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Nausea

Nausea is an unpleasant, subjective sensation often described as feeling sick to one's stomach, associated with the imminent urge to vomit, though vomiting does not always follow. It functions primarily as a protective mechanism, signaling the body to avoid or expel potentially harmful substances such as toxins or pathogens.^[1] This symptom is highly prevalent in the general population, with a point prevalence of approximately 12%, and it can manifest alone or alongside other autonomic responses like increased salivation, sweating, pallor, or tachycardia.^[2]^[3] The causes of nausea are diverse and span multiple organ systems, reflecting its role as a nonspecific symptom rather than a disease itself. Common triggers include gastrointestinal issues such as viral gastroenteritis, food poisoning, or motion sickness; systemic factors like pregnancy (affecting up to 70-80% of pregnant individuals), medications (e.g., chemotherapy or opioids), and metabolic disturbances (e.g., diabetic ketoacidosis); as well as central nervous system conditions including migraines, vestibular disorders, or increased intracranial pressure.^[4]^[5]^[6] Less frequently, nausea signals serious underlying pathology, such as appendicitis, myocardial infarction, or meningitis, necessitating prompt medical evaluation when accompanied by severe pain, dehydration, or neurological symptoms.^[7] Pathophysiologically, nausea arises from complex interactions between peripheral and central neural pathways, primarily involving the gastrointestinal tract, chemoreceptor trigger zone in the brainstem, and vomiting center.^[1] Key neurotransmitters implicated include serotonin (5-HT3 receptors), dopamine (D2 receptors), histamine (H1 receptors), and substance P (NK1 receptors), which mediate signals from visceral afferents and the central nervous system.^[8] This multisynaptic network explains the symptom's responsiveness to a variety of antiemetic therapies targeting specific receptors, though its subjective nature complicates precise measurement and treatment.^[9] Management of nausea focuses on addressing the underlying cause while providing symptomatic relief through nonpharmacologic measures—such as dietary modifications (e.g., bland foods, small frequent meals), hydration, and avoidance of triggers—and pharmacologic interventions like antihistamines (e.g., meclizine for motion sickness), anticholinergics, or serotonin antagonists (e.g., ondansetron for chemotherapy-induced nausea).^[10] In severe or refractory cases, such as hyperemesis gravidarum or postoperative nausea, multidisciplinary approaches including hospitalization for intravenous fluids and specialized antiemetics may be required.^[11] Early recognition and tailored therapy are essential to prevent complications like electrolyte imbalances or malnutrition.^[12]

Definition and Presentation

Definition

Nausea is defined as an unpleasant, subjective sensation of unease or discomfort in the upper abdomen, often accompanied by an urge to vomit, but without the actual expulsion of gastric contents.^[13] This distinguishes it as a distinct symptom from the physical act of vomiting, emphasizing its primarily sensory and emotional character, which can vary in intensity and may occur independently of emesis.^[3] The term "nausea" originates from the ancient Greek word "nausia," meaning seasickness, derived from "naus" (ship), reflecting its initial association with motion-induced discomfort at sea.^[14] Over time, its usage evolved in Latin and English medical contexts to encompass a broader range of gastrointestinal disturbances, transitioning from a specific nautical affliction to a general descriptor of stomach-related queasiness in clinical practice by the early modern period.^[15] Nausea differs from vomiting (emesis), which involves the forceful, coordinated expulsion of stomach contents through retching and abdominal contractions, and from regurgitation, the passive reflux of esophageal or gastric material without nausea or effort.^[3] Often serving as a prodromal symptom, nausea signals the potential onset of vomiting but can persist without progression.^[16] Common triggers include motion sickness and pregnancy, though these are explored in detail elsewhere.^[17] Chronic nausea is characterized, per the 2025 European Guideline on Chronic Nausea and Vomiting, as persistent or recurrent episodes lasting more than 4 weeks without an identifiable acute cause, warranting targeted diagnostic evaluation.^[18]

Symptoms and Signs

Nausea is primarily characterized by a subjective sensation of queasiness or gastric discomfort, often accompanied by an urge to vomit, aversion to food smells or tastes, and a general feeling of unease in the upper abdomen.^[1] These symptoms can vary in intensity and may not always progress to actual vomiting.^[16] Common physical signs observed during nauseous episodes include pallor, profuse sweating, increased salivation, and dizziness, which reflect activation of the autonomic nervous system.^[1] Associated autonomic responses often involve tachycardia (increased heart rate), fluctuations in blood pressure, and alterations in gastrointestinal motility, such as delayed gastric emptying, contributing to the sensation of fullness or bloating.^[19] Nausea presentations differ between acute and chronic forms; acute nausea typically has a sudden onset, lasting minutes to hours and frequently linked to immediate triggers, while chronic nausea is intermittent or persistent over weeks to months, potentially worsening quality of life.^[3] In chronic cases, meal-related patterns are common, with symptoms often emerging within 60 minutes postprandially, as noted in recent gastroenterology analyses of functional disorders.^[20] Prolonged nausea can lead to significant functional impacts, including fatigue from disrupted sleep and daily activities, as well as risks of dehydration and electrolyte imbalances if fluid intake is reduced due to ongoing aversion to eating or drinking.^[16]

Causes

Gastrointestinal Causes

Gastrointestinal causes of nausea primarily arise from disorders affecting the digestive tract, where irritation, inflammation, delayed emptying, infection, or obstruction disrupts normal gastric function and triggers emetic responses. These pathologies often involve direct stimulation of mechanoreceptors or chemoreceptors in the gut mucosa, leading to signals transmitted via the vagus nerve to the brainstem's nausea center. Common non-infectious conditions include gastritis, peptic ulcers, gastroesophageal reflux disease (GERD), and gastroparesis, each characterized by varying degrees of mucosal damage or motility impairment that provokes nausea, particularly in relation to meals. Gastritis, an inflammation of the stomach lining often caused by Helicobacter pylori infection, excessive alcohol, or nonsteroidal anti-inflammatory drugs, frequently presents with nausea alongside epigastric pain and bloating.^[21] The nausea in gastritis stems from gastric mucosal irritation, which can worsen after eating due to increased acid exposure. Peptic ulcers, erosions in the stomach or duodenal lining typically linked to H. pylori or NSAID use, also induce nausea, especially when ulcers bleed or obstruct gastric outflow, leading to a sensation of fullness and potential vomiting.^[22] GERD, involving recurrent acid reflux into the esophagus due to lower esophageal sphincter dysfunction, causes nausea through esophageal irritation and secondary gastric distension, often exacerbated by large or fatty meals. Gastroparesis, marked by delayed gastric emptying from impaired stomach muscle contractions—commonly due to diabetes or idiopathic factors—results in persistent nausea, early satiety, and bloating as undigested food accumulates.^[23] Infectious etiologies represent a major source of acute nausea from gastrointestinal invasion. Viral gastroenteritis, caused by pathogens like norovirus or rotavirus, leads to nausea through rapid onset of intestinal inflammation and fluid secretion, often accompanied by vomiting and diarrhea lasting 1-3 days.^[24] Bacterial food poisoning from Salmonella or Escherichia coli strains triggers nausea via enterotoxin production that disrupts gut epithelial integrity, causing abdominal cramps and watery diarrhea within hours of ingestion.^[25] Parasitic infections such as giardiasis, induced by Giardia lamblia from contaminated water, produce nausea alongside foul-smelling stools and flatulence due to malabsorption and small bowel inflammation, with symptoms persisting for weeks if untreated.^[26] Obstructive gastrointestinal issues further contribute to nausea by impeding the flow of contents through the digestive tract, resulting in distension and reflex emesis. Intestinal blockage, or small bowel obstruction from adhesions, hernias, or tumors, causes crampy pain and nausea as proximal bowel dilates with accumulated fluids and gas.^[27] Appendicitis, inflammation of the appendix often due to fecalith obstruction, manifests with nausea in up to 80% of cases, alongside right lower quadrant pain and low-grade fever, signaling potential perforation risk.^[28] Pancreatitis, acute or chronic inflammation of the pancreas from gallstones or alcohol, induces severe nausea through ileus—a temporary paralysis of bowel motility—and retroperitoneal irritation, with symptoms intensifying postprandially.^[29] Postprandial nausea, occurring specifically after meals, often links to bile reflux or small intestinal bacterial overgrowth (SIBO). Bile reflux, where duodenal bile backs into the stomach due to pyloric dysfunction or post-cholecystectomy changes, irritates the gastric mucosa and provokes nausea with a bitter taste, distinguishing it from acid reflux.^[30] SIBO, an excessive bacterial proliferation in the small intestine from motility disorders or structural abnormalities, generates nausea via fermentation of undigested carbohydrates, producing gas and toxins that ferment in the proximal gut.^[31] Recent 2025 reviews emphasize integrated approaches to meal-related nausea, incorporating motility assessments to address these gut-specific triggers beyond traditional antiemetics.^[32]

