“I was suffering too grievously to think of the danger, since a sluggish seasickness [nausea] which brought no relief was racking me, the sort that upsets the liver without clearing it.”
-Seneca, Epistle 53
The ancient philosopher Seneca the Younger (c. 4 BC-AD 65), and presumably the rest of his Roman friends, would have understood the term “nausea” to be equated with the symptoms of seasickness. In this letter to his friend Lucilius, Seneca is describing a particularly nasty bout of nausea he endured after reluctantly agreeing to travel by ship. Even after jumping into the water rather than wait for the captain to complete docking procedures, Seneca’s woes were not fully resolved: “one does not escape seasickness by escaping from the sea.”
Historians have uncovered numerous other sources that make this same connection between seasickness and nausea; indeed, nausea is literally the Latin word for seasickness that itself comes from a translation of an ancient Greek word. It really wasn’t until the early 1900s that the two terms began to see a divergence in meaning and a more clinical approach to their definitions.
What Is Nausea?
So with all of that in mind, what actually is nausea? As the ancient Greeks and Romans certainly understood in their own way, the word tends to be a bit of blanket terminology for a whole set of symptoms. In some ways, this is still the case; the definition can have subtle differences depending on who you ask.
Even after it came to be differentiated from seasickness during the course of the twentieth century, nausea has often been defined as “an awareness that vomiting is imminent.” The link with the urge to potentially vomit certainly rings true medically and anecdotally, but we all also know that we’ve felt what we describe as nausea at times other than when we think we’re about to puke.
Nausea truly is one of the vaguest symptoms to define; terms like “unease,” “discomfort,” and “queasiness” are interchangeably used to describe the feeling. But whatever different words get used, the common theme is an unpleasant feeling in the stomach related to the urge to vomit (regardless of whether you actually do end up vomiting).
What Can Cause Nausea?
One of the reasons nausea is so hard to define is because of how non-specific it is as a symptom; while it’s very clear when you have it, it’s entirely unclear what it might represent. Nausea can be caused by a wide variety of major and minor diseases and ailments. Some of the more common causes of nausea include:
- Food poisoning
- Motion sickness
- Morning sickness associated with pregnancy
- Ingestion of toxins or excessive amounts of alcohol
- Eating too much
- Viral gastroenteritis (stomach flu)
- Side effects of some medications
- Severe pain (possibly from trauma)
- Severe headache
- Abdominal pain or stomach pain
- Gastroparesis (slow emptying of the stomach that may accompany diabetes)
- Bowel obstruction
- Psychiatric conditions like anxiety or depression or emotional stress
- Radiation therapy
- Gallbladder disease
- Heart attack
- Brain tumor
- Some types of cancer and cancer treatment
- Peptic ulcer
- Gastroesophageal reflux disease (GERD)
As is readily apparent from the huge list above, there is a wide range of medical conditions that can be the cause of nausea. And because the sensation of nausea is so common to so many medical situations, it’s important to be mindful of the different nuances of nausea symptoms and what they might be pointing to.
Nausea Symptoms and Signs
Since nausea is itself a symptom, it tends to be one of the first sensations you might experience before other symptoms begin to arise. The urge to vomit, for example, may actually result in vomiting. Depending on your age or the timing, vomiting may give some clues to the cause of the initial nausea.
In children, for example, nausea accompanied by a fever and followed by vomiting may indicate a viral infection. Vomiting without a fever might also indicate an early milk allergy as well as more common causes like food poisoning or overeating.
Timing may also be a factor in determining the cause. If nausea and vomiting occur shortly after eating, it could point to inflammation of the stomach lining (gastritis) or an ulcer. If it takes considerably longer, say several hours, it could very well be food poisoning. Some food-borne pathogens like salmonella can even take several days before symptoms begin to appear.
Another connection point between nausea and vomiting that can help identify the initial cause of nausea is related to whether or not the vomiting improves the feeling of nausea. In many situations, the brain triggers vomiting to forcefully expel harmful contents, and then, when those elements are out of the body, nausea subsides. The cessation of nausea after vomiting doesn’t always indicate that “the coast is clear,” but for most people, it is a good sign that the nausea was a temporary problem that is now over.
Sometimes when nausea leads to excessive vomiting, the loss of so much fluid can actually cause a person to become dehydrated. In turn, dehydration can cause a whole host of problems that quickly have an adverse effect on one’s health. Dehydration can be identified by darker-than-normal urine color, dry lips, dry mouth, and an increased rate of breathing.
How Can I Prevent Nausea?
While nausea will almost certainly affect all of us at some point in our lives, there are some everyday tweaks to our eating, drinking, and life habits that can help you avoid it for the most part:
- Minimize greasy, spicy, or high-fat foods
- Eat small meals more frequently throughout the day rather than larger meals
- Eat more slowly
- Drink fluids between meals instead of while eating
- After you eat, rest with your head elevated above your feet
- Avoid strenuous physical activity right after eating
Since everyone’s bodies are different, there will be other potential triggers for nausea that you will have to be aware of yourself. For some, it might mean avoiding particularly pungent odors, sometimes the kind that wafts off of hot foods. For others nausea can follow migraine headaches, so avoiding the triggers for migraines will naturally help you avoid nausea. And, of course, if you share Seneca’s ancient Roman propensity for seasickness, you might need to avoid boat trips.
How Do I Prevent Vomiting Once I Feel Nauseated?
If despite your best efforts you still end up feeling nausea, there are also a few things you can do to stave off that sometimes powerful (and unpleasant) urge to vomit. One of the best things you can do is drink clear liquids like fruit juice or soda; just be sure to avoid acidic liquids like citrus juices. Another thing you can do is sitting quietly or lying down; if lying down, make sure your head is elevated above your feet. Engaging in too much activity while nauseated can exacerbate nausea and cause vomiting. It’s better to rest quietly until the urge passes.
When to Call a Doctor
For the most part, feeling some nausea can be waited out and dismissed as just a normal part of life that we will all encounter at some point. But there are some signs that a more serious condition might be cropping up:
- Severe nausea that lasts more than a few days and home treatment isn’t helping
- You’ve recently had a head injury
- If there are also heart attack-like symptoms such as chest pain/pressure, headaches, sweating, or pain running down the arms
- Vomiting that lasts longer than 24 hours and especially if there are additionally signs of dehydration
- For children six years old and younger, vomiting that lasts longer than a few hours or fever or dehydration are present
Nausea can, of course, run the gamut in terms of intensity and related symptoms, so be mindful of an experience that is different or lasts longer than normal. If you have been experiencing some of the symptoms described here and would like medical advice from a knowledgeable doctor, contact Dr. Sameer Islam.