What causes nausea? 12 common causes and their treatments

Several conditions can cause nausea, including stress, anxiety, infections, and motion sickness. Occasional temporary nausea is also common but typically not cause for concern.

Nausea is a sensation that makes a person feel they need to vomit. Sometimes, individuals with nausea do vomit, but not always.

In this article, we explore what triggers nausea, including a list of 12 common causes. We will also discuss some of these conditions in more detail and describe their symptoms and treatments.

Several types of infection may cause nausea, including:

Food poisoning or stomach flu

Gastrointestinal infections, such as those caused by food poisoning or viruses, are among the most common reasons for nausea.

Symptoms may include:

• nausea
• stomach pain or cramping
• vomiting
• diarrhea

Food poisoning occurs when a person ingests food or drink containing a virus, toxin, or bacterium, such as Salmonella and Escherichia coli. Other gastrointestinal viruses, such as norovirus or rotavirus, occur due to close contact with someone who is sick.

These infections usually clear up on their own at home. Drinking enough fluids and electrolytes is important for preventing dehydration, particularly in young children.

Flu and COVID-19

Other types of viral infection can also trigger nausea, such as flu and COVID-19. The symptoms of COVID-19 include:

• fever or chills
• loss of taste or smell
• cough
• shortness of breath
• fatigue
• headache
• body aches
• blocked or runny nose
• sore throat
• nausea
• vomiting
• diarrhea

A 2021 review found that out of 6,335 people with COVID-19, 79% experienced nausea.

People with flu can also have many of these symptoms. Nausea is more common in children with flu compared to adults, but both groups may experience it.

Because the symptoms of COVID-19 are similar to those of flu and can vary from person to person, it is important to stay at home and follow local guidelines if someone has any symptoms that may indicate COVID-19.

Learn the differences between the common cold, flu, and COVID-19.

A range of digestive disorders can induce nausea, including:

• Gastritis: Acid or a bacterium called H. pylori often cause inflammation of the stomach, which can lead to stomach ulcers.
• Gastroparesis: With this condition, the stomach empties much slower than it should. Certain medications or nerve damage usually cause this, which is common in people with diabetes.
• Gastroesophageal reflux disease: Triggers chronic acid reflux and indigestion.
• IBS: Causes stomach cramping, along with diarrhea or constipation.
• Celiac disease: An autoimmune condition that causes symptoms in response to gluten.
• Gallbladder conditions: Includes issues such as gallstones.
• Pancreas conditions: Includes issues such as pancreatitis.

Typically, nausea is not the only symptom of chronic digestive disorders. A person may also experience:

• abdominal bloating or fullness
• gas or belching
• heartburn or indigestion
• diarrhea, constipation, or both
• abdominal pain and cramping
• reactions or intolerance to specific foods or food groups

The diagnosis and treatment for digestive disorders vary depending on the cause. They may involve a combination of medications, dietary or lifestyle changes, or in some cases, medical procedures.

Learn more about common and uncommon digestive disorders.

Mental health and digestive health are closely linked. People with mental health conditions can experience digestive symptoms, including nausea. Similarly, stress can also exacerbate digestive conditions.

People who frequently feel stressed, anxious, or panicked may have an anxiety disorder. The symptoms of anxiety include:

• nausea
• rapid heartbeat
• quick or shallow breathing
• choking sensation in the throat
• sweating
• dizziness
• tense muscles

Severe anxiety can also trigger panic attacks, or in some cases, fainting. For example, people with a fear of needles or blood may experience nausea, dizziness, and loss of consciousness. This is known as vasovagal syncope.

People can also experience a phobia of nausea and vomiting itself. Doctors call this emetophobia.

Treatment for anxiety disorders typically involves talking therapy, medication to manage symptoms, or both.

Find a comprehensive list of mental health resources here.

The vestibular system resides in the inner ear, helping the body retain a sense of balance and know where it is relative to its surroundings. Issues with this system can cause dizziness or vertigo, which in turn causes nausea.

