Nausea

WHEN TO SEE YOUR DOCTOR

* Nausea persists for more than two days or frequently recurs.

* You're pregnant and nausea is so severe that you can't eat or drink.

What Your Symptom Is Telling You

You're wedged in the back of a rickety bus that's bumping along a winding country road. The air's a stifling mix of stale perfume, diesel exhaust and somebody's lunch. In fact, you're perilously close to losing your lunch.

When you're queasy from a bus ride or a too-greasy burger from Bob's Bar and Grill, it's hard to believe that nausea is sometimes a helpful sensation. But it is.

"Nausea is nature's way of suppressing your appetite," says Ronald Hoffman, M.D., director of the Hoffman Center for Holistic Medicine in New York City. Whenever something irritates your digestive tract—whether it's a burger or bacteria—a signal is relayed to "vomiting central" in the brain. The brain tells your mouth to start salivating, your digestive tract to do the rumba, your windpipe to narrow and your appetite to shut down. You perceive all these bodily activities as a single symptom: nausea. "And that keeps you from putting anything else in your stomach and further irritating it," says Dr. Hoffman.

But nausea isn't always a digestive system defense mechanism. The balance center in the inner ear can also spark nausea. When you're rocking in a boat, for example, your brain receives a mixed message: Your eyes are steady on a book or deck chair, but the fluid in your inner ears is rocking with the boat movement. This sensory mismatch triggers the release of stress hormones that make your stomach muscles quiver. This stomach distress creates the wretched feeling—often followed by the equally wretched vomiting—that we know as seasickness.

Fortunately, there's Dramamine. But certain other drugs, such as anesthesia, chemotherapy medications and tricyclic antidepressants, can cause nausea.

Other causes include migraine headaches, emotional stress or unpleasant odors. And severe hormone shifts—most notoriously, during the first trimester of pregnancy—can trigger recurring nausea.

Persistent nausea can also indicate a serious digestive problem such as colitis, ulcers, gastroenteritis or gallstones. In those diseases, however, nausea is usually accompanied by pain and other symptoms. Nausea can also be one of the signs of a heart attack, some types of cancer and kidney or liver disorders.

Symptom Relief

If you have severe, persistent nausea, see your doctor. But for "normal," everyday queasiness there are a number of things you can do to make the experience a little less—well, nauseating.

Eat something. This is probably the last thing you want to do. It should be the first. "Eating something bland and starchy at the first twinge of nausea may help control irregular stomach rhythms," says Kenneth Koch, M.D., professor of medicine at the Hershey Medical Center at Pennsylvania State University. Crackers or toast are good choices, but skip the butter. Fatty foods are too hard on the stomach, says Dr. Koch, and can make nausea worse.

Drink something. Right, not another beer. Take a spoonful of syrup. Emetrol is a sugary, over-the-counter antinausea drug that's very similar to cola syrup, a time-honored home remedy. Emetrol, however, doesn't have caffeine and has a little phosphoric acid added to settle the stomach, says Dr. Gebhard.

Remember to breathe. Anxiety, says Dr. Koch, can stimulate the stress hormones that trigger nausea. To reduce anxiety, take several slow, deep breaths, especially when you first feel woozy. Deep breathing can also soothe your stomach contractions.

Review your medications. Tricyclic antidepressants can cause nausea if the dosage is too high, says Dr. Hoffman. If you're taking this medication (or any prescription drug) and experience unexplained nausea, call your doctor and ask whether your medication could be causing the problem and whether it should be adjusted.

Just do it. If you're still feeling like you need to throw up, don't try to stifle it. It may be the best thing to do if something doesn't agree with you or you have the flu, says Dr. Koch.

How to Calm Motion Sickness

If cruising the ocean blue leaves you green around the gills, here's what you can do for smoother sailing.

Take your medication early. Over-the-counter motion sickness medication, such as Bonine and Dramamine, is most effective if you take it at least an hour before you set sail, says Dr. Koch. Your doctor can also prescribe a scopolamine patch before the trip. Worn behind the ear, it delivers antinausea medication to your bloodstream for four days. The downside to these medications is that they can make you drowsy.

Try ginger. Scientific studies show that the herb ginger can work nearly twice as long as Dramamine with none of the side effects. Take three or four 400-milligram ginger capsules 15 minutes before leaving and every four hours once you get underway, suggests researcher Daniel Mowrey, Ph.D., director of the American Phytotherapy Research Laboratory in Salt Lake City.

Come up on deck. Enclosed spaces aggravate motion sickness. And once on deck, you should stand near the center of the ship, where there is less pitching motion, says R. J. Oenbrink, D.O., a physician in private practice in Tequesta, Florida, who often works on ships.

Keep your eyes on the level. On a boat, keep your eyes on the horizon. In a car, focus on the distant terrain ahead of you. It's helpful to stabilize your vision even though your inner ears are registering a lot of motion, says Dr. Koch.

Press your wrist. The Chinese technique of acupressure helps short-circuit motion sickness in even the most weak-kneed sailors, says Dr. Koch. The spot is located exactly in the middle of your wrist, three finger-widths down from the wrinkle that separates your palm and your wrist. You can buy elastic acupressure wrist bands that exert constant pressure on the correct point. But, says Dr. Koch, acupressure seems to work better if you exert a strong rubbing pressure on the point.

Morning Sickness

Morning sickness (which can occur any time of day) usually appears during early pregnancy. Episodes generally disappear after the third month. If you have morning sickness, you'll want to discuss it with your doctor. Here are a few helpful recommendations.

Have a little breakfast right away. Eating crackers or another bland food before you get out of bed can help prevent nausea, says Jennifer Niebyl, M.D., professor and head of Obstetrics and Gynecology at the University of Iowa in Cedar Rapids. She also suggests eating several small meals throughout the day.

Sip ginger tea. Danish researchers discovered that powdered ginger root reduces nausea and vomiting, which was so severe it required hospitalization.

Many pregnant women benefit from this herb. To try it, dissolve a teaspoon of powdered ginger in a cup of hot water. Drink the tea every four hours as needed.

Be aware of B₆. Dr. Niebyl conducted a study in which women who took 25 milligrams of vitamin B₆ three times daily for three days reduced severe nausea. Women who took a placebo—a fake, look-alike pill—had no benefit. But B₆ only worked for severe cases. "The nutrient had no effect on mild nausea," says Dr. Niebyl. Ask your doctor whether B₆ supplements are right for you. (Pregnant women should check with their doctors before taking any over-the-counter medications or nutritional supplements.)

Rehydrate with fruit juice. If nausea has advanced to the vomiting stage, you'll need to drink lots of fluids—especially carbohydrates like fruit juice—to guard against dehydration, says Dr. Niebyl. If you can't keep any food or drink down, see your doctor immediately.