Medications: Some medications can cause nausea as a side effect. If you are taking any medications, it’s worth discussing with your healthcare provider to see if they could be contributing to your symptoms.

6. Dietary Factors: Although you mentioned avoiding sweet, fried, and spicy foods, it’s essential to consider other dietary habits. Eating large meals or consuming foods that are hard to digest can exacerbate nausea.

7. Underlying Medical Conditions: Conditions such as peptic ulcers, pancreatitis, or even more serious issues like gastrointestinal obstructions can lead to chronic nausea.

Solutions and Management Strategies
1. Consult a Gastroenterologist: Given your symptoms, it would be beneficial to consult a gastroenterologist who can perform necessary evaluations, including an upper endoscopy (gastroscopy) if deemed appropriate. While you mentioned feeling apprehensive about this procedure, it can provide valuable insights into the state of your gastrointestinal tract.

2. Dietary Modifications: Keeping a food diary may help identify any specific triggers. Smaller, more frequent meals can sometimes alleviate symptoms. Incorporating bland foods that are easier to digest, such as bananas, rice, applesauce, and toast (the BRAT diet), may also help.

3. Hydration: Staying hydrated is crucial, especially if you are experiencing nausea that leads to vomiting. Sipping on clear fluids or electrolyte solutions can help maintain hydration levels.

4. Medications: Over-the-counter anti-nausea medications, such as meclizine or dimenhydrinate, may provide temporary relief. However, it’s essential to consult with a healthcare provider before starting any new medication.

5. Stress Management: Techniques such as mindfulness, yoga, or cognitive-behavioral therapy (CBT) can help manage anxiety and stress, which may, in turn, alleviate nausea.

6. Regular Follow-ups: Regular follow-ups with your healthcare provider are essential to monitor your symptoms and adjust treatment plans as necessary.

Conclusion
Chronic nausea can significantly impact your quality of life, and it’s essential to approach this issue comprehensively. By consulting with a specialist, exploring dietary changes, and considering psychological factors, you can work towards finding relief. Remember, you are not alone in this, and there are effective strategies to help manage your symptoms. Don’t hesitate to seek support from healthcare professionals who can guide you through this process.

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