Conditions that may cause this include:

• Motion sickness: Occurs in response to conflicting signals of movement sent to the brain. Riding in cars, planes, or boats often triggers this.
• Labyrinthitis: An inner ear infection that can occur following a cold or flu.
• Vestibular neuritis: Occurs when the nerve inside the inner ear becomes inflamed.
• Meniere’s disease: Causes sudden episodes of dizziness, which can be severe.

The treatment for inner ear disorders can vary depending on the cause and the individual. People with an ear infection may find symptoms improve on their own over time, while over-the-counter (OTC) travel sickness medications may be enough to ease occasional motion sickness.

Those with more chronic conditions may need to try various medications, lifestyle changes, or coping techniques to manage their symptoms.

Changes in hormone levels, such as those caused by pregnancy, hormonal contraception, or endocrine disorders, may also cause nausea.

Pregnancy

Nausea is a common symptom during pregnancy. It is often known as morning sickness, although it can occur at any time. It may also develop suddenly or gradually.

Pregnant people may experience nausea when around certain foods or smells, or when they are hungry. Generally, morning sickness improves after 14 weeks.

Doctors may prescribe vitamin B6 or doxylamine to help with nausea and vomiting during pregnancy.

Thyroid disorders

The thyroid gland controls hormones that regulate the body’s metabolism. Both overactive or underactive thyroid can cause nausea.

Symptoms of an overactive thyroid, or hyperthyroidism, include:

• nervousness
• tiredness or muscle weakness
• irritability
• intolerance to heat
• difficulty sleeping
• shaky hands
• rapid heartbeat
• frequent bowel movements
• weight loss and difficulty gaining weight

Symptoms of an underactive thyroid, or hypothyroidism, include:

• tiredness
• puffy face
• weight gain and difficulty losing weight
• constipation
• intolerance to the cold
• dry skin and hair
• depression
• slower heartbeat

Doctors often treat these conditions with medication, which can also cause nausea as a side effect.

There are many ways in which changes in the brain and nervous system can cause nausea. Scientists do not fully understand all of them yet.

One of the most common neurological conditions that triggers nausea is migraine. This is a disorder that causes episodes of moderate-to-severe headache, along with other symptoms, including:

• light or sound sensitivity
• nausea
• vomiting
• aura, which are neurological changes that some people experience before pain develops

Some individuals also experience silent or acephalgic migraine, which does not cause any pain.

There are several treatments for migraine. For occasional or less severe episodes, people may find taking OTC pain medications and avoiding triggers is enough. For severe or frequent migraine, a person may need preventative medications or other therapies.

More serious neurological causes for nausea include head trauma, meningitis, or a hemorrhage.

Nausea is a common side effect of many medications, including:

• antibiotics
• antidepressants
• OTC pain medication, such as aspirin or ibuprofen
• certain supplements, such as iron
• opioids
• chemotherapy

Medications work by changing chemical processes in the brain and body. For example, neurotransmitters, such as serotonin and dopamine, can impact nausea and vomiting, so drugs that act on these chemicals can worsen or improve these symptoms.

Medication-related nausea and vomiting can be constant or occur at random intervals. It usually starts shortly after taking a new medication. Speak with a doctor if medicines could be causing nausea.

What helps people manage nausea can vary depending on the cause. For general nausea relief, the United Kingdom’s National Health Service (NHS) suggest:

• getting fresh air
• eating small, frequent meals
• staying hydrated by sipping cold drinks, such as water or juice
• drinking ginger or peppermint tea
• eating foods that contain ginger
• avoiding spicy, strong-smelling, or greasy foods

People who experience nausea because of stress or anxiety may also find breathing techniques, relaxation training, or mindfulness exercises helpful.

Learn 17 ways to improve nausea at home.

While home remedies can relieve the feeling of nausea, they are not a replacement for medical treatment for those with underlying conditions.

