Nausea On An Empty Stomach : Causes, Symptoms, Diagnosis & Treatment

• Causes Of Nausea On An Empty Stomach
• Toxicosis Of Pregnant Women
• Stomach Diseases
• Parasitic Infestations
• Erosion Of The Esophagus
• Migraine
• Endogenous Intoxications
• Emergency Conditions
• Survey
• Symptomatic Therapy

Nausea on an empty stomach is painful sensations in the epigastric region, oral cavity and pharynx that occur on an empty stomach with subthreshold excitation of the vomiting center. Nausea can be observed both with pathologies of the gastrointestinal tract, and as a result of toxicosis of pregnant women, endogenous intoxication syndrome, and neurological disorders. To detect the causes of nausea, ultrasound, endoscopy, pH-metry, laboratory blood and stool tests are prescribed, women are recommended a gynecological examination. In order to relieve discomfort, herbal teas, prokinetics, sedatives, antacids are used.

Causes of nausea on an empty stomach

Nausea on an empty stomach usually indicates the presence of an organic or functional pathology of the digestive system, may indicate endotoxicosis, neurological disorders. The most common physiological causes of nausea include taking vitamin complexes on an empty stomach. More often, unpleasant sensations develop after the use of ascorbic acid, B vitamins, quercetin. The symptom is a common side effect of oral iron preparations.

Toxicosis of pregnant women

The presence of nausea on an empty stomach during pregnancy is associated with early toxicosis, which is determined in 60% of women, starting from 5-6 weeks. The appearance of discomfort in the morning has several reasons: a change in the concentration of sex hormones in the blood, irritation of the nerve endings of the body of the uterus due to the attachment of a fetal egg, a violation of the immunological status of a woman. Discomfort is accompanied by salivation, aversion to food, weakness, dizziness. Nausea usually precedes vomiting, the frequency of which correlates with the severity of toxicosis.

Stomach diseases

Unpleasant symptoms are more often caused by hyperacid states, when an excess of free hydrochloric acid irritates the gastric mucosa, causing pathological impulses from the nerve receptors of the organ. Nausea is associated not only with organic diseases of the stomach, but also with a functional variant of dyspepsia. The symptom is combined with abdominal pain of various localization and intensity, stool instability. Often, nausea on an empty stomach develops with the following pathologies:

• Erosive gastritis . Discomfort and urge to vomit are caused by irritation of the intramural plexus of the stomach. Nausea with erosions of the gastric mucosa is accompanied by mild epigastric pain, stool disorders, and bloating. Also, patients are worried about heartburn, belching with air or sour. A dangerous complication of the disease is bleeding, which provokes vomiting with streaks of blood.
• Chronic gastritis . Nausea on an empty stomach is more often observed with helicobacteriosis - an inflammatory process of bacterial origin. Patients feel dull pain in the epigastric region, heartburn, belching sour, loss of appetite. Disturbed stool with alternating constipation and diarrhea. Over time, the disease becomes hypoacid type, manifested by severe digestive disorders.
• Ulcer disease . Complaints of nausea after awakening and on an empty stomach are more pathognomonic for duodenal ulcers, but also occur with an organic defect in the stomach wall. Painful sensations are combined with sharp pains in the epigastric zone, periodic vomiting. For peptic ulcer, seasonal exacerbations are typical in spring and autumn, worsening after errors in the diet, drinking alcohol.
• Biliary reflux gastritis. This variant of inflammation is characterized by irritation of the nerve endings of the stomach due to the reflux of bile in violation of normal peristaltic activity. Dyspeptic disorders occur on an empty stomach, patients complain of nausea, belching, burning behind the sternum. The pain syndrome often worries after eating, heaviness in the abdomen is constantly felt.
• Irritable stomach syndrome . The disease is associated with a periodic increase in the production of hydrochloric acid, which is the result of stress, nutritional errors and irregular nutrition. Symptoms of functional indigestion are more common in younger people. Dyspeptic disorders are accompanied by emotional lability, changes in the work of the autonomic nervous system.

