Everybody will experience nausea (feeling sick) and vomiting (being sick) at some point in their lives. Usually, it is not a sign of anything serious, and is simply the body’s way of quickly getting rid of the contents of the stomach (to cool down the internal body temperature).
The most common causes of nausea and vomiting in adults include [1]:
- gastroenteritis – this is most likely to be the cause if you also have diarrhoea
- pregnancy – pregnant women often have nausea and vomiting during the early stages of pregnancy
- migraines – intense, throbbing headaches that last for a few hours to days at a time
- labyrinthitis – which also causes dizziness
- motion sickness – nausea and vomiting associated with travelling by different modes of transport
Vomiting in adults can also be caused by a number of other things, including [1]:
- certain medicines, such as antibiotics and opioid painkillers
- drinking too much alcohol
- kidney infections and kidney stones
- a blockage in your bowel, which may be caused by a hernia or gallstones
- chemotherapy and radiotherapy
- an inflamed gallbladder (acute cholecystitis)
People who menstruate may also experience nausea or vomiting at certain times in their cycle [2], or associated with menstrual migraines (with or without a headache) [3]. This may occur around ovulation and/ or before or during menstruation [2]. Others find that their period pain can be so bad that it causes them to vomit [2].
Similarly, nausea and vomiting are often listed as known side effects of hormonal medications e.g. contraceptive pills [4], or oestrogen-based HRT (Hormone Replacement Therapy) [5].
Usually, there is no need to seek medical advice for nausea or vomiting, unless [1]:
- you’ve been vomiting repeatedly for more than 48 hours and it’s not improving
- you’re unable to keep down any fluids
- you have signs of severe dehydration – such as dizziness and passing little or no urine
- your vomit is green (this could mean you’re bringing up bile, which suggests you may have a blockage in your bowel – see below)
- you’ve lost a lot of weight since you became ill
- you experience episodes of vomiting frequently (track symptoms to check if your menstrual cycle may be involved)
When to get emergency help
Call 999 for an ambulance, or go to your nearest hospital accident and emergency (A&E) if you also have [1]:
- sudden, severe stomach pain – this may be a sign of appendicitis
- severe chest pain
- blood in your vomit or what looks like coffee granules
- a stiff neck and high temperature (fever)
- a sudden, severe headache that’s unlike any headache you’ve had before
- diabetes and have been vomiting persistently – particularly if you need to take insulin
You should also get emergency help if you think you’ve swallowed something poisonous.
Note: If your symptoms are caused by your hormonal medication, we suggest that you discuss your options with a doctor. These steps may reduce symptom severity, but are unlikely to be able to stop them completely whilst you remain on the same medication.
Managing hormone-related nausea or vomiting:
The good news is that hormone-related nausea or vomiting responds particularly well to the steps outlined on our ‘all symptoms‘ page.
Try a hormone-balancing diet– As outlined in this blog, a vegetable-based ‘anti-inflammatory’ diet can significantly improve all hormone-related symptoms. We highlight a few of the key steps that are especially relevant for those suffering from nausea or vomiting, below;
Eat lots of fresh fruit and vegetables– Eat small, light meals, regularly (try not to leave too long between meals- an empty stomach can cause nausea) and avoid fatty or very spicy foods [6].
Avoid caffeine and alcohol– The most important thing to do if experiencing nausea or vomiting, is to keep taking small sips of water so you don’t become dehydrated [1]. Drinking alcohol or caffeine, can both increase the likelihood of feeling nauseous, whilst also having a dehydrating effect on the body.
A sweet drink such as fruit juice can be useful for replacing lost sugar, although you should avoid sweet drinks if they make you feel sick. Salty snacks, such as crisps, can help replace lost salt [1].
Take nutritional supplements, if needed- You may also find ginger helps to relieve your nausea and vomiting. This is available as supplements, or can be found in ginger biscuits and ginger tea [1].
TOP TIPS!
- eat cold meals rather than hot ones as they don’t give off the smell that hot meals often do
- avoid drinks that are very cold, tart (sharp) or sweet
- ask the people close to you for extra support and help – e.g. it helps if someone else can cook
Exercise regularly– Regular exercise, particularly light aerobic exercise, may help you combat stress and release tension.
This in turn, can reduce nausea, so long as you do not overdo it e.g. try not to sprint, or exercise at maximum capacity, since this can cause vomiting (even in athletes who do not otherwise experience hormone-related nausea or vomiting!).
Frequent nausea or vomiting can significantly effect your self-esteem. You may feel unable to socialise for fear of being sick in public, or in front of friends and family, and so become socially isolated. It is also easy to become a little anxious about your health since nausea and vomiting are quite disruptive to normal life e.g. the ability to work, or household responsibilities.