If a person frequently experiences nausea for no clear reason, they can consider speaking with a doctor to determine the cause. If the cause is psychological, speaking with a therapist may help.

Nausea is not usually an emergency. However, if it occurs alongside symptoms of a serious condition or after an injury, someone may need emergency help. Dial 911 if someone experiences nausea:

• after a recent head injury
• alongside a severe, sudden headache
• with neck stiffness, fever, headache, and vomiting

In some cases, nausea can be an early warning sign of a heart attack. This is more common in females, who can experience less obvious symptoms during a heart attack. Seek emergency help if someone has:

• pain, pressure, or squeezing in the center of the chest
• trouble breathing
• pain in one or both arms, the back, neck, or jaw
• lightheadedness
• a cold sweat

There are many potential causes of nausea. In most cases, it is not a sign of a serious illness. Many conditions that trigger nausea are treatable or temporary.

Speak with a doctor about chronic or recurring nausea, as there may be ways to reduce this symptom and improve quality of life.

Constant nausea: Causes and treatment

Nausea is a feeling of discomfort that makes a person feel as though they might vomit. Constant nausea is when this feeling lasts for long periods.

Nausea is a symptom of an underlying condition. It can also be a side effect of some medications. People with constant nausea should speak with their doctor to determine the cause.

In this article, we will look at some common causes, treatments, and home remedies for constant nausea.

Share on PinterestConstant nausea may be a side effect of certain medications.

People sometimes describe nausea as feeling queasy, feeling sick, or having an upset stomach. Some people with nausea may also vomit.

Nausea is not a disease, but a symptom of many different medical conditions. Sometimes people with nausea will experience other symptoms, such as:

• increased production of saliva
• dizziness
• light-headedness
• trouble swallowing
• changes in skin temperature
• rapid heartbeat

According to the American Family Physician (AFP), acute nausea lasts for 1 month or less. Chronic nausea lasts for more than 1 month.

When evaluating a person who is constantly nauseous, a doctor will ask them detailed questions to determine the cause. This will include questions about:

• when the nausea began
• when it comes and goes
• the duration of each episode
• whether they vomit, and if so, what the vomit looks like
• other associated symptoms

Pregnancy

According to the American College of Obstetricians and Gynecologists (ACOG), women often feel nauseous after around 9 weeks of pregnancy.

Although many people refer to nausea and vomiting in pregnancy as morning sickness, it can occur at any time of the day. Nausea and vomiting are not harmful to the baby, but it can affect a woman’s quality of life.

Mild nausea during pregnancy involves feeling temporarily nauseous and vomiting 1–2 times each day. Women who experience nausea for several hours and vomit more often have severe nausea.

Hyperemesis gravidarum is a severe form of pregnancy-related nausea, which may mean a woman has to spend time in the hospital. According to ACOG, women with hyperemesis gravidarum can lose 5% of their prepregnancy body weight and may experience dehydration.

An article in the AFP recommends that when doctors treat people of childbearing age for nausea and vomiting, they must consider pregnancy as a possible cause.

Gastroparesis

During digestion, the stomach contracts and empties food into the small intestine. Gastroparesis occurs when the stomach does not empty properly. One article states that gastroparesis can cause the following symptoms:

• feeling full quickly
• abdominal pain
• bloating
• weight loss
• vomiting a few hours after meals

Common causes of gastroparesis include diabetes, medications, and surgery. However, sometimes doctors cannot determine the exact cause.

Bowel obstruction

A bowel obstruction happens when the intestines become wholly or partially blocked. This prevents food from traveling through the digestive system. According to one report, blockage of the bowel can cause the following symptoms:

• abdominal pain
• nausea
• vomiting
• constipation
• bloating

Other conditions can also cause constant nausea. Digestive conditions that can cause frequent nausea include:

• dyspepsia
• gastroesophageal reflux disease (GERD)
• peptic ulcer
• irritable bowel syndrome (IBS)
• food intolerance

However, according to the AFP, nausea is not the main or only symptom of these conditions.