Parasitic infestations

Nausea on an empty stomach is often one of the first symptoms of helminthiases, protozoal infections, especially in children. Irritation of the vomiting center occurs due to damage to the mucous membrane of the digestive tract, as well as under the influence of toxic metabolic products of helminths that accumulate in the body. Hypersensitization to parasite antigens plays a significant role. Nausea is most often experienced by patients with infectious diseases such as:

• Giardiasis . With this protozoal infection, reflex nausea is observed, which is associated with damage to the intestines, the biliary system. Symptoms include heaviness and pain in the epigastrium, right hypochondrium, belching, stool instability with a tendency to diarrhea. Giardiasis is characterized by a syndrome of intoxication of varying intensity: subfebrile condition, fatigue, headaches.
• Toxoplasmosis . Nausea is one of the manifestations of the disease and is caused by damage to the digestive tract - a symptom often occurs as part of mesadenitis along with abdominal pain, constipation, and flatulence. With toxoplasmosis, there is a polymorphism of the clinical picture with the involvement of many systems and organs. Symptoms of general intoxication increase, the liver and spleen increase, maculopapular rashes on the skin appear.
• Ascariasis . Dyspeptic disorders are typical for the intestinal form of the disease and include pain along the intestines, nausea on an empty stomach, stool disorders with a predominance of constipation. With a massive invasion of helminths, partial intestinal obstruction, weight loss, and lack of appetite are possible. Ascaris sometimes penetrate the bile and pancreatic ducts, which leads to inflammation in the gallbladder, pancreas.

Erosion of the esophagus

Nausea on an empty stomach is caused by the flow of aggressive stomach contents into the lower esophagus in a horizontal position. Hydrochloric acid is an additional irritant for the affected mucosa. The symptom is usually combined with sour belching, burning behind the sternum. Patients complain of swallowing disorders, sharp retrosternal pain after eating. With a massive organic lesion of the wall of the esophagus, bleeding is possible, in which streaks of scarlet blood are present in the vomit.

Migraine

Nausea on an empty stomach with migraine is of central origin and is associated with the spread of excitation from the pathological focus to the vomiting center of the medulla oblongata. The symptom occurs in the precursor stage, combined with weakness, drowsiness, yawning. During the peak period, patients experience sharp unbearable pain in one half of the head, more often in the frontal, temporal zone. The pain syndrome is aggravated by the action of bright light, loud sounds, nausea and vomiting often develop at the height of the pain. The duration of the attack ranges from 4 hours to several days.

Endogenous intoxications

In the syndrome of endotoxicosis, the development of nausea is associated with direct irritation of the trigger zone in the region of the fourth ventricle of the brain by toxic substances. Unpleasant sensations are formed against the background of a general severe condition caused by damage to other nervous structures and functional disorders of the internal organs. The symptom is observed in various chronic liver diseases (hepatitis, fatty degeneration), which lead to a decrease in its detoxification function.

Nausea on an empty stomach is often noted by patients with chronic renal failure and uremia, in which the body is poisoned by protein metabolism products that are delayed due to impaired excretory function. The manifestation is combined with constant thirst, dry mouth, loss of appetite, tremor of the fingers. The skin looks very pale with a grayish tint, itchy skin bothers. Nausea on an empty stomach becomes a consequence of cancer intoxication when metabolic products of malignant cells enter the general bloodstream.

Emergency conditions

The appearance of nausea on an empty stomach is typical for acute diseases that require immediate medical attention. Discomfort sensations are formed in various ways: by direct action on the trigger zone of the vomiting center in the medulla oblongata, by reflex mechanisms when visceral receptors or nerve endings in the serous membranes are stimulated. These diseases are characterized by severe or extremely severe general condition. Nausea occurs in pathologies such as:

