Why You May Have Chronic Nausea

Chronic nausea is when queasiness is constant or comes and goes for several days or more. It can be a symptom of a number of health conditions, like peptic ulcer disease or gastroesophageal reflux disease (GERD). People who are pregnant may also experience chronic nausea, better known as morning sickness.

This is different from acute nausea, like what happens when you suddenly don't feel well due to motion sickness or a virus. Chronic nausea can be a symptom of an underlying issue that may need treatment.

Chronic nausea may not come with vomiting. But when it does, potentially serious issues like dehydration can occur.

Common Causes of Chronic Nausea

In some cases, chronic nausea may come on after a triggering factor, such as eating, only to improve and then come on again after the next meal.

Some common causes of chronic nausea include:

• Pregnancy
• Gallstones
• GERD
• Migraine
• Peptic ulcers
• Central nervous system disorders
• Hepatitis
• Hiatal hernia
• Inflammatory bowel disease (IBD)
• Intestinal obstruction
• Pancreatitis

Pregnancy

Chronic nausea is common in pregnancy, especially in the first trimester, and is called “morning sickness” even though it can last all day. Often, nausea comes on in the middle of the first trimester and is gone by the second. But some people have nausea their entire pregnancy or it comes back towards the end.

When nausea is severe and is accompanied by vomiting to the point where keeping any food or water down is challenging, this could be a condition called hyperemesis gravidarum. 

Gallstones

Gallstones are common, especially in women, who are twice as likely to have stones as men. Gallbladder stones might cause no symptoms but may also cause pain in the back, shoulder, or upper abdomen, and nausea and vomiting.

Symptoms might be worse after eating, especially when eating a meal containing high levels of fat. Gallstones might be diagnosed with one of several different imaging tests and are most often treated with gallbladder removal.

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is a common condition that occurs when stomach contents come back up into the esophagus. This can cause symptoms of heartburn, regurgitation, and nausea.

Symptoms might be worse after eating or at night after lying down. The nausea may linger, especially if stomach acid backs up into the throat.

In many cases, GERD is treatable with over-the-counter or prescription medication (including antacids, histamine-2 receptor antagonists, H2RAs; and proton pump inhibitors, PPIs).

Lifestyle changes such as losing weight and sleeping with the head elevated, as well as avoiding potential triggers for symptoms (such as smoking, alcoholic beverages, coffee, chocolate, fatty foods, and fried foods) may also help.

Migraine

Migraine headaches might cause nausea either before the headache comes on or during the headache. Diagnosing headaches can be complex because there are several different types of migraines that have different symptoms. Treatment may involve both lifestyle changes and medications.

Peptic Ulcer

A peptic ulcer is when there are sores in the stomach, small intestine, or esophagus. In most cases, peptic ulcers are caused by a bacteria called Helicobacter pylori (H pylori). Another cause of peptic ulcers is the use of non-steroidal anti-inflammatory medications (NSAIDs) such as ibuprofen, but this is not as common.

Peptic ulcers often cause pain or discomfort, but may also cause nausea, vomiting, loss of appetite, weight loss, and feeling full after small meals. For ulcers caused by H pylori, antibiotics will be prescribed, along with other medications to help alleviate symptoms.

Central Nervous System Disorders

Conditions that affect the nervous system such as intracranial hemorrhage or infections may be associated with nausea. These conditions are serious and are usually accompanied by symptoms of confusion, dizziness, or changes in memory.

If these symptoms occur and a hemorrhage or an infection like meningitis are suspected, they are a reason to seek medical attention right away.

Hepatitis

Hepatitis is an inflammation of the liver and can occur as a result of an infection with a virus or from autoimmune hepatitis or alcoholic hepatitis. Hepatitis can be acute or chronic and may cause nausea along with jaundice, fever, headache, and joint pain.

Treatment will depend on the cause of hepatitis but will range from lifestyle changes to antiviral medications to steroids.

Hiatal Hernia

A hiatal hernia is when there’s a weak point in the abdominal wall and the stomach pushes through it and up into the chest. Hernias may cause symptoms of reflux as well as pain or discomfort and in some cases, there may also be nausea.

Small hernias might not be noticeable, cause any symptoms, or even require treatment, but larger ones may require surgery.

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) includes Crohn’s disease, ulcerative colitis, and indeterminate colitis, which are diseases of the digestive tract. These diseases cause inflammation in various parts of the digestive system and can be associated with chronic nausea.

In some cases, nausea might be an adverse effect of medications or be the result of a complication (such as a bowel obstruction). Treatment will depend on the cause of nausea and might also include effective treatment of the inflammation caused by the IBD. 

Intestinal Obstruction

An obstruction is when the small or large intestine gets blocked. A blockage could be caused by one of several reasons, including scar tissue or a kink or twist in the intestine.

Usually, the most prominent symptom of an intestinal obstruction is pain, but nausea and vomiting can also happen in some cases. Obstructions are more common in people who have IBD (Crohn’s disease in particular) but they can happen to anyone.

Pancreatitis

The pancreas is an organ that releases enzymes for digestion into the stomach and hormones into the bloodstream. Pancreatitis is when the pancreas becomes inflamed, which can lead to symptoms of pain that gets worse after eating, fever, nausea, and vomiting.

Pancreatitis is rare and people who have the condition are often quite sick because it is a serious condition. Treatment will depend on what is causing pancreatitis.

Chronic Nausea Without a Known Cause

Nausea that persists without a known cause is called idiopathic chronic nausea. In some cases, it might also be called functional nausea.

This doesn’t mean that there isn’t a cause or that one won’t become clear in the future. It simply means the reason for the nausea is not clear at the moment.

When to See a Healthcare Provider

Call your doctor if your nausea has lasted more than one week, if you might be pregnant, or if you've had vomiting or diarrhea for more than 24 hours.

Nausea isn’t typically an emergency. But call a doctor right away in the case of:

• Black or tarry stools
• Blood in the stool or vomit
• Confusion
• Dizziness
• High fever
• Severe abdominal pain
• Signs of dehydration 
• Vomiting that won’t stop

Nausea is a nonspecific symptom. It might be challenging to pin down exactly what’s causing it. In many cases, related symptoms (such as pain, fever, or vomiting) can give a physician more insight into what might be causing your nausea.

Be sure to share any such details with your healthcare provider.

Treating Chronic Nausea

A big part of chronic nausea treatment is addressing the underlying cause, if known. Treatment options that are specific to the causes covered in this article are described above.

That aside, the following strategies can help ease persistent queasiness and help prevent vomiting, no matter the cause:

• Taking antihistamines or antiemetics (on the advice of a physician)
• Taking motion sickness medication, such as Dramamine (on the advice of a physician)
• Keeping the room temperature cool
• Taking deep, even breaths
• Eating foods that are less likely to cause nausea (crackers, bread, rice)
• Eating foods containing ginger or sucking on ginger candy
• Taking sips of cold water, ginger ale, or tea
• Opting for smaller, more frequent meals
  

A Word From Verywell

Having nausea that comes or goes or won't let up is a reason to schedule an appointment with a physician. When nausea is accompanied by red flag symptoms such as severe pain or vomiting or blood in the vomit or stool, seek an evaluation right away.

Common conditions that are associated with nausea might be treated in various ways, but strategies like eating ginger and deep breathing might also help you cope with nausea in the short term.