A review in Therapeutic Advances in Gastroenterology notes that some psychological conditions can cause constant nausea, include:

• anxiety disorders
• eating disorders
• depression

Some neurological factors can also cause constant nausea, such as:

• frequent migraine headaches
• increased intracranial pressure due to a mass, blood clot, or hemorrhage
• demyelinating disorders
• seizure disorders

A rare condition called cyclic vomiting syndrome can also cause frequent bouts of nausea, as it involves repeated cycles of nausea, vomiting, and tiredness.

Ear conditions such as Ménière’s disease or labyrinthitis can cause nausea, in addition to dizziness and vertigo.

The review also highlights drugs that can cause nausea as a side effect, including:

• hormones (e.g., birth control pills)
• antibiotics
• antivirals
• anticonvulsants
• opioids
• nicotine
• gastrointestinal medications
• cardiovascular medications
• medications to treat Parkinson’s disease

Some people may want to stop taking their medications because they experience nausea. However, people should always speak with their doctor before stopping or changing any of the medications they take.

According to the American Cancer Society, cancers affecting the digestive system or areas in the brain that control digestion may cause constant nausea.

For example, people with cancer of the esophagus may experience symptoms such as:

• pain or discomfort in the belly
• nausea and vomiting
• loss of appetite
• fatigue or weakness
• vomiting blood or passing blood in the stool
• weight loss
• feeling full quickly when eating

However, different types of cancer cause a variety of symptoms. Some cancers may not present any obvious early symptoms. The American Cancer Society state that whether someone with cancer develops frequent nausea will depend on a range of factors, such as:

• the type of cancer they have
• the type of treatment they receive
• any other medications they take
• slow digestion or constipation
• inner ear problems
• electrolyte levels
• any infections they have
• stress or anxiety

Cancer treatment can also cause nausea. A person can find out if the treatment they need is likely to cause nausea by looking at whether that treatment has high, moderate, low, or minimal risk.

People who need cancer treatments that cause nausea and vomiting should speak with their doctors about how to reduce the side effects.

Once a doctor determines the cause of constant nausea, they may recommend treatments for the underlying condition.

To control nausea, they may also prescribe antiemetic drugs, which stop people from vomiting. The following types of medications have an antiemetic effect:

Some of types of drugs, such as benzodiazepines, cause dependence. Researchers advise doctors not to prescribe benzodiazepines for more than 1–2 weeks at a time.

If a person frequently vomits because of chronic nausea, a doctor may also need to treat dehydration or an electrolyte imbalance.

Ginger

Researchers report that taking 250 milligrams (mg) of powdered ginger root before meals and at bedtime may help reduce nausea during pregnancy.

Women with pregnancy-related nausea may take up to 250 mg of ginger every 6 hours. It is possible to take up to 1000 mg of ginger per day without any side effects.

Ginger may also help people with chemotherapy-induced nausea and vomiting. However, researchers have had mixed results. Some studies show no difference between taking ginger and taking a placebo. Others found that ginger reduced the severity and frequency of vomiting.

Peppermint

One study published in the Journal of Holistic Nursing compared the effects of peppermint essential oil on postoperative nausea. The participants included 35 women who felt nauseous after they had given birth via cesarean delivery.

Although the study was small, the research showed that inhaling peppermint may help control postoperative nausea. Researchers need to confirm this result with more studies.

Vitamin B6

In early pregnancy, vitamin B-6 may help control nausea. A small study showed that taking 25 mg every 8 hours was more effective than a placebo.

According to the American Cancer Society, nausea can make it difficult for people to get the nutrition and hydration their body needs. Some people may feel unable to eat or to drink when they feel nauseous. This can cause dehydration, malnutrition, and other serious conditions.