Systemic Causes

Systemic causes of nausea arise from disorders affecting multiple organ systems beyond the gastrointestinal tract, often involving metabolic derangements, neurological disturbances, cardiovascular instability, or widespread infections that disrupt homeostasis and activate emetic pathways. Examples include pregnancy (due to hormonal surges), uremia from renal failure (toxin buildup), and sepsis (systemic inflammation and hypoperfusion), which stimulate central emetic centers or visceral afferents.^[4]

Metabolic and Endocrine Causes

Uremia in chronic kidney disease manifests as persistent nausea due to the buildup of nitrogenous waste products that irritate the gastrointestinal mucosa and stimulate central emetic centers. Diabetic ketoacidosis (DKA), a complication of diabetes mellitus, commonly presents with nausea and vomiting driven by severe acidosis, dehydration, and electrolyte shifts that exacerbate systemic stress. Hypercalcemia, frequently linked to hyperparathyroidism or malignancy, induces nausea through direct effects on smooth muscle tone and neuronal excitability in the central nervous system. Adrenal insufficiency, as seen in Addison's disease, causes nausea via cortisol deficiency leading to hyponatremia, hypoglycemia, and hypotension that impair organ perfusion. Pregnancy, a common endocrine-related cause, introduces nausea (termed morning sickness) affecting 70-80% of pregnant individuals, peaking in the first trimester due to surges in human chorionic gonadotropin (hCG) levels produced by the placenta. In severe cases, hyperemesis gravidarum occurs in 0.3-3% of pregnancies, characterized by persistent vomiting leading to dehydration and weight loss, often requiring medical intervention like hospitalization and antiemetic therapy.^[33]^[34]

Neurological Causes

Migraines often accompany nausea, which affects up to 80% of patients and may result from trigeminovascular activation and serotonin dysregulation influencing the brainstem emetic nuclei.^[1] Vestibular disorders, including motion sickness and Meniere's disease, trigger nausea by generating sensory conflicts between the vestibular, visual, and proprioceptive systems, leading to activation of the vestibulo-autonomic pathway. Increased intracranial pressure from conditions like brain tumors or meningitis provokes nausea and vomiting, typically projectile, due to compression of the area postrema and distortion of cerebrospinal fluid dynamics.^[3]

Cardiovascular Causes

Myocardial infarction can elicit nausea as an atypical symptom, particularly in older adults and women, stemming from vagal stimulation and autonomic imbalance during acute ischemia.^[35] Congestive heart failure contributes to nausea through visceral congestion, reduced cardiac output, and secondary hepatic and renal dysfunction that amplify systemic toxin accumulation. Hypotension, whether acute from hypovolemia or chronic orthostatic, induces nausea via baroreceptor-mediated activation of the nucleus tractus solitarius, prompting compensatory autonomic responses.

Infectious and Systemic Causes

Sepsis, a life-threatening response to infection, frequently includes nausea as part of the cytokine storm and multi-organ hypoperfusion that heightens emetic sensitivity. Hepatitis, especially viral forms, leads to nausea from hepatocellular inflammation and impaired bilirubin metabolism, with some overlap to gastrointestinal manifestations. COVID-19 and its long-term sequelae often feature nausea, persisting in approximately 7-11% of cases as part of post-viral autonomic and inflammatory dysregulation noted in 2025 reviews.^[36] Chronic post-viral syndromes, including those following SARS-CoV-2, can sustain nausea through lingering immune activation, as highlighted in recent analyses of symptom persistence.^[37]

Iatrogenic and Psychological Causes

Iatrogenic causes of nausea arise from medical treatments and interventions, particularly those involving cytotoxic agents and analgesics. Chemotherapy, especially with highly emetogenic drugs like cisplatin, induces nausea in up to 80% of patients due to activation of central and peripheral emetic pathways.^[38] Radiation therapy targeting the brain, upper abdomen, or total body also triggers nausea in 40-80% of cases, often within hours of exposure, as radiation affects the gastrointestinal mucosa and chemoreceptor trigger zone.^[39] Opioid analgesics, such as morphine and oxycodone, commonly cause nausea through stimulation of the chemoreceptor trigger zone and delayed gastric emptying, affecting up to 25% of patients initiating therapy.^[40] Postoperative nausea and vomiting (PONV) represents a significant iatrogenic issue following general anesthesia, with an incidence of up to 30% when inhalational anesthetics like isoflurane are used without prophylaxis. PONV is exacerbated by opioids administered perioperatively and patient-specific factors such as female sex and non-smoking status, leading to prolonged recovery and increased healthcare costs.^[41] Certain antibiotics, including erythromycin, induce nausea via motilin receptor agonism that accelerates gastric motility, while non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can provoke it through mucosal irritation; recent pharmacotherapy guidelines from 2021 emphasize monitoring these effects in vulnerable populations.^[42]^[43] Psychological factors contribute to nausea through stress-mediated autonomic responses and underlying mental health conditions. Anxiety disorders often manifest with nausea due to heightened vagal tone and sympathetic activation, triggering the emetic reflex in response to perceived threats.^[44] Depression is associated with chronic nausea via altered serotonin signaling and hypothalamic-pituitary-adrenal axis dysregulation, while acute stress elicits it through cortisol surges that sensitize the brainstem vomiting center.^[45] In bulimia nervosa, nausea accompanies binge-purge cycles, stemming from gastric distension and electrolyte imbalances induced by self-induced vomiting.^[46]

