Nausea is no joke and easily tops the list of worst feelings ever. You’ve likely experienced that sudden wave of queasiness and wanting to make it stop ASAP. It can be especially baffling when the answer to "Why do I feel nauseous?" isn't immediately obvious, like if you haven't eaten anything bad or your period is right on schedule.
Let's make it clear: When you say you feel nauseous, you're typically referring to the sensation of having to vomit or an uneasy feeling in your stomach. "It typically has to do with the body's response to a stressor, so people start having retching, increased salivation, a feeling of vomiting, and queasiness in the stomach," explains Camilo Ruiz, DO, an internist and sleep specialist at Sleep and Internal Medicine Specialists.
One important note: Nausea is always caused by an underlying disturbance in the body, says Thomas Vanderheyden, DO, a gastroenterologist at Michiana Gastroenterology. It is not a disease or condition in and of itself, but a sign or symptom of one. Once you have the medical problem under control, the nausea tends to get better as well, he says.
To get to the bottom of the exact cause of nausea, you need to pay attention to other discomfort you may be experiencing, such as a lack of appetite, cramping, diarrhea, pain in the back of the throat, sweating, lightheadedness, and vomiting. These could all be clues to the primary reason you feel like you're going to throw up.
If nausea is a problem for you on the reg, it’s time to consider whether one of these common issues is the culprit.
Meet the experts: Caren Behar, MD, is a clinical professor in the department of medicine at NYU Grossman School of Medicine and the medical director of Joan H. Tisch Center for Women's Health.
Thomas Vanderheyden, DO, is a gastroenterologist at Michiana Gastroenterology. Camilo Ruiz, DO, is an internist and sleep specialist at Sleep and Internal Medicine Specialists
1. You're taking pain meds.
Nausea is a common side effect of certain medications, but especially over-the-counter pain relievers or non-steroidal anti-inflammatory drugs, a.k.a. NSAIDs (think: aspirin, Motrin, Advil), says Caren Behar, MD, an internist at NYU Langone Health. “Anti-inflammatories are directly irritating to the stomach lining, and they can cause gastritis (inflammation) or ulcers,” she explains. “It’s like your stomach lining has a sunburn, so you can get nauseous or have vomiting, abdominal pain, or reflux.”
To help prevent this, always eat a snack before taking your meds since food coats your stomach lining (unless your doctor says otherwise), and limit your use of NSAIDs. “If you injure yourself, try to switch off between an anti-inflammatory and Tylenol because Tylenol is the only pain reliever that does not affect the stomach,” notes Dr. Behar.
If the stomach irritation is severe and nausea becomes unbearable, stop your meds entirely and talk with your doc about other pain relief options.
2. You are anxious.
It’s not fully understood why, but if you’re nervous or stressed (they usually go hand-in-hand), you may experience abdominal pain and nausea. “Our gastrointestinal tract has a very specific nervous system called the enteric nervous system, and it communicates directly with our central nervous system (brain and spinal cord),” Dr. Vanderheyden explains. “If a patient is stressed or anxious, nerves fire in the gut, and the body and brain will perceive it as nausea.”
And when your fight-or-flight response kicks in, a rush of hormones is released. These hormones then send chemical signals to the nerves in your gut, leading to nauseating contractions, according to Harvard Health.
There are lots of stress management strategies to choose from, but a healthy diet, plenty of sleep, drinking mint or ginger tea, meditating, yoga, journaling, and avoiding alcohol or tobacco are all easy ways to minimize anxiety and calm nausea, per the CDC. If you continually find yourself stressed to the point of feeling nauseous, talk with your doctor and consider working with a therapist to lower your overall stress levels.
3. You're pregnant.
You’re familiar with morning sickness, but nausea is often one of the first signs of pregnancy and it can happen day or night. In fact, 75 percent of women are said to suffer from nausea and vomiting while pregnant, says Dr. Behar. “It usually begins within the first nine weeks of pregnancy, and if it begins later than that, a patient should be evaluated by their doctor,” she says. The nausea typically subsides around 14 weeks, but it can last longer.
And while nausea is normal and common during pregnancy due to fluctuating hormones, always talk with your ob-gyn before taking any medications. “We have to be careful with using drugs in pregnancy because it can affect the baby,” notes Dr. Behar.
Instead, try using ginger and increasing your vitamin B6 intake to soothe nausea. In rare cases, some women develop severe nausea and excessive vomiting, which can cause dehydration, also known as hyperemesis gravidarum. So, if you can’t keep anything down, talk with your ob-gyn ASAP, adds Dr. Behar.
4. You have a migraine.
If you suffer from migraines on a regular basis, you know nausea is one of the symptoms that usually accompanies the throbbing head pain. “One of the symptoms associated with migraine is nausea and vomiting, but [nausea] can also signal that a migraine is about to occur,” says Dr. Behar. This warning sign, a.k.a an aura, typically starts 30 minutes to an hour prior to an attack, but it can continue after the migraine sets in.
Other symptoms you may experience include blurry vision, ringing in the ears, flashes of light, and fatigue, says Dr. Ruiz.
You can try taking an OTC medication like Excedrin, Tylenol, and Advil to mitigate symptoms, but also make sure to stay hydrated and drink fluids because dehydration can make the nausea worse, adds Dr. Behar. If your migraines are chronic and frequently debilitating, it’s time to talk with your doctor about prescription medications or lifestyle changes.
5. You have food poisoning.
If you have an upset stomach along with cramps, diarrhea, nausea, vomiting, and a fever, you may have food poisoning, says Dr. Ruiz. It’s the body’s stress response to get rid of bacteria, viruses, and parasites that were in the food you ate.
Symptoms typically start a few hours after eating the contaminated food and generally last from a few hours to several days, says Dr. Ruiz. “If it's going on for more than a day and you're not able to keep even water down, then it's time to seek medical care because you're going to need IV fluids and anti-nausea medication,” he adds.
In addition, if you have bloody vomit or stool, severe abdominal pain, or extreme signs of dehydration like excessive thirst, dry mouth, lightheadedness, and fatigue, then it’s time to call a doctor, he adds.
6. You have gastroparesis.
Also known as delayed gastric emptying, gastroparesis is the slowing down or partial paralysis of your stomach muscles that prevents proper digestion, says Dr. Vanderheyden. Because of this, food sits in your stomach longer. Your stomach cannot accommodate new food and contracts when anything new enters the system, causing you to feel nauseous.
While most cases of gastroparesis are spontaneous, you’ll want to eat smaller, more frequent meals, so it’s easier on your stomach to pass and digest food, says Dr. Vanderheyden. That said, if you have extreme pain or severe nausea that is preventing you from eating, a trip to your doctor's office is a must because you may be prescribed medications to help stimulate the stomach muscles and reduce nausea.
7. You have an ear infection.
This may surprise you, but ear infections could be the culprit. “The semicircular canals in the ear are one of the main components of balance in our body, and if you have inflammation in the canals, you may experience nausea and vomiting,” Dr. Behar explains.
This inflammation can be caused by bacteria, viruses, and a buildup of fluid in the ears that throws off your body’s ability to regulate itself and maintain balance, leaving you feeling nauseous and dizzy.
So, if you have ear pain or pressure accompanied by nausea or dizziness, check in with your doctor and they’ll likely prescribe an antibiotic to fight off the infection, adds Dr. Behar.
8. You get motion sickness.
Motion sickness is caused by any movement, but it’s usually associated with riding in a car, boat, or plane, says Dr. Behar. And similar to an ear infection, motion can cause an imbalance in the semicircular canals of your ear and can result in vertigo, nausea, and motion sickness.
Luckily, the nausea usually subsides once you are out of the moving vehicle, but if you are prone to motion sickness, you can take antihistamines before a trip like Dramamine, Zyrtec, and Claritin, says Dr. Behar.
9. You're having a heart attack.
Women are more likely to experience other symptoms along with chest pain when having a heart attack, according to Mayo Clinic. If you have chest pressure that persists for minutes and you feel nauseous, go to the emergency room ASAP.
“You can have nausea, vomiting, shortness of breath, palpitations, and lightheadedness, which are all associated with cardiac causes,” says Dr. Behar. “It may just be reflux or heartburn, but you always have to rule out the worst.”
A heart attack is serious and needs to be checked out by a doctor. Your risk of having one is higher if you have high blood pressure, unhealthy cholesterol levels, diabetes, and obesity, per the CDC. It's important to manage these conditions with medications and lifestyle changes so you can lower your likelihood of getting a heart attack.
10. You have a bacterial or viral infection.
If your nausea is accompanied by vomiting, congestion, fatigue, fever, diarrhea, abdominal cramping, or body aches, you may have a stomach bug, says Dr. Behar. You’ll likely need to go to the doc for an exact diagnosis, but the stomach flu, viral gastroenteritis, and COVID-19 all commonly present with nausea.
Unfortunately, stomach bugs usually have to run its course on its own, but anti-nausea medication can help and hydration (with electrolytes!) is key to a speedy recovery, says Dr. Behar. You’ll typically start to feel better after two days, but if you feel like you're going to pass out, have bloody diarrhea, or your symptoms are getting worse, see a doctor immediately.
So, is there anything you can do to prevent nausea?
While nausea is sometimes inevitable (we’re looking at you, plane turbulence), there are a few things you can do to keep the queasiness at bay.
“The most important thing, believe it or not, is hydration and drinking a lot of fluids,” says Dr. Behar. Anytime you’re dehydrated you’re likely to feel nauseous, so women should always aim for about 11.5 cups a day, according to Mayo Clinic.
And you'll want to quit smoking since it’s directly associated with stomach inflammation, limit alcohol consumption, and minimize your use of anti-inflammatory meds, says Dr. Behar.
If you’re aware of specific triggers that make you nauseous such as certain scents, foods, or temperatures, do your best to avoid them whenever possible, notes Dr. Ruiz.
When should you see a doctor?
Some common causes of nausea may resolve on their own or with OTC medications and rest, but if your nausea affects your ability to go about your daily activities or you’re unable to function at work or at home, then it’s time to see a doctor.
“If you're not yourself, and certainly if it's been going on for more than four weeks, I would encourage someone to see their primary care provider,” says Dr. Vanderheyden
And if you are in extreme pain, constantly throwing up, have bloody stool, chest tightness, blurred vision, confusion, or other alarming symptoms, you need to go to the emergency room immediately.
Andi Breitowich is a Chicago-based writer and graduate student at Northwestern Medill. She’s a mass consumer of social media and cares about women’s rights, holistic wellness, and non-stigmatizing reproductive care. As a former collegiate pole vaulter, she has a love for all things fitness and is currently obsessed with Peloton Tread workouts and hot yoga.