People who have constant nausea should speak with a doctor if:

• they cannot keep fluids down
• they have been vomiting for 24 hours or longer

People should also see a doctor if they have:

• fatigue
• trouble concentrating
• slow wound healing
• weight loss
• little or no appetite

People experience constant nausea for a variety of reasons. Some common causes of constant nausea include pregnancy, gastroparesis, and bowel obstructions.

Antinausea medications and home remedies may help control nausea. However, a person with constant nausea should seek medical help, as it is a sign of an underlying condition. Antiemetic drugs will only treat the symptom of constant nausea and not the root cause.

Where does seasickness come from and how to get rid of it? in events.

Image copyright Getty Images

Seasickness is undoubtedly a very unpleasant phenomenon. Reviewer BBC Future finds out why our body reacts so painfully to monotonous swaying and what can be done about it.

The pirate ship looked just like in adventure movies: on its bow was a creepy figure in the form of the head of a gorgon Medusa, a Jolly Roger fluttered from the mast, and a double Jack Sparrow with a braided beard greeted us on board.

We went to see the dolphins off the coast of Tenerife and my 3 year old was absolutely delighted with the trip, while I… tried to keep my breakfast to myself.

• Sickness? Scientists are looking for a way to overcome seasickness
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Seasickness is one of the worst enemies of vacationers. According to a recent study, cruise ship passengers cite seasickness as the number one inconvenience they have experienced while on vacation.

Plus, it’s hard to avoid. As British comedian Spike Milligan said, “The only way to not get seasick is to sit under a tree.”

However, in the heat of summer, many people dream of traveling by water – leisurely cruises, boat trips from island to island, or boat trips powered only by the wind.

Some try to deal with these terrible feelings, as I did, others simply prefer to have firm ground under their feet.

Image copyright, Getty Images

Photo caption,

Large cruise ship passengers generally don’t get seasick at all

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Seasickness is a form of motion sickness. Car sickness, sea sickness, and air sickness are caused by physical stimuli, while exercise sickness and cyber sickness are caused by visual stimuli, but all of these types of motion sickness share a common mechanism of occurrence.

We get motion sickness when our inner ear (or labyrinth) and central nervous system cannot recognize where the vertical plane is.

Or, in other words, when the sense of balance and equilibrium, which is responsible for the inner ear, is disturbed by movement – for example, by rough seas.

However, the main difference between seasickness is that in many cases it lasts for quite a long time.

“Even the worst travel by bus, car or plane doesn’t last a few days. Yes, the plane can shake, but not for long,” says Richard Dawood, travel medicine specialist at London’s Fleet Street Clinic.

While driving, you can stop and get out. On the high seas, one can only dream of this. You feel like you are trapped, and this feeling makes you more likely to get seasick.

Even famous sailors suffered from seasickness, including Admiral Nelson, Charles Darwin and Christopher Columbus.

When the English ships of Queen Elizabeth I collided with the Invincible Armada, the Spanish Admiral Duke of Medina Sidonia got seasick. It is believed that this was one of the factors that led to the victory of England.

In the days of the Roman Empire, the poet Horace wrote that everyone is equal before seasickness: both the poor and the rich.

Beth Leonard, a seasoned seafarer, says that many sailors today experience motion sickness to varying degrees. This usually happens within the first two to three days of each swim.

Most get used to it in three days, no matter what attempts are made to cope with it.

Leonard interviewed 38 sea travelers and found that three-quarters of them suffer from nausea every time they go to sea.

Another Yachting World survey of 223 people found that 62% experienced symptoms of motion sickness.

These include not only a strong feeling of nausea. Typically, things start with milder symptoms, such as yawning or increased salivation, and then things get worse.

A person breaks out in cold sweat, dizziness and headache, he feels tired, and all this ends with nausea and, possibly, vomiting.

In the first days at sea, many also complain of problems with concentration.

33% of Beth Leonard’s respondents complained of drowsiness, a quarter of lethargy, the vast majority (79%) of nausea, and half of vomiting.

