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  Nausea

Nausea is not an illness but a sensation or an uneasy feeling of having an urge to vomit. Nausea can be a sudden, short-term or a long-term symptom. The possibility of having nausea preceding episodes of vomiting or nausea without vomiting may occur. These symptoms may be part of an overwhelming infection or serious medical condition. Likewise, it can also be psychological in origin. In fact, most cases of nausea are actually from other causes and does not necessarily be gastrointestinal (the esophagus, stomach, small and large intestine and the accessory organs of digestion which include the liver, pancreas and the gall bladder) in origin.

Nausea
Nausea


Adverse drug reaction may manifest as nausea therefore, it is important to take note of all other medications that you are taking which include herbal products, over-the-counter and prescribed medicines. Inform your doctor before starting any medication because the possibility of a drug interaction may occur. Cancer patients undergoing chemotherapy sessions are also experiencing nausea with vomiting. This is due to the fact that the chemoreceptor trigger zone (vomiting center) in the brain has been triggered by the anti-neoplastic agents. Some patients give up the chemotherapy regimen just because of not being able to tolerate the severity of nausea and vomiting symptoms as a side effect. In other mild cases, patients feel nauseated (with vomiting) when traveling also known as motion sickness. Any impairment between the coordination of the inner ear and the sense of vision or between the perception of movement and the actual movement itself can also lead to nausea. Nausea and vomiting may occur also after any major surgical procedure and the effect of the general anesthesia has something to do with it. Lastly, nausea is common among pregnant women especially during the first trimester of pregnancy. This is largely attributed to the hormone known as hCG or the human chorionic gonadotropin secreted by the placenta which peaks at around 60 to 90 days of early pregnancy. Some pregnant women develop severe nausea and vomiting leading to a condition known as hyperemesis gravidarum which necessitates hospitalization to prevent dehydration.

Nausea and vomiting are uncomfortable symptoms that sometimes hinder patients’ normal daily activities. They can have difficulties in performing their usual duties at work and even household chores. It is important to consult a doctor if you experience nausea with or without vomiting especially if it is recurrent and for a prolonged period of time. This condition necessitates further medical investigation to determine the exact cause. Other accompanying symptoms and determining what preceded the onset of nausea and vomiting can guide the doctor in identifying the probable underlying cause. Symptoms such as fever, body malaise, runny nose, cough, joint pains and loose bowel movement may indicate possible infectious process. Suspect possible pregnancy for patient complaining of early morning sickness but this may be seen in patients with metabolic problems like kidney failure as well. Nausea with vomiting several hours postprandial may suggest an upper gastrointestinal tract obstruction especially if accompanied by signs of abdominal distention during abdominal physical examination.

Referral to a psychiatrist is needed if the nausea and vomiting is associated with a psychiatric problem such as eating disorder (anorexia nervosa and bulimia); anxiety attacks or panic disorders. In these cases, a mental status examination may be performed by the doctor to appropriately manage the case.

A complete medical history of the patient is essential in the proper diagnosis of nausea. The doctor may request for laboratory tests such as blood chemistry, urinalysis and imaging studies such as abdominal x-ray (supine, lateral and upright view) and CT scan. These tests may provide evidences like presence of drugs or toxic substances in the patient's blood or urine; head injuries or gastrointestinal tract problem.

Pharmacologic intervention for medical conditions with nausea and vomiting include: antiemetics such as Meclizine (Bonamine) and Dimenhydrinate (Dramamine), both for travel sickness; oral or intravenous rehydrating solution for patients who developed dehydration and correction of possible electrolyte imbalance. Most recent drugs that are given as antiemetic drugs for patients undergoing chemotherapy regimen are ondansetron (Zofran) and granisetron (Kytril).

Others advocate the use of alternative medicine approach to control nausea which include the following: acupressure, herbal products (to calm the body), exercise and relaxation techniques and acupuncture. But not all patients are relieved with acupuncture; some even have nausea as a side effect of this type of alternative treatment.

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