Cognitive behavioural therapy (CBT) is one of the most effective treatments for health anxiety and can also be used to build self-esteem. CBT helps you to understand how your problems, thoughts, feelings and behaviour affect each other. It can also help you to avoid behaviours that are more likely to make you feel nauseous. CBT usually involves meeting with a specially trained and accredited therapist for a one-hour session every week for 10-12 weeks.
Note: The Oxford Cognitive Therapy Centre produces highly effective (and cheap!) booklets that may help; Building Self-Esteem and ‘Understanding health anxiety’.
Reduce stress hormones– Most of us know that anxiety can trigger nausea or vomiting e.g. before a job interview, or after a shock. When you get nervous your body produces adrenaline and other chemicals. These chemicals speed up the normal function of your nervous system and can make your stomach start to churn… Some people are even a bit afraid of vomiting, since it is not the most pleasant of experiences, but sadly, this fear only tends to increase the nausea.
For this reason, it is important to try to reduce the levels of stress hormones in your body. You may find relaxation and breathing exercises helpful, or you may prefer to listen to a radio show, or call someone on the telephone to distract your thoughts away from the nausea.
TOP TIPS!
- distract yourself as much as you can – the nausea can get worse the more you think about it
- wear comfortable clothes without tight waistbands
- wear anti-nausea wristbands– clinically proven to reduce nausea [7] [8]!
By tracking symptoms over time, and getting to know when you feel more anxious, or nauseous, you can feel more in control, and ‘resist’ those first fluttery feelings in the pit of your stomach.
Take note of any triggering experiences- this will help you to identify the cause(s) of stress. If your symptoms regularly occur at a certain point in your menstrual cycle, you can take steps to avoid them e.g. by wearing anti-nausea wristbands, chewing ginger sweets, and ensuring that you eat small amounts but regularly throughout the day.
If you have tried the suggested tips and tricks for at least 3 months, and your symptoms do not improve, please consult your doctor.
If you’re considering taking medication for nausea or vomiting, make sure to tell your doctor about the hormonal factor in your symptoms. They can then consider different treatment options.
If you have any suggestions, or tips, for managing nausea or vomiting- please let us know– we can share them with others!
Further information:
- NHS information on ‘morning sickness’; http://www.nhs.uk/Conditions/pregnancy-and-baby/pages/morning-sickness-nausea.aspx
- NHS information on cyclical vomiting syndrome; http://www.nhs.uk/conditions/cyclical-vomiting-syndrome/Pages/Introduction.aspx
Page last reviewed and updated: June 2018
References:
1. NHS. (2016) Nausea and vomiting in adults. [ONLINE] Available at: http://www.nhs.uk/conditions/vomiting-adults/Pages/Introduction.aspx. [Accessed 2 August 2017].
2. De Sanctis V, Soliman A, Bernasconi S, Bianchin L, Bona G, Bozzola M, Buzi F, De Sanctis C, Tonini G, Rigon F, Perissinotto E. (2015) ‘Primary Dysmenorrhea in Adolescents: Prevalence, Impact and Recent Knowledge’. Pediatr Endocrinol Rev. Dec;13(2):512-20. Review. PubMed PMID: 26841639
3. Calhoun AH, Pruitt AP. (2014) Injectable sumatriptan for cyclic vomiting syndrome in adults: a case series. Headache. Oct;54(9):1526-30. doi: 10.1111/head.12444. Epub 2014 Aug 28. Review. PubMed PMID: 25168483.
4. NHS. (2014) The combined contraceptive pill. [ONLINE] Available at: http://www.nhs.uk/Conditions/contraception-guide/Pages/combined-contraceptive-pill.aspx. [Accessed 2 August 2017].
5. NHS. (2016) Hormone Replacement Therapy. [ONLINE] Available at: http://www.nhs.uk/Conditions/Hormone-replacement-therapy/Pages/Side-effects.aspx. [Accessed 2 August 2017].
6. NHS (2015) Morning sickness. [ONLINE] Available at: http://www.nhs.uk/conditions/pregnancy-and-baby/pages/morning-sickness-nausea.aspx. [Accessed 2 August 2017].
7. Stern RM, Jokerst MD, Muth ER, Hollis C, (2001) Acupressure relieves the symptoms of motion sickness and reduces abnormal gastric activity. Alternative Therapies in Health and Medicine July-Aug;7(4):91-4
8. Xu JH, Mi HY. (2017) A randomized controlled trial of acupressure as an adjunctive therapy to sodium valproate on the prevention of chronic migraine with aura. Medicine (Baltimore). Jul;96(27):e7477. doi: 0.1097/MD.0000000000007477.