Chronic Nausea: Causes and Remedies

Chronic nausea occurs when queasiness is constant or comes and goes for several days or longer.

It can be a symptom of multiple health conditions, from inflammatory bowel disease (IBD) to anxiety disorders. Chronic nausea during pregnancy (morning sickness) is also common.

Constantly feeling nauseated is different from acute nausea, which may come on suddenly during a viral or bacterial infection or when you have motion sickness.

What Is Chronic Nausea?

Chronic or constant nausea is defined as feeling nauseated for four weeks or more. Often the sensation comes and goes and the intensity varies, but the relief doesn't last and the nausea keeps returning.

While you may feel like you are going to throw up, you may never vomit. In situations when vomiting does occur, it could cause dehydration or other potential complications.

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.

Pregnancy

Chronic nausea is common in pregnancy. So-called "morning sickness” can last all day and during the entire pregnancy, although it's most common during the first three months. While not harmful to the baby, it can be difficult to deal with.

Hyperemesis gravidarum describes a condition in which nausea and vomiting can be so severe that it is difficult to keep down food or water. This extreme, persistent condition can lead to weight loss, lightheadedness, and dehydration.

Treatment involves antiemetics (anti-nausea medication) and hospitalization so fluids and nutrients can be administered intravenously.

Gallbladder Disease

Gallbladder disease includes infections and blockages that affect the gallbladder, the digestive organ that releases bile to break down food. Gallstones are a common nausea-causing issue.

Gallstones may cause pain in the back, shoulder, or upper abdomen, nausea, and vomiting. These symptoms worsen after eating, especially high-fat foods.

Gallstones might be diagnosed with one of several imaging tests and are most often treated with gallbladder removal.

Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease is a common condition that occurs when stomach contents come back up into the esophagus.

Common symptoms are heartburn, regurgitation, and nausea. Other symptoms may include:

• Pain in the middle of the chest
• Sore throat and/or trouble swallowing (dysphagia)
  
• Cough and/or shortness of breath
  

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

GERD is treatable with over-the-counter (OTC) or prescription medication. Lifestyle changes and avoiding potential triggers (e.g., smoking, alcohol, fatty foods) also help.

Gastroparesis

Gastroparesis is a disorder in which the nerves in the stomach are damaged or stop working, which causes the digestive system to take a long time to move food along.

The delays in emptying the stomach lead to chronic nausea along with:

• Heartburn
• Loss of appetite
• Vomiting
• Feeling full after small meals
• Weight loss
• Abdominal bloating
  

Chronic Migraine

Chronic migraine is diagnosed when someone experiences at least 15 migraine attacks per month for at least three months. Migraine headaches might cause nausea either before or during the headache.

Treatment may involve both lifestyle changes and medications.

Peptic Ulcer

A peptic ulcer happens 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) or the use of non-steroidal anti-inflammatory medications (NSAIDs).

In addition to pain, peptic ulcers may cause nausea and:

• Vomiting
• Loss of appetite
• Weight loss
• Feeling full after small meals

Ulcers caused by H pylori are treated with antibiotics, medications, and lifestyle changes. Rarely, surgery may be necessary.

Central Nervous System Disorders

Conditions that affect the nervous system such as stroke (intracranial hemorrhage), neurological infections, and brain tumors may be associated with chronic nausea.

Along with headache pain and nausea, symptoms can include:

• Confusion and/or memory loss
• Dizziness or loss of consciousness
• Pain, tingling, or numbness in arms or legs
• Muscle weakness or paralysis

Disorders of the nervous system are serious. If these symptoms occur, seek medical attention right away.

Hiatal Hernia

A hiatal hernia occurs 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 acid reflux as well as pain or discomfort. In some cases, there may also be nausea.

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

Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease includes Crohn’s disease, ulcerative colitis, and indeterminate colitis.

These diseases cause inflammation in the digestive system and can be associated with chronic nausea. Nausea may also result from medications used to treat IBD or result from a complication (e.g., a bowel obstruction).

Treatment will depend on which disease is causing nausea.