Pathophysiology

Peripheral Mechanisms

Peripheral mechanisms of nausea primarily involve sensory afferents that detect peripheral stimuli and transmit signals to the central nervous system via the vagus nerve and other pathways. One key pathway originates from the gastrointestinal (GI) tract, where vagal afferents innervate the gut wall and respond to mechanical distension, inflammation, or chemical toxins. These afferents are activated when enterochromaffin cells in the intestinal mucosa release serotonin (5-HT) in response to luminal stimuli, such as bacterial toxins or mechanical stretch, which then binds to 5-HT3 receptors on the terminals of vagal afferent fibers. This activation generates action potentials that travel along the vagus nerve to initiate nausea signaling.^[47]^[48] Vestibular inputs contribute to nausea through the detection of motion imbalances by inner ear structures, transmitted via the eighth cranial nerve (vestibulocochlear nerve). The semicircular canals sense angular accelerations during head rotation, while the otolith organs (utricle and saccule) detect linear accelerations and static head tilts relative to gravity. In conditions like motion sickness, conflicting signals from these organs—arising from mismatched visual and vestibular cues—activate vestibular afferents that project to the brainstem, eliciting autonomic responses including nausea. This peripheral sensory conflict is a primary trigger for vestibular-induced emesis.^[49]^[50] Recent molecular studies from 2024 have elucidated the role of transient receptor potential vanilloid 1 (TRPV1) channels in visceral afferents as key mediators of nausea signaling. Expressed on vagal and spinal afferent neurons innervating the GI tract, TRPV1 channels are sensitized by inflammatory mediators or toxins, leading to calcium influx and subsequent release of substance P from afferent terminals. This neuropeptide amplifies nociceptive and emetic signals peripherally before central integration, highlighting TRPV1 as a potential therapeutic target for toxin- or inflammation-induced nausea. These insights build on earlier work but provide new evidence for TRPV1's involvement in substance P dynamics at peripheral sites.^[51]^[52]

Central Mechanisms

The nucleus tractus solitarius (NTS), located in the dorsal medulla oblongata, functions as the primary central relay for nausea and emetic signals. It integrates visceral afferents from the gastrointestinal tract via vagal and glossopharyngeal nerves, as well as chemosensory inputs from the area postrema (the chemoreceptor trigger zone, or CTZ), which detects blood-borne emetic toxins due to its location outside the blood-brain barrier. The CTZ, located in the area postrema of the medulla oblongata, serves as a critical interface for nausea induction. This circumventricular organ lacks a complete blood-brain barrier, allowing it to directly sense blood-borne emetogens, such as chemotherapy agents like cisplatin or opiates. Upon detection, the CTZ neurons release neurotransmitters including dopamine and substance P, which relay emetic signals to adjacent vomiting centers. This mechanism is particularly relevant in systemic toxicities where circulating toxins bypass GI barriers to provoke nausea. From the NTS, excitatory projections extend to the vomiting center in the retrofacial nucleus of the medullary reticular formation, coordinating motor outputs for emesis, while also activating autonomic responses such as salivation and sweating. This relay role positions the NTS as a critical hub for modulating the intensity and progression of nausea into vomiting.^[47]^[53]^[1]^[54] Several neurotransmitters mediate signaling within the NTS and CTZ, facilitating the transmission and amplification of nauseogenic stimuli. Dopamine exerts pro-emetic effects primarily through D2 receptors in these regions, contributing to nausea from dopaminergic agonists or vestibular disturbances. Serotonin, via 5-HT3 receptors in the CTZ and 5-HT4 receptors in the NTS, relays signals from enterochromaffin cells and is a key mediator in chemotherapy-induced nausea. Histamine acts on H1 receptors in the NTS and CTZ to promote motion sickness-related nausea, while substance P binds NK1 receptors in both areas to propagate emetic reflexes from various triggers, including radiation and opioids. These neurotransmitter systems not only drive the central coordination of nausea but also serve as primary targets for antiemetic pharmacotherapy.^[47]^[51] Cortical and limbic structures process the conscious perception and emotional dimensions of nausea, transforming brainstem signals into subjective discomfort. The anterior insula integrates interoceptive cues to generate the core sensory experience of queasiness, while the anterior cingulate cortex contributes to the motivational and attentional aspects, often correlating with nausea severity in functional imaging studies. Limbic involvement, particularly through connections to the amygdala and orbitofrontal cortex, heightens the aversive and anxiety-like components, amplifying emotional responses that can exacerbate or prolong nausea episodes. These higher-order pathways underscore nausea as a multifaceted phenomenon beyond mere reflex.^[55]^[56] Advances in neural circuit mapping have revealed specific pathways involving the NTS and parabrachial nucleus in emetic responses. In 2024 optogenetic studies using rodent models, calbindin1-positive (Calb1+) neurons in the NTS projecting to the parabrachial nucleus were found to be activated by emetic toxins like cereulide and critical for both nausea and retching behaviors, as assessed by behavioral analyses. This NTS-parabrachial circuit, involving calcitonin gene-related peptide (CGRP) neurons in the parabrachial nucleus, contributes to toxin-induced nausea and emetic reflexes, offering insights into circuit-specific interventions for nausea and vomiting.^[57]

Diagnosis

History and Physical Examination

The evaluation of nausea begins with a detailed history to characterize the symptom's onset, duration, and pattern, which helps differentiate acute from chronic presentations and guide further assessment. Acute nausea and vomiting typically lasts one month or less, often linked to infectious or self-limited causes, while chronic nausea persists for more than one month or recurs over a longer period.^[58] Key historical elements include the timing of symptoms, such as postprandial onset suggesting gastroparesis or gastroesophageal reflux, or cyclical patterns indicative of conditions like cyclic vomiting syndrome. Severity should be quantified using validated tools like the Rhodes Index of Nausea, Vomiting, and Retching (Rhodes INVR), an eight-item self-report scale assessing occurrence, amount, and distress from nausea, vomiting, and retching on a 0-4 Likert scale, with higher scores reflecting greater intensity.^[59] Alleviating and aggravating factors, such as relief with antacids or worsening with fatty meals, are elicited, alongside associated symptoms like abdominal pain, diarrhea, weight loss, or headache, which may point to underlying gastrointestinal or systemic issues.^[10] Red flags in the history warrant urgent evaluation to rule out serious etiologies. These include projectile vomiting, which may indicate increased intracranial pressure; unexplained weight loss exceeding 10% of body weight; persistent or severe headache; or neurological symptoms such as confusion, vision changes, or focal deficits suggesting central nervous system involvement.^[10] Other concerning features encompass signs of dehydration (e.g., reduced urine output), fever, or a history of recent chemotherapy, radiation, or medication changes that could precipitate iatrogenic causes. A thorough dietary history is essential, documenting intake patterns, food intolerances, and relation to symptom triggers, as emphasized in recent guidelines for identifying functional or postprandial components.^[18] The physical examination complements the history by identifying objective signs of underlying pathology or complications. Vital signs are assessed for tachycardia, hypotension, or orthostasis indicating dehydration or autonomic dysfunction. Abdominal examination involves inspection for distension, auscultation for bowel sounds, and palpation for tenderness, guarding, rigidity, or masses, which could signal peritonitis or obstruction. Neurological evaluation includes testing for vestibular function through gait, nystagmus, or positional changes to detect balance issues, and a general exam screens for jaundice, cachexia, or lymphadenopathy.^[58] In chronic cases, the 2025 European Guideline on Chronic Nausea and Vomiting references Rome IV criteria for chronic nausea and vomiting syndrome during evaluation, defined as bothersome nausea and/or vomiting occurring at least once per week on average during the previous 3 months, with onset at least 6 months before diagnosis, not solely postprandial, without predominant vomiting or evidence of organic disease.^[18]^[60] This structured approach ensures red flags are promptly addressed while focusing on pattern recognition for targeted diagnosis.

