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Nausea is a noxious feeling of wanting to vomit. It may be followed by regurgitation or vomiting, and it may be accompanied by other symptoms such as dizziness, loss of appetite, changes in bowel movements, bloating, inability to finish meals, excessive fullness, and stomach ache. Vomiting occurs when stomach contents are forcefully discharged from the mouth, and it may or may not be preceded by nausea. These two symptoms are often associated with various diseases of the gastrointestinal tract, as well as other conditions affecting the central nervous system, the kidneys, the liver, or other factors such as hormonal changes, migraines, drug intake, infection, radiotherapy and so on.

Most people experience acute episodes of nausea and vomiting related to stomach flu, drug intake, or food poisoning. However, some people experience chronic nausea, with or without vomiting, which makes their life quite miserable because it affects not only their eating habits, but also their overall health.

Possible Causes of Chronic Nausea and Vomiting

Some of the common causes include:

  • Delayed emptying of food from the stomach (gastroparesis), which may be due to uncontrolled diabetes, narcotic use, injury to the vagus nerve, Parkinson's disease, and multiple sclerosis

  • Gastroesophageal reflux disease (GERD or reflux esophagitis)

  • Peptic ulcer disease

  • Inner ear disease (benign positional vertigo or Meniere's disease)

  • Cyclic vomiting syndrome

  • Chronic kidney disease

  • Liver disease

  • Brain tumors

  • Inflammatory bowel disease

  • Migraine headaches

  • Psychiatric disorders such as chronic anxiety and depression

These are just some of the possible causes of chronic nausea and vomiting. Researchers have found out, however, in 25% of patients, symptoms are not related to delayed stomach emptying or other identifiable causes. In these patients, symptoms are indistinguishable from those who have delayed emptying times.

Functional vomiting or cyclic nausea and vomiting are also known to occur, where in the individual experiences intense symptoms for days, followed by a period of wellness between cycles. The cause is not known, but patients are often suspected to have gastroenteritis or psychogenic vomiting.

When to Consult a Doctor

Nausea and vomiting are often associated with a medical condition, and if persistent and untreated, may lead to complications such as dehydration, electrolyte imbalance, and tears in the esophagus. In most cases, the doctor will be able to diagnose your condition from your history, physical examination and laboratory work-up. It is important to identify the underlying cause of your symptoms so that appropriate treatment may be done.

However, in a few cases, the exact cause may be difficult to identify. In these cases, supportive treatment must be done to prevent complications. These treatments may include antiemetics, dietary supplements, dietary changes, and use of gastric pacemakers, which can regulate the movement of the stomach.

Consult a doctor immediately if you also experience these symptoms:

  • Severe abdominal pain

  • Chest pain

  • Fainting

  • Blurred vision

  • Confusion

  • Cold, clammy skin

  • High fever

  • Stiff neck

  • Blood in the vomit

  • Fecal odor or fecal material in the vomit

  • Black stools

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