Intestinal Obstruction

A bowel obstruction occurs when the small or large intestine gets blocked. A blockage could be caused by several things, 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 common complications of IBD and Crohn’s disease, but they can happen to anyone.

Pancreatitis

The pancreas is an organ that releases digestive enzymes into the stomach and hormones into the bloodstream.

Pancreatitis occurs when the pancreas becomes inflamed, which can lead to symptoms of chronic nausea and:

• Pain that gets worse after eating
• Fever
• Vomiting

Pancreatitis can be acute or chronic. Treatment both types may include:

• A hospital stay to treat dehydration with intravenous (IV) fluids
• Pain medication and sometimes antibiotics
• Feeding tube or IV nutrition or a low-fat diet

Surgery and other procedures may also be necessary. Chronic cases may need additional treatment for coexisting conditions and vitamin supplementation.

Postural Tachycardia Syndrome (POTS)

POTS is a blood circulation disorder characterized by a dramatic increase in heart rate within minutes of standing.

Symptoms include:

• Lightheadedness
• Headaches
• Blurred vision
• Palpitations

These symptoms are worse while standing and improve when seated or lying down.

Gastrointestinal symptoms related to POTS include:

• Chronic nausea
• Vomiting
• Bloating
• Diarrhea or severe constipation

Treatment for gastrointestinal issues related to this condition includes dietary modifications, medications, and surgical procedures.

Anxiety Disorders

Anxiety disorders are mental health conditions in which someone experiences excessive fear and distress.

Anxiety can cause physical as well as mental or emotional symptoms. Several types of anxiety disorders, including generalized anxiety disorder, cause chronic nausea and other digestive issues.

Additional symptoms may include:

• Restlessness, irritability, and/or difficulty concentrating
• Trouble sleeping
  
• Fatigue
• Headaches, muscle aches
• Sweating
• Diarrhea

Home Remedies for Constant Nausea

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

No matter the cause, these strategies may also help ease persistent queasiness and prevent vomiting:

• Try breathwork.
• Eat bland foods that are less likely to cause nausea (e.g., crackers, bread, bananas).
• Avoid spicy, fried, fatty, sweet, or processed foods.
• Stay hydrated by sipping cold water, ginger ale, or tea.
• Avoid caffeinated and carbonated beverages (e.g., coffee, soda).
• Eat ginger or try it in capsule form.
  
• Try OTC antacids, bismuth subsalicylate, and motion sickness medications.
• Avoid being too full or having an empty stomach by eating smaller, more frequent meals.
  
• Take peppermint orally or try as an aromatherapy.
• Avoid physical activity after eating; instead, recline with your head elevated about 12 inches above your feet.
  
• Try to eat when you feel least nauseous.
• Try acupressure by pressing your middle and index fingers between the two large tendons on the inside of your wrist. Anti-nausea wristbands that apply this pressure are sold over the counter.

When to See a Healthcare Provider

Consult your healthcare provider if:

• Nausea has lasted more than one week.
• You might be pregnant.
• Vomiting or diarrhea has lasted more than 24 hours.

Talk to your healthcare provider before taking motion sickness medication, antihistamines, or antiemetics.

Nausea isn’t typically an emergency. But consult a healthcare provider right away if you have:

• Signs of dehydration
• Dizziness
• High fever
• Confusion
• Severe abdominal pain 
• Vomiting that won’t stop
• Black or tarry stools
• Blood in stools or vomit
  
• An atypical headache (such as "the worst headache of your life")

Chronic nausea is a nonspecific symptom and it may be challenging to pin down exactly what’s causing it.

In many cases, other symptoms (such as pain, fever, or vomiting) will help to indicate a cause. So, share all your symptoms—even those that don’t seem related—along with recent injuries, vaccinations, and any medications and supplements you are taking.

Summary

Chronic nausea can be caused by a variety of underlying conditions that result in constantly feeling like you are going to throw up. This sensation persists for four or more weeks.

Having nausea that comes or goes or won't let up is a reason to schedule an appointment with a healthcare provider. When nausea is accompanied by red flag symptoms such as severe pain, dehydration, or blood in 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 may help you cope with nausea in the short term.