• Hypertensive crisis . Nausea on an empty stomach is caused by severe disorders of cerebral hemodynamics and secondary neurovegetative reactions. Intense headaches develop in the back of the head and temples, combined with visual impairment (“flickering of flies”, the appearance of a “shroud”), excessive sweating, redness of the skin of the face and neck. In classical cases, the duration of an uncomplicated crisis is up to 5-6 hours.
• Appendicitis . Inflammation of the appendix is ​​accompanied by a pronounced pain syndrome, which causes reflex nausea and vomiting. With appendicitis, pain often migrates - first they occur in the navel, and after a while they are localized in the right iliac region. The general intoxication syndrome is growing due to the ingress of toxins and products of inflammation into the blood, tachycardia, and a decrease in blood pressure.
• Peritonitis . At the initial stages of the disease, the onset of nausea is due to reflex reactions of the vomiting center to irritation of the peritoneal receptors. In the future, indomitable vomiting begins, associated with intestinal paresis and severe endotoxicosis. Peritonitis is characterized by a gradual subsidence of abdominal pain as the general condition of the patient worsens. In severe situations, an increase in multiple organ failure is possible.

Survey

The appearance of nausea on an empty stomach is due to various pathologies of both the digestive tract and other body systems. Therefore, a comprehensive examination prescribed by a gastroenterologist includes a wide range of instrumental methods and laboratory tests. First, the state of the gastrointestinal tract is studied, then other organs are examined. The most valuable in terms of diagnostics are:

• Sonography . Ultrasound of the abdominal cavity is used at the initial stage of the examination to quickly assess the state of the digestive tract and develop further tactics. Non-invasive ultrasound examination allows to detect non-specific signs of the inflammatory process, to determine morphological disorders in the organs of the gastrointestinal tract.
• Endoscopy . According to the indications, EGDS is performed for a clear visualization of the mucous membrane of the stomach, esophagus, and upper parts of the duodenum. The method is used to confirm inflammatory diseases, neoplasms, cicatricial changes. To clarify the diagnosis, a biopsy with histological examination is performed.
• Intragastric pH-metry . Hyperacid diseases often lead to nausea on an empty stomach, therefore, in the presence of specific complaints, it is recommended to measure the pH in the stomach within 24 hours. The method allows to evaluate the quality, the degree of activation of the acid-producing function of the organ. Additionally, carry out the measurement of pH in the esophagus.
• Fecal analysis . All patients are prescribed a standard coprogram to detect violations of the intestines, they are analyzed for helminth eggs. If an infectious etiology of the disease is suspected, an extended bacteriological examination of feces is performed. To exclude bleeding from the gastrointestinal tract, the Gregersen reaction is recommended.
• Laboratory Research . Biochemical analysis of venous blood is a highly informative method that can be used to confirm violations of the liver and kidneys, to identify the degree of endogenous intoxication. The blood is also examined for the most common antigens of intestinal infections, the level of gastrin, pepsinogen.

All women of reproductive age with complaints of morning sickness are prescribed a consultation with a gynecologist with the delivery of a specific analysis for hormones to confirm or deny the presence of pregnancy. When nausea is combined on an empty stomach with intense headaches, a neurological examination is recommended. In difficult cases, consultations of other specialists may be required to verify the diagnosis.

With complaints of nausea, a comprehensive gastroenterological examination is indicated.

Symptomatic therapy

If unpleasant symptoms are caused by taking medications, it is enough to change the time of taking medications or take them after a small snack. In severe intolerance to pharmaceuticals, doctors recommend parenteral methods of administration. Non-intense nausea in pregnant women, which does not violate or slightly disrupt the diet, does not require correction. A woman is recommended frequent fractional meals, observance of psychological rest, feasible gymnastics. Severe toxicosis is an indication for hospitalization.

Since nausea on an empty stomach is associated with various diseases, for its relief it is necessary to carry out etiotropic, pathogenetic treatment of the underlying pathology. Until the root cause of nausea is established, herbal teas (chamomile, ginger) can be used to reduce discomfort, prokinetics, antacids, light sedative herbal remedies are prescribed from medications. When a symptom is combined with repeated vomiting, severe pain in the abdomen, and violations of the general condition, you should immediately consult a doctor.