Diagnostic Tests

Diagnostic tests for nausea are selected based on the patient's history and physical examination to identify or exclude underlying causes, providing objective evidence beyond clinical assessment. Laboratory evaluations typically begin with basic blood tests to detect common systemic abnormalities contributing to nausea. A complete blood count (CBC) is performed to evaluate for anemia, which may indicate gastrointestinal bleeding, or leukocytosis suggesting infection. Electrolyte panels assess for imbalances such as hyponatremia or hypokalemia, often resulting from vomiting-induced losses. Liver function tests and renal function assessments, including serum creatinine and blood urea nitrogen, help rule out hepatic or renal disorders that can manifest as nausea. In women of childbearing age, a urine or serum pregnancy test is essential to exclude pregnancy as a cause.^[61]^[58] Imaging studies are indicated when structural or obstructive pathologies are suspected. Abdominal ultrasound or computed tomography (CT) scans are used to detect obstructions, gallstones, or appendicitis in the gastrointestinal tract. Upper endoscopy (esophagogastroduodenoscopy) visualizes the upper gastrointestinal mucosa for ulcers, erosions, or malignancies, while colonoscopy may be employed for lower tract evaluation in cases with associated diarrhea or bleeding. For suspected central nervous system involvement, such as in migraines or tumors, magnetic resonance imaging (MRI) of the brain is recommended.^[58]^[10] Specialized functional tests target motility and secretion disorders in persistent or chronic nausea. Gastric emptying scintigraphy measures the rate of solid or liquid emptying from the stomach, confirming gastroparesis when delayed. Esophageal pH monitoring, often combined with impedance, quantifies acid reflux episodes in suspected gastroesophageal reflux disease (GERD). The 2025 European Guideline on Chronic Nausea and Vomiting recommends antroduodenal manometry to assess for underlying motility disorders like intestinal pseudo-obstruction following exclusion of mechanical obstruction.^[32]^[10]^[62]

Management

Pharmacological Treatments

Pharmacological treatments for nausea focus on antiemetic agents that target specific neurotransmitter receptors and pathways to alleviate symptoms across various etiologies. These medications are selected based on the underlying mechanism, with combinations often used for enhanced efficacy, particularly in high-risk scenarios like chemotherapy-induced nausea and vomiting (CINV).^[63] Serotonin (5-HT3) receptor antagonists, such as ondansetron, are first-line agents for acute CINV and postoperative nausea and vomiting (PONV), working by blocking serotonin release in the gut and central nervous system to prevent emetic signals. Ondansetron is typically administered at 8-32 mg orally or intravenously before emetogenic chemotherapy, achieving complete response rates of up to 75% in acute phases when combined with other agents. Other 5-HT3 antagonists like granisetron and palonosetron offer similar efficacy, with palonosetron noted for its longer half-life and better control of delayed nausea.^[64]^[38]^[65] Neurokinin-1 (NK1) receptor antagonists, including aprepitant, are particularly effective for preventing delayed CINV, targeting substance P in the brainstem emetic center to reduce nausea persisting beyond 24 hours post-chemotherapy. Aprepitant is given as a 125 mg oral dose on day 1 followed by 80 mg on days 2-3, often in combination with 5-HT3 antagonists and dexamethasone, improving complete response rates by 20-30% in highly emetogenic regimens compared to 5-HT3 therapy alone. Fosaprepitant, an intravenous prodrug, provides equivalent efficacy for patients unable to take oral medications.^[66]^[67] Corticosteroids like dexamethasone are adjunctive therapies that modulate inflammatory pathways and enhance antiemetic effects, commonly used in CINV and PONV prophylaxis at doses of 8-20 mg intravenously pre-treatment. Their mechanism involves prostaglandin inhibition and possible direct central antiemetic action, with studies showing a 25-40% reduction in nausea incidence when added to 5-HT3 antagonists. Dexamethasone is particularly valuable for delayed phases but requires caution in patients with diabetes due to hyperglycemia risks.^[68]^[69] Anticholinergics, such as scopolamine, are indicated for motion sickness-related nausea, acting by blocking muscarinic receptors in the vestibular system and gastrointestinal tract to dampen afferent signals. Transdermal scopolamine patches (1.5 mg over 72 hours) prevent nausea in 60-80% of susceptible individuals during travel, though side effects like dry mouth and drowsiness limit use in some populations.^[70]^[71] In multifactorial or opioid-induced nausea, low-dose haloperidol (0.5-2 mg orally or subcutaneously every 6-8 hours) serves as an alternative by antagonizing dopamine D2 receptors in the chemoreceptor trigger zone, demonstrating efficacy comparable to metoclopramide with fewer extrapyramidal effects at these doses. Olanzapine, at 2.5-5 mg daily, offers broad-spectrum antiemetic activity through multiple receptor blockade (including 5-HT3, D2, and histamine), effectively managing refractory nausea in palliative settings with response rates exceeding 70% in small trials. These agents are preferred over escalating opioids due to lower addiction potential and targeted symptom control.^[72]^[73]^[74] For nausea in pregnancy, the combination of vitamin B6 (pyridoxine, 10-25 mg) and doxylamine (25 mg) is a safe first-line option, approved for mild to moderate symptoms and significantly reducing nausea severity, with studies showing reductions of up to approximately 50% in the first trimester without fetal risks. This delayed-release formulation is taken as 2-4 tablets daily, with guidelines recommending it before escalating to ondansetron due to the latter's potential cardiac concerns.^[75]^[76]^[77]^[78] As of 2025, controversies persist regarding QT interval prolongation with 5-HT3 antagonists like ondansetron, particularly at higher intravenous doses (16-32 mg), though recent analyses indicate minimal clinical risk (average prolongation of 7-10 ms) in most patients without congenital long QT syndrome, prompting updated labels to advise ECG monitoring only in high-risk cases. New European guidelines for chronic nausea pharmacotherapy in palliative care emphasize individualized regimens, prioritizing NK1 antagonists for refractory symptoms, considering olanzapine as a second-line option despite limited evidence and no consensus, and incorporating haloperidol for specific indications such as cannabinoid hyperemesis syndrome; haloperidol is also used for opioid-related nausea based on general practice, with a focus on multidisciplinary assessment to optimize tolerability.^[79]^[80]^[32]

Non-Pharmacological Approaches

Non-pharmacological approaches to managing nausea encompass a range of lifestyle modifications, behavioral interventions, and complementary therapies that provide evidence-based relief, often serving as adjuncts to standard care in conditions like chemotherapy-induced nausea and vomiting (CINV), postoperative nausea and vomiting (PONV), motion sickness, and psychogenic causes. These methods focus on symptom alleviation through non-invasive means, with systematic reviews highlighting their efficacy in reducing nausea severity and frequency across diverse etiologies.^[81]^[82] Dietary strategies form a foundational element, emphasizing small, frequent meals to minimize gastric overload and prevent symptom exacerbation. Avoiding triggers such as fatty, greasy, or spicy foods reduces irritation to the gastrointestinal tract, while opting for bland, low-fat options like toast, crackers, or yogurt supports tolerance.^[83]^[84] Hydration is maintained through sipping clear fluids or electrolyte solutions in small amounts to avoid dehydration without provoking retching.^[85] A 2025 systematic review of nutritional patterns for nausea in pregnancy further endorses diets rich in fruits, vegetables, and proteins for symptom reduction, demonstrating improved outcomes over unrestricted eating.^[86] Complementary physical interventions include acupressure and ginger supplementation. Applying pressure to the P6 (Neiguan) acupoint on the inner wrist using bands or manual stimulation effectively mitigates acute nausea, with a 2025 Cochrane update confirming benefits for PONV, reducing first-day nausea incidence by up to 30% compared to sham controls.^[87] Oral ginger root at a standardized dose of 1 g per day has demonstrated antiemetic effects in randomized trials, significantly lowering nausea scores in postoperative and pregnancy-related cases, with meta-analyses supporting its superiority over placebo for prevention.^[88]^[89] Behavioral therapies target psychological contributors, particularly for psychogenic or anticipatory nausea. Cognitive behavioral therapy (CBT) addresses underlying anxiety or phobias, such as specific phobia of vomiting, through exposure and cognitive restructuring, yielding symptom reductions in clinical cases and small trials.^[90]^[91] Hypnotherapy induces relaxation to interrupt nausea cycles, with meta-analyses showing large effect sizes in reducing CINV and anticipatory symptoms in cancer patients, often outperforming no intervention.^[92] For motion sickness, positional adjustments like sitting in the front seat of vehicles or focusing on the horizon stabilize vestibular input, decreasing nausea onset as per clinical guidelines.^[93]^[94] Recent evidence from 2024-2025 underscores mindfulness-based practices for chronic nausea. App-delivered heartfulness meditation in cyclic vomiting syndrome patients improved psychological outcomes and augmented endocannabinoid signaling in a pilot study, potentially aiding symptom management including nausea.^[95] Systematic reviews also indicate potential benefits of cannabinoids, such as dronabinol, for refractory CINV, with 2025 analyses showing significant reductions in acute and delayed symptoms when added to standard prophylaxis but insufficient evidence for routine recommendation due to limited comparisons with modern regimens and side effects.^[96]^[97]