Of those who ignored the first signs of motion sickness, 86% worsened, leading to severe bouts of vomiting.

Image copyright, Getty Images

Image caption,

The ship’s movement in three changes throws off our sense of balance and makes us feel sick

However, experienced sailors often have their own tricks to help them get over seasickness quickly. Sebastian Smith is one of them.

He often goes to sea with his wife Adele and two young daughters and has written several books on how to deal with motion sickness.

“I’ve never understood why everyone has such a different experience of being on the deck of a ship,” he says. “It’s clear that seasickness has nothing to do with a person’s age or strength.”

“It can also come on suddenly. A person can be in a good mood, feel relaxed, and then his face suddenly changes. Ten minutes later he is already in the fetal position.”

Smith says that at first he also suffered greatly, but as soon as he began to swim long distances, seasickness went away by itself and never returned.

“From my own experience, I can say that there is also a psychological aspect,” he says. “Now I know that even if I have the first symptoms, I will be able to cope with them. This is experience, and it matters a lot” .

His wife Adele still suffers from seasickness on long trips, usually within the first day or two. When their children were very young, they did not get sick at all.

“And, interestingly, Adele was fine too, although it would seem that it should be the other way around, since she had to change her diapers in a tiny, stuffy cabin while rocking.”

When the children grew a little, they began to suffer from seasickness. Nevertheless, now they cope with it, and always.

“They may be sick for three days, but then suddenly everything stops, and they feel great again, like experienced sea wolves.”

Smith says that for some, the best way to combat seasickness may be to sleep. As a rule, the pitching is the least felt in the cabin, so even if you are better in the open air, do not be afraid to go to the cabin and take a nap.

Image copyright, Getty Images

Image caption,

Abstaining from fatty foods may help with motion sickness

However, this does not work for everyone, and many have to take medications such as Stugeron or Dramamine. However, Smith warns that any drugs should be tried on land first, as some of them have a strong sedative effect.

Dawood says that for a long-term effect – up to three days – the first thing to try is the Scopoderm patch (although the patches have side effects, and this should definitely be a doctor’s prescription).

“Talk to your doctor about the problem. Another effective prescription drug for severe vomiting is Ondansetron. It doesn’t need to be swallowed, just put under the tongue.”

The timing of the medication is also important. One sailor named Andrew Barton, interviewed by Leonard, organized a program called Adventure Sailing, in which several sailing ships regularly sailed between Bermuda and the Caribbean.

Once, when his fleet consisted of nine ships with 54 crew members, they were all stuck in Newport for three days due to bad weather. Every evening, Barton asked them to take their seasickness medication, thinking they would leave port the next day.

When they finally set sail, there was a strong wind and big waves on the sea, but only one person got seasick – the one who did not follow Smith’s advice.

Experienced sailors advise taking motion sickness medication not a few hours before the trip, but much earlier, at least the night before.

Another recommendation is not to go on deck with a hangover. Smith advises to refrain from drinking alcohol for at least a couple of days before the trip.

If you suddenly feel strange, chew something, even if you don’t feel like it. Dry crackers, fresh fruit, and raw vegetables are great. Someone recommends gingerbread cookies and ginger tea.

“And oranges for some reason,” adds Smith.

In addition, three days before your trip, avoid foods that have ever made you upset, especially spicy and fatty foods, as well as foods high in caffeine, salt and sugar.

Image copyright, Getty Images

Image caption,

Catamarans experience three times less motion sickness than monohulls

If you feel sick while on a high speed sailboat, don’t lean over the side as you risk falling in water. Bring a bucket or biodegradable bag (often used by dog ​​owners).

Since vomiting leads to dehydration, drink plenty of fluids to replenish the body’s moisture loss.

One of the sailors interviewed by Leonard recommended that they prepare as best as possible for the trip: for example, take a supply of easily digestible food with you for the first five days.

Seasickness can be exacerbated by strong odors (such as diesel), overheating or exposure to cold, and eye strain from reading