When your insides are churning, you likely run through a mental checklist of all the reasons why you might feel so nauseous: Did I eat something funky? Do I have some kind of stomach bug? Am I…pregnant?
Even though nausea is simply part of being human, it’s not something you should just endure if it strikes you often—that about-to-puke sensation can make you really miserable, not to mention anxious if you have no idea what the culprit might be.
Turns out, beyond babies and bad food, plenty of things can trigger this unpleasant symptom. Here are the most common causes of nausea, plus when it’s time to see a doctor.
What does nausea feel like, exactly?
Ultimately, your stomach just feels uneasy or queasy, and that boils down to “gastric discomfort,” says Rudolph Bedford, MD, a gastroenterologist at Providence Saint John’s Health Centre. The swirling sensation is often accompanied by the urge to vomit (or you might feel like it’s going to happen).
This is a little different for everyone—and it depends on what triggered the nausea in the first place—but you may experience a strange feeling in your chest, upper abdomen, or back of the throat; an unsettled or anxious feeling in your stomach; start sweating a lot; lose your appetite; start retching or gagging; or suddenly have a ton of saliva in your mouth.
What are the possible causes of nausea?
1. Stress and anxiety
On top of the mental load, stress and anxiety can also spur a cascade of physical effects in your body. This includes your gut, which is sensitive to negative emotions, says Randy Wexler, MD, a professor of family medicine at theOhio State University Wexner Medical Center.
The lining of your digestive tract has its own nervous system that works to expand and contract the muscles that keep food moving through your intestines. But when you’re stressed or anxious, your brain may send signals to those nerves and cause additional contractions (medically known as tachygastria). This messes with your gut’s normal rhythm, which can make you feel nauseous. Dr. Wexler says you don’t have to be in a severely anxious state to notice these changes—even minor stress can be a trigger.
Taking some deep breaths (ideally getting some fresh air) can help you feel calmer, which might tame the queasiness. Another option: Sip a cup of ginger tea or chew on a piece of candied ginger, says Kristine Arthur, MD, an internist at Orange Coast Memorial Medical Centre. The spicy root has properties that are thought to ease nausea. And if you routinely find yourself feeling sick to your stomach because your mental health has taken a dip, consider seeking out a therapist if you haven’t already.
2. Hunger (or eating very quickly)
When you’ve gone several hours without eating, your blood sugar can get too low, triggering nausea, shakiness, or dizziness. You might even feel like you’re going to pass out, Dr. Arthur says. The quickest fix: Have something high in carbs like a glass of fruit juice, fresh or dried fruit, or a piece of bread. Getting sugar into your system will bring your blood glucose back up to normal, so you’ll start to feel better.
On the flip side, it’s also possible to feel nauseous because you chowed down on a giant meal at lightning speed. When your stomach is stuffed and feeling swirly, OTC nausea-reducing medications, like Pepto Bismol, can come in handy.
3. Dehydration
Nausea can also be your body’s way of telling you it’s parched. And we’re not talking about day-in-the-desert levels here—for some people, even mild dehydration is enough to upset your stomach, Dr. Wexler says. (The dehydration and low blood sugar that come with a gnarly hangover is a notoriously brutal combo too.)
You’ll likely be able to tell if dehydration is causing your rumbly stomach if you also feel really low energy, thirsty, and headache-y. If that’s the case, drink up. Usually plain water will do the trick, says Dr. Wexler, but if you have signs of severe dehydration, like dizziness or confusion, seek medical attention right away.
4. Certain medications
Plenty of meds—including over-the-counter drugs, as well as supplements—can wreak havoc on your gut. (You’re probably well aware of this if you’ve ever popped an ibuprofen on an empty stomach.) Without some food in your belly to act as a buffer, the components of certain capsules, powders, or liquids can irritate the lining of your stomach, Dr. Wexler says. Supplements like vitamin C and iron can have a similar side effect.
If it’s been more than an hour or two since your last meal, you can keep discomfort at bay by eating something small. “Often just a piece of bread or a few crackers will suffice,” Dr. Wexler says. And in the future, just be sure to have a little snack before you pop any pills.
5. Motion sickness
Motion sickness can hit when you’re in a car, train, airplane, boat…pretty much anytime you’re firmly planted in something that’s traveling from point A to B. It happens when your inner ear (which affects both your hearing and balance) senses movement that clashes with what your eyes see.
If you know you’re prone to motion sickness, pay close attention to your in-transit habits. “Don’t look at your phone; look at what’s outside and in front of you,” says Ashkan Farhadi, MD, a gastroenterologist at MemorialCare Orange Coast Medical Centre. Sitting in the front of a car or bus, choosing a window seat on flights and trains, and distracting yourself with things like music or lulling yourself to sleep might also help. And be sure to plan ahead by packing medications like Benadryl or Dramamine in your bag, which can help lower your risk of feeling sick in the first place (your doctor can help advise on the best option for you).
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6. Acid reflux
Acid reflux—a condition in which your powerful stomach acids flow back up into your esophagus—doesn’t just trigger heartburn: You might regurgitate partially digested food, have a sore throat or trouble swallowing, develop a cough, or experience a wave of nausea, among a slew of other symptoms. “There can also be a sour taste in the mouth—that in and of itself can cause nausea,” Dr. Bedford says.
Acid reflux is common, and eating spicy, acidic, or high-fat foods is a major trigger for most people, Dr. Farhadi says. Avoiding things like tomatoes, chocolate, or coffee (we know, the good stuff!) might be enough to calm your stomach. But you should see a doctor if this is a regular thing for you—say, heartburn is consistently waking you up at night or you’re popping antacids like Tums multiple days per week. Chronic reflux (a.k.a. gastro-oesophageal reflux disease, or GERD) can really impact your day-to-day life and is even linked to a higher risk of oesophageal cancer when left untreated, so don’t hesitate to get checked out.
7. A stomach bug
Fingers crossed this isn’t the case, but there are two health issues to keep top of mind here: food poisoning and the stomach flu. Food poisoning happens when your GI tract is irritated or infected due to contaminated food or drinks. The stomach flu, or gastroenteritis, happens when a pathogen, like norovirus, infects your GI system. Nausea is just the start of both of these hellish experiences—you’ll likely be hit with stomach pain and cramps, bloating, diarrhoea, vomiting, and fever or other flu-like symptoms too.
8. Migraine
Yep, nausea can be a symptom of migraine, and it can go hand-in-hand with sensitivity to light, diarrhoea, and vomiting. According to a 2017 study in the Journal of Pain Research, 58% of nearly 8,000 migraineurs reported feeling nauseous during an episode—but that number has been as high as 90% in previous research. Experts don’t fully understand why nausea can happen during a migraine attack, but they suspect it comes down to various changes that can happen in the brain, from hormonal fluctuations to effects on the blood vessels.
If you’ve been dealing with these symptoms alongside your brutal headaches and OTC meds aren’t giving you enough relief, talk with your health care provider. They can prescribe migraine-specific medications that may be more helpful.
9. An ear infection
The canals in your inner ear play an important role in keeping your balance in check. But when there’s a blockage in that zone (thanks to, say, allergies or a cold), fluid can build up and trap bacteria, potentially leading to an infection, Dr. Arthur says. Your brain then gets an alert that the pressure in your infected ear is different than the pressure in your healthy ear. And those mixed signals can leave you feeling nauseous and dizzy.
“Typically, an ear infection causes pain, a feeling of pressure in the ear, changes in hearing, nasal congestion, headache, and fever,” Dr. Arthur says. If this sounds like you, see a doctor as soon as you can. They can prescribe antibiotics if an infection is indeed at play, and you’ll hopefully start feeling better within a couple of days.
10. Pregnancy
We’d be remiss not to mention this one! Due to fluctuating hormones, nausea is a common sign of pregnancy, especially early on. The queasiness usually begins before nine weeks gestation, and although it typically recedes by 14 weeks, some pregnant folks experience nausea and vomiting even longer than that. This is commonly known as “morning sickness,” but the unfortunate truth is that it can happen at any time of day (or night). These symptoms are par for the course; however, if your stomach woes are affecting your quality of life or even scaring you, you should talk to your ob-gyn. Severe nausea and vomiting during pregnancy is called hyperemesis gravidarum, and it can lead to issues like dehydration.
11. Heart attack
Heart attack symptoms can go beyond chest pain, especially for women. While chest discomfort that persists for minutes or advances and recedes is still the most common sign of a heart attack, no matter your gender, women are more likely to experience some lesser-known signs, including nausea; vomiting; a cold sweat; shoulder or arm pain; back, neck, or jaw pain; and shortness of breath. Listen to your body—and if you have any suspicion that your heart is in trouble, seek immediate medical care.
When to see a doctor about treating nausea
Sometimes home remedies can only get you so far. Nausea and vomiting that lasts more than two days for adults, 24 hours for children under two years old, or 12 hours for infants deserves your doctor’s attention. You should also seek care if nausea is preventing you from eating enough or paired with unexplained weight loss. And even if your uneasy stomach doesn’t drag on for several days, if you have on-and-off episodes that continue longer than a month, you should still book an appointment.
“Nausea is a defense mechanism for the body,” Dr. Farhadi stresses. Something is “signalling the alarm,” and you won’t start to feel better until you figure out what’s flipping the switch.
This article originally appeared on Self.