Prognosis and Epidemiology

Prognosis

The prognosis of nausea varies significantly depending on its duration, underlying cause, and patient-specific factors. Acute nausea, often triggered by transient events such as viral gastroenteritis or foodborne illness, typically resolves spontaneously within 24 to 48 hours with supportive care like hydration.^[98] For instance, in cases of food poisoning, approximately 90% of affected individuals recover fully without medical intervention, as the condition is self-limited.^[99] However, complications such as dehydration can arise, particularly if vomiting leads to significant fluid loss; electrolyte imbalances may also occur but are less common in otherwise healthy adults.^[100] Chronic nausea, defined as persisting beyond four weeks, carries a more guarded outlook, especially when no identifiable structural or metabolic cause is found, such as in functional nausea. According to the 2025 European Guideline on Chronic Nausea and Vomiting, while most episodes are transient, a minority of patients experience prolonged symptoms that remain stable over time, with diagnoses like chronic idiopathic nausea often enduring beyond 48 weeks in follow-up studies.^[18]^[101] Prognosis improves markedly if a treatable etiology is identified; for example, in post-chemotherapy nausea, modern antiemetic regimens achieve control rates of 85% to 97% for acute and delayed phases, respectively, allowing most patients to complete treatment cycles without interruption.^[102] Several factors influence overall outcomes, including younger age, which correlates with higher symptom severity and persistence due to lower tolerance thresholds, and comorbidities such as diabetes or cardiovascular disease, which exacerbate risks by impairing compensatory mechanisms.^[103]^[104] Early intervention, such as prompt fluid replacement, further enhances resolution rates across both acute and chronic forms. Long-term complications remain rare but include malnutrition and persistent electrolyte disturbances in untreated chronic cases, potentially leading to weight loss and fatigue if symptoms disrupt nutrition for extended periods.^[105]^[106] In cancer-related nausea, incidence reaches 30% to 90% with moderate- to high-risk chemotherapy, but contemporary antiemetic protocols have substantially improved control, reducing severe episodes and supporting better quality of life per 2025 National Cancer Institute data.^[38]^[39]

Epidemiology

Nausea is a prevalent symptom in the general population, with population-based studies indicating that more than 50% of adults experience at least one episode annually.^[1] The prevalence is notably higher among women, occurring approximately three times more frequently than in men.^[1] In specific contexts such as pregnancy, 70-80% of women report nausea during the first trimester.^[33] Point prevalence in community settings is estimated at around 12%, often linked to functional gastrointestinal disorders.^[2] Incidence varies significantly by clinical context. In patients undergoing chemotherapy, 60-80% experience nausea, particularly without adequate prophylaxis, making it one of the most common adverse effects of cancer treatment.^[38] Among individuals recovering from COVID-19, chronic nausea as part of gastrointestinal symptoms affects about 13%, with rising reports of persistent cases contributing to long COVID burdens as of 2025 estimates.^[107] In postoperative settings, incidence reaches 20-30% in the general surgical population, escalating to 70-80% in high-risk groups.^[108] Key risk factors include female sex, which consistently elevates susceptibility across various etiologies.^[1] Age plays a role, with prevalence peaking in the elderly, where approximately every second to third individual is affected due to multifactorial causes such as medications and comorbidities.^[109] Other contributors encompass obesity, which may heighten risk through associations with gastroesophageal reflux, smoking, and psychological stress, the latter correlating with higher community reporting via somatization pathways.^[110] Geographic variations are evident in conditions like motion sickness, which shows elevated incidence among frequent travelers exposed to vestibular stimuli.^[111] Recent trends highlight increased recognition of nausea in specialized care settings. In palliative care, up to 50% of patients report nausea, reflecting a stable yet significant burden as noted in 2024 clinical updates, often exacerbated by opioids and disease progression.^[112] Overall, post-pandemic shifts have amplified chronic nausea documentation, particularly in long COVID cohorts, underscoring evolving epidemiological patterns.^[107]

References

[1]
Nausea: a review of pathophysiology and therapeutics - PMC
It has been defined as an 'unpleasant painless subjective feeling that one will imminently vomit' [Hasler and Chey, 2003].
[2]
The prevalence of nausea in the community - PubMed
Nausea is a commonly reported symptom with a point prevalence of about 12% in the community. Nausea is a prominent symptom in functional gastrointestinal ...
[3]
Nausea and Vomiting - Clinical Methods - NCBI Bookshelf - NIH
Nausea is the unpleasant sensation that precedes vomiting. Nausea frequently is relieved by vomiting and may be accompanied by increased parasympathetic nervous ...Technique · Basic Science · Clinical Significance
[4]
Nausea and vomiting Causes - Mayo Clinic
Motion sickness and drinking alcohol are among the many common causes of nausea and vomiting. Serious diseases can also have this effect.
[5]
Nausea and vomiting - Mayo Clinic
Nausea and vomiting are common signs and symptoms that can be caused by numerous conditions. Nausea and vomiting most often are due to viral gastroenteritis ...
[6]
AGA technical review on nausea and vomiting - Gastroenterology
Endocrinologic and metabolic causes of nausea and vomiting include uremia, diabetic ketoacidosis, hyperparathyroidism, hypoparathyroidism, hyperthyroidism, and ...
[7]
Nausea and vomiting When to see a doctor - Mayo Clinic
Seek prompt medical attention if nausea and vomiting are accompanied by other warning signs, such as: Chest pain; Severe abdominal pain or cramping; Blurred ...Nausea And Vomiting · When To See A Doctor · Schedule A Doctor's Visit<|control11|><|separator|>
[8]
Nausea: a review of pathophysiology and therapeutics - PubMed
Nausea is considered to function as a protective mechanism, warning the organism to avoid potential toxic ingestion.Missing: treatment | Show results with:treatment
[9]
Nausea: Current knowledge of mechanisms, measurement and ...
Nausea is a subjective sensation, which often acts as a signal that emesis is imminent. It is a widespread problem that occurs as a clinical sign of disease.
[10]
Approach to the adult with nausea and vomiting - UpToDate
Dec 16, 2024 · INTRODUCTION. The definition of nausea has varied, but it is generally regarded as the unpleasant sensation of being about to vomit [1].
[11]
A Practical 5-Step Approach to Nausea and Vomiting
Mar 1, 2022 · We provide a practical 5-step approach to the clinical evaluation and treatment of N/V, suitable for application in the primary care and subspecialty settings.
[12]
Nausea and Vomiting: Common Etiologies and Management
Sep 21, 2021 · Nausea is an unpleasant feeling causing the desire to vomit (2). Vomiting is the contraction of abdominal and diaphragmatic muscles triggering ...
[13]
Nausea - an overview | ScienceDirect Topics
Nausea is typically defined as a subjective, unpleasant sensation that often precedes vomiting, but may occur in isolation and on a chronic basis.<|control11|><|separator|>
[14]
What Is Nausea? A Historical Analysis of Changing Views - PMC
Nausea referred to a wide range of perceptions and actions, including lethargy and disengagement, headache (migraine), and anorexia.
[15]
Nausea - Etymology, Origin & Meaning
Early 15c. "nausea" originates from Latin and Greek meaning "seasickness" (from naus "ship"), though in English it broadly means vomiting or disgust.
[16]
Nausea (Feeling Sick or Nauseous ) Causes & Treatment
Nausea is that sick-to-your-stomach feeling that you'd rather do without. It can happen on its own, but commonly comes before vomiting.
[17]
Nausea and vomiting – adults: MedlinePlus Medical Encyclopedia
Aug 7, 2023 · Nausea is feeling an urge to vomit. It is often called being sick to your stomach. Vomiting or throwing-up forces the contents of the stomach up through the ...
[18]
European Guideline on Chronic Nausea and Vomiting—A UEG and ...
Jan 4, 2025 · We recommend that antiemetics, antianxiety medications, and analgesics should be used as needed during the vomiting phase to ameliorate symptoms ...
[19]
Motion Sickness - StatPearls - NCBI Bookshelf
The symptoms of motion sickness can be diverse, ranging from the most common, nausea and vomiting, too cold sweating, pallor, headache, drowsiness, yawning, ...
[20]
Comparison of the Prevalence of Meal‐Related Nausea in Different ...
Jun 2, 2025 · In patients with meal-related nausea in all FD subgroups and CNVS, nausea started in the vast majority within 60 min after meal intake. This is ...
[21]
Gastritis - Symptoms and causes - Mayo Clinic
Feb 14, 2024 · Gnawing or burning ache or pain, called indigestion, in your upper belly. This feeling may become either worse or better after eating. Nausea.
[22]
Peptic ulcer - Symptoms and causes - Mayo Clinic
Aug 16, 2024 · Nausea. Peptic ulcers can cause bleeding from the ulcer. Then symptoms might include: Vomiting blood, which may appear red or black. Having ...Overview · Causes · Risk Factors
[23]
Gastroparesis - Symptoms and causes - Mayo Clinic
Sep 6, 2024 · Gastroparesis affects digestion. It can cause nausea, vomiting and belly pain. It also can cause problems with blood sugar levels and nutrition.Diagnosis and treatment · Diabetic Gastroparesis · Stomach and pyloric valve<|separator|>
[24]
Viral Gastroenteritis - StatPearls - NCBI Bookshelf - NIH
May 4, 2025 · Viral gastroenteritis is a widespread infectious illness caused by various viruses, including rotavirus, norovirus, adenovirus, and astrovirus, ...
[25]
Bacterial Diarrhea - StatPearls - NCBI Bookshelf - NIH
Jan 21, 2025 · Bacterial infections can present with symptoms that may overlap with those of viral gastroenteritis. ... nausea and vomiting as the initial ...
[26]
About Giardia Infection - CDC
May 3, 2024 · Upset stomach or nausea; Dehydration (loss of fluids). Symptoms usually begin 1 to 2 weeks after becoming infected with Giardia and last for 2 ...
[27]
Intestinal obstruction - Symptoms & causes - Mayo Clinic
Signs and symptoms of intestinal obstruction include: Crampy abdominal pain that comes and goes; Loss of appetite; Constipation; Vomiting; Inability to have a ...Missing: nausea | Show results with:nausea
[28]
Appendicitis - Symptoms and causes - Mayo Clinic
Jan 18, 2025 · Nausea and vomiting. Loss of appetite. Low-grade fever that may rise as the illness worsens. Constipation or diarrhea. Belly bloating. Gas ...Appendicitis · Diagnosis and treatment · Urinalysis
[29]
Pancreatitis - Symptoms and causes - Mayo Clinic
Symptoms · Constant pain in the upper belly. · Belly pain that feels worse after eating. · Losing weight without trying. · Diarrhea. · Oily, smelly stools.Pancreatitis caused by... · Diagnosis and treatment
[30]
Bile reflux - Symptoms & causes - Mayo Clinic
In cases of bile reflux, the valve doesn't close properly, and bile washes back into the stomach. This can lead to inflammation of the stomach lining, called ...Overview · Causes · Complications
[31]
Small intestinal bacterial overgrowth (SIBO) - Symptoms & causes
Symptoms · Loss of appetite · Abdominal pain · Nausea · Bloating · An uncomfortable feeling of fullness after eating · Diarrhea · Unintentional weight loss ...
[32]
European Guideline on Chronic Nausea and Vomiting—A UEG and ...
This European Guideline aims to provide a well‐structured approach to harmonizing the diagnosis and management of chronic nausea and vomiting.
[33]
https://pmc.ncbi.nlm.nih.gov/articles/PMC3676933/
[34]
Long COVID Symptom Management Through Self-Care and ... - NIH
Aug 29, 2025 · The goal of this review is to provide clinicians with a better understanding of long COVID and review the latest recommendations for managing ...
[35]
Causes of symptoms and symptom persistence in long COVID and ...
Aug 19, 2025 · Many factors cause the symptoms to become chronic, including persistent infectious agents (and/or their nucleic acids and antigens) and the fact ...
[36]
Nausea and Vomiting Related to Cancer Treatment (PDQ®) - NCI
Mar 10, 2025 · Chemotherapy-induced N&V is one of the most common and distressing acute side effects of cancer treatment. It occurs in up to 80% of patients.
[37]
Nausea and Vomiting and Cancer - Side Effects - NCI
May 9, 2025 · Radiation therapy can cause nausea and vomiting, especially when radiation is directed at the brain, upper abdomen, or whole body. People ...
[38]
Nausea and vomiting side effects with opioid analgesics ... - PubMed
Gastrointestinal (GI) side effects such as nausea and vomiting are common following opioid analgesia and represent a significant cause of patient discomfort.
[39]
Nausea and Vomiting After Surgery Under General Anesthesia - NIH
The incidence of postoperative nausea and vomiting (PONV) after general anesthesia is up to 30% when inhalational anesthetics are used with no prophylaxis.
[40]
Nausea, emesis, and antiemetics - EMCrit Project
Apr 8, 2025 · medications which may cause nausea. Chemotherapy. Analgesics: Aspirin. NSAIDs. Opioids. Anesthetic agents. Antibiotics: Erythromycin.
[41]
Nausea and Vomiting in 2021: A Comprehensive Update - PMC
A comprehensive review of treatments for nausea and vomiting. Nausea and vomiting (N/V) are common symptoms encountered in medicine.
[42]
Chronic Unexplained Vomiting: A Case Report on Psychogenic ...
Jun 15, 2022 · Psychogenic vomiting is defined as recurrent vomiting without any known discernible organic reasons, or functional vomiting occurring from psychological stress.
[43]
Psychogenic vomiting: A case series - PMC - NIH
Psychogenic vomiting is a syndrome in which there is recurrent vomiting, without any organic pathology or as “functional vomiting” as a result of psychological ...
[44]
What are Eating Disorders? - Psychiatry.org
Eating disorders are behavioral conditions characterized by severe and persistent disturbance in eating behaviors and associated distressing thoughts and ...Missing: autonomic | Show results with:autonomic
[45]
Nausea and Vomiting of Pregnancy - PMC - PubMed Central
Women with severe nausea and vomiting during pregnancy may have hyperemesis gravidarum (HG), an entity distinct from NVP, which if left untreated may lead to ...
[46]
Hyperemesis Gravidarum - StatPearls - NCBI Bookshelf - NIH
Jul 6, 2025 · Hyperemesis gravidarum is a severe form of nausea and vomiting during pregnancy, typically beginning between 4 and 6 weeks of gestation, ...
[47]
Mechanisms of Nausea and Vomiting - PubMed Central - NIH
Nausea and vomiting are common gastrointestinal complaints that can be triggered by diverse emetic stimuli through central and/or peripheral nervous systems.
[48]
Role of central vagal 5-HT3 receptors in gastrointestinal physiology ...
5-HT is released from enterochromaffin cells in response to mechanical or chemical stimulation of the GI tract which leads to activation of 5-HT3 receptors on ...
[49]
Physiology, Chemoreceptor Trigger Zone - StatPearls - NCBI - NIH
The chemoreceptor trigger zone (CTZ) for emesis, also commonly known as the area postrema (AP), is located within the dorsal surface of the medulla oblongata.
[50]
Motion Sickness: Current Knowledge and Recent Advance - PMC
It has been demonstrated that brain regions associated with nausea and vomiting not only receive vestibular afference but also converge gastrointestinal (GI) ...Missing: VIII | Show results with:VIII<|separator|>
[51]
The neural basis of motion sickness | Journal of Neurophysiology
Mar 12, 2019 · Activity and structures that produce motion sickness include vestibular input through the semicircular canals, the otolith organs, and the ...
[52]
Molecular and Circuit Mechanisms Regulating Nausea and Vomiting
Oct 8, 2024 · Furthermore, Substance P can stimulate NK1 receptor activation in the AP neurons, leading to vomiting. Specific deletion of intestinal or ...
[53]
TRPV1: The key bridge in neuroimmune interactions - ScienceDirect
TRPV1 activation can lead to the release of calcitonin gene-related peptide (CGRP), substance P (SP), somatostatin, and other neurotransmitters, and these ...
[54]
The area postrema and vomiting - PubMed - NIH
Activation of the AP probably leads to nausea and vomiting through its projection to the neighboring NTS. The NTS may serve as the beginning of a final ...
[55]
Neural networks involved in nausea in adult humans: A systematic ...
Inferior frontal gyrus, anterior insula and cingulate cortex were most commonly activated. •. Basal ganglia (e.g., putamen) structures were also consistently ...
[56]
Brain Circuitry Underlying the Temporal Evolution of Nausea in ...
Apr 2, 2012 · Increasing sustained response following increased nausea was found in a broader network including insular, anterior cingulate, orbitofrontal, ...
[57]
Brain circuits for retching-like behavior - Oxford Academic
Calb1NTS-PBNel pathway activation induced the nausea response via CFA analysis. CGRP neurons in PBNel may play a critical role in nausea. Direct activation ...
[58]
Evaluation of Nausea and Vomiting | AAFP
Jul 1, 2007 · A comprehensive history and physical examination can often reveal the cause of nausea and vomiting, making further evaluation unnecessary.
[59]
The Index of Nausea, Vomiting, and Retching: a new ... - PubMed
To determine the reliability of the Index of Nausea, Vomiting, and Retching (INVR), a new format of the Rhodes Index of Nausea and Vomiting Form 2 (INV-2).
[60]
Rome IV Criteria - Rome Foundation
Two or more periods of intense, unremitting nausea and paroxysmal vomiting, lasting hours to days within a 6-month period; Episodes are stereotypical in each ...ROME IV Criteria Booklet · About the Rome Foundation · Rome V, DGBI 5th Edition
[61]
Vomiting and Nausea Diagnosis | Stanford Health Care
Complete blood count to look for signs of anemia and infections; Electrolyte and kidney function panel to look for electrolyte abnormalities and liver issues ...
[62]
European guideline on indications, performance, and clinical impact ...
This consensus‐based clinical practice guideline defines the clinical indications, performance, and interpretation of H2‐CH4‐breath tests in adult and pediatric ...<|separator|>
[63]
Antiemetic Medications - StatPearls - NCBI Bookshelf - NIH
Sep 26, 2022 · Nausea is a commonly encountered symptom in healthcare that is difficult for any patient. Causes may be as simple as the body's defense ...
[64]
Antiemetics, Selective 5-HT3 Antagonists - StatPearls - NCBI - NIH
Pregnancy considerations: Ondansetron for nausea and vomiting: 4 mg PO every 8 hours in pregnant women who are not dehydrated or 8 mg IV every 12 hours to be ...
[65]
A systematic review and meta-analysis of randomised controlled trials
Jan 11, 2025 · The meta-analysis reported that palonosetron was more efficacious than ondansetron in preventing early postoperative nausea (PON), late PON, and ...
[66]
Antiemetic Neurokinin-1 Receptor Blockers - StatPearls - NCBI - NIH
Jan 11, 2024 · Neurokinin-1 (NK-1) receptor antagonists are antiemetic drugs with unique anxiolytic, antidepressant, and antiemetic properties.<|separator|>
[67]
Individual patient data meta-analysis of NEPA versus aprepitant ...
Aug 9, 2025 · While current antiemetic therapies have substantially improved outcomes in controlling vomiting, optimally managing nausea, particularly in ...
[68]
Corticosteroids, the oldest agent in the prevention of chemotherapy ...
Double therapy consisting of a setron and dexamethasone is used as treatment for acute and delayed emesis following administration of agents with MEC, with the ...
[69]
Dexamethasone Alone or in Combination with Ondansetron for the ...
May 25, 2000 · Dexamethasone alone provides adequate protection against delayed emesis in patients at low risk (those who have not had acute emesis).Missing: corticosteroids | Show results with:corticosteroids<|separator|>
[70]
Scopolamine - StatPearls - NCBI Bookshelf - NIH
Scopolamine is a medication used to manage and treat postoperative nausea and vomiting (PONV) and motion sickness. It is in the anticholinergic class of drugs.
[71]
Scopolamine (transdermal route) - Side effects & dosage - Mayo Clinic
Aug 31, 2025 · It is also used to prevent nausea and vomiting caused by motion sickness. Scopolamine belongs to the group of medicines called anticholinergics.
[72]
Haloperidol for the treatment of nausea and vomiting in palliative ...
Haloperidol is often used to help control nausea (feeling sick) or vomiting (being sick), both of which are common problems for patients with serious life‐ ...Missing: alternatives | Show results with:alternatives
[73]
Antiemetic drugs: what to prescribe and when
Apr 1, 2020 · Haloperidol and olanzapine are effective for chemotherapy-induced nausea and vomiting. Olanzapine is now recommended as part of first-line ...
[74]
The use of olanzapine as an antiemetic in palliative medicine
Apr 22, 2020 · All studies concluded on the efficacy of olanzapine as an antiemetic in the palliative care setting. No serious adverse effects were reported.Missing: opioid alternatives
[75]
Nausea and Vomiting of Pregnancy - AAFP
Jul 1, 2003 · Several medications, including pyridoxine and doxylamine, have been shown to be safe and effective treatments. Pregnant women who have severe ...
[76]
Doxylamine-pyridoxine for nausea and vomiting of pregnancy ... - NIH
Jan 17, 2018 · Doxylamine-pyridoxine is recommended as a first line treatment for nausea and vomiting during pregnancy and it is commonly prescribed.
[77]
Morning Sickness: Nausea and Vomiting of Pregnancy - ACOG
Vitamin B6 is a safe, over-the-counter treatment that may be tried first for nausea and vomiting of pregnancy. Doxylamine, a medication found in over-the- ...
[78]
What antiemetic is safe to use in a patient with QTc (corrected QT ...
Oct 19, 2025 · Many commonly used antiemetics can prolong the QT interval, including: 5-HT3 receptor antagonists (ondansetron, granisetron, dolasetron) 2, 1 ...
[79]
Morbidity and Mortality of Ondansetron in Patients with Non ...
Aug 12, 2025 · This review explores the underlying mechanisms of QT-interval prolongation associated with the selective 5-HT3 receptor antagonist ondansetron, ...
[80]
Effect of non-pharmacological interventions on chemotherapy ...
Conclusion. Non-pharmacological interventions can serve as an effective complementary approach to managing delayed chemotherapy-induced nausea and vomiting.
[81]
Nonpharmacological Nursing Interventions in Postoperative Nausea ...
Oct 20, 2023 · Acupuncture, aromatherapy, the oral intake of ginger, listening to music, and educating and visiting patients were used as nonpharmacological ...
[82]
Diet Modifications for Nausea and Vomiting | UCSF Health
Smaller portions of foods that are low in fat seem to work best. · Eat salty foods and avoid overly sweet ones, especially if you have been vomiting. · If there ...
[83]
Managing Nausea and Vomiting at Home | American Cancer Society
Jun 26, 2024 · Sour foods, such as sour candy, pickles, lemons, or lime might help with nausea. Eat foods when they are cool or at room temperature, so their ...
[84]
[PDF] Nutrition Tips for Nausea and Vomiting - Stanford Health Care
Take anti nausea/vomiting medications as directed by your doctor. Try these general nutrition tips as well; however, nutritional treatment of your nausea and ...
[85]
A Food Pyramid and Nutritional Strategies for Managing Nausea ...
Jan 23, 2025 · The findings highlight the beneficial effects of dietary patterns rich in fruits, vegetables, and protein sources in reducing NVP symptoms.
[86]
What are the benefits and risks of different wrist PC6 acupoint ...
Sep 12, 2025 · Stimulating the wrist acupuncture point known as PC6 (Neiguan) is an alternative method that may help alleviate nausea and vomiting with fewer ...
[87]
Efficacy of ginger for nausea and vomiting: a systematic review of ...
We have performed a systematic review of the evidence from randomized controlled trials for or against the efficacy of ginger for nausea and vomiting.
[88]
The efficacy of ginger for the prevention of postoperative nausea ...
This meta-analysis demonstrates that a fixed dose at least 1 g of ginger is more effective than placebo for the prevention of postoperative nausea and vomiting ...
[89]
Cognitive behaviour therapy for specific phobia of vomiting ...
This is the first randomised controlled trial to evaluate a protocol for cognitive behaviour therapy (CBT) for a Specific Phobia of Vomiting (SPOV) compared ...
[90]
Behavioral treatment of psychogenic vomiting in the context of social ...
A case of psychogenic vomiting in the context of social phobia was treated by a combination of exposure in vivo, social skills training, and cognitive ...
[91]
Hypnosis for nausea and vomiting in cancer chemotherapy: a ...
Dec 12, 2006 · Meta-analysis has demonstrated that hypnosis could be a clinically valuable intervention for anticipatory and CINV in children with cancer.
[92]
Motion sickness: First aid - Mayo Clinic
If you're susceptible to motion sickness: Focus on the horizon or on a distant, stationary object. Don't read or use electronic devices while traveling.
[93]
Motion Sickness | Travelers' Health - CDC
Sit in the front of a car or bus. · Choose a window seat on flights and trains. · If possible, try lying down, shutting your eyes, sleeping, or looking at the ...
[94]
Acute and Long-Term Effects of App-Delivered Heartfulness ...
Jul 1, 2024 · App-delivered HFM is feasible, safe and effective and improves psychological outcomes and augments endocannabinoids.
[95]
Cannabinoids for the prevention of chemotherapy-induced nausea ...
Aug 12, 2025 · The most recent published study revealed that THC oil significantly outperformed placebo over 5 days (0–120 h, p = 0.001) and in the acute ...Missing: non- pharmacological
[96]
Cannabinoids for the prevention of chemotherapy-induced nausea ...
Aug 12, 2025 · The objective of this systematic review was to provide an overview of the existing evidence regarding the use of cannabinoids for the management ...Missing: non- pharmacological
[97]
Vomiting and Nausea - Symptom information, causes and treatment
Jun 21, 2018 · Many cases of nausea and vomiting are self-limiting and will resolve within 24-48 hours but if you experience any of these other signs then ...Missing: acute | Show results with:acute
[98]
The Rundown of Food Poisoning - UT Health Austin
Jul 14, 2022 · “90% of Americans experiencing food poisoning or other foodborne illness are self-limited, which means they will get better on their own ...Missing: rate | Show results with:rate
[99]
Managing Acute Gastroenteritis Among Children - CDC
Early intervention can reduce such complications as dehydration and malnutrition. ... dehydration (5%--10%), and severe dehydration (>10%). Studies that have ...
[100]
Characteristics of Patients with Chronic Unexplained Nausea and ...
Symptom severity indices were similar between groups for nausea, retching, vomiting, stomach fullness, inability to complete a meal, feeling excessively full ...Clinical Features And... · Analysis By Rome Iii... · Discussion
[101]
[PDF] Chemotherapy-Induced Nausea and Vomi ng—Adult Evalua on ...
Total control rates: 1. Acute: 97%, 95% CI. [84.7, 99.5%]. 2. Delayed 84.8 ... management of chemotherapy- induced nausea and vomiting.
[102]
Patient-Related Risk Factors for Chemotherapy-Induced Nausea ...
Apr 1, 2020 · Studies have reported that patient-related factors significantly impact the risk of Chemotherapy-Induced Nausea and Vomiting (CINV).
[103]
Predictive factors of chemotherapy‑induced nausea and vomiting in ...
Several factors influence the incidence and severity of CINV, including patient-related factors such as age, sex, comorbidities and psychological aspects, as ...
[104]
Prognostic impact of disease-related malnutrition - ScienceDirect.com
Malnutrition increases morbidity and mortality in acute and chronic diseases, impairs recovery and convalescence, prolongs treatment duration, and increases ...
[105]
(PDF) Malnutrition and Chemotherapy-Induced Nausea and Vomiting
Aug 7, 2025 · Patients with malnutrition and/or intake-limiting CINV and in need of improved nutrition symptom management may be overlooked, particularly ...
[106]
Prevalence of gastrointestinal symptoms after recovery from COVID-19
The most commonly reported symptoms were diarrhea (13.2%), nausea (13.2%), anorexia (12.7%), abdominal pain (11%), and constipation. Male sex ...Missing: chronic | Show results with:chronic
[107]
[PDF] Fourth Consensus Guidelines for the Management of Postoperative ...
Jul 14, 2020 · 5-HT3 receptor antagonist and has antinausea and antiemetic properties used mostly for chemotherapy- induced nausea and vomiting (CINV). While ...
[108]
[Update nausea and vomiting amongst the elderly] - PubMed
Mar 29, 2021 · Approximately every 2nd to 3rd elderly person is affected.There are many possible causes of nausea (cerebrally caused, cerebrally controlled or ...
[109]
The prevalence of nausea in the community: psychological, social ...
Nausea is a commonly reported symptom with a point prevalence of about 12% in the community. Nausea is a prominent symptom in functional gastrointestinal ...
[110]
Gender Differences in Visually Induced Motion Sickness
Aug 10, 2025 · In general, females have been reported to be more susceptible to motion sickness and experience greater malaise.Missing: ratio | Show results with:ratio
[111]
Nausea and vomiting - ScienceDirect.com
Nausea and vomiting are common problems in palliative care, occurring in 40–70% of patients with advanced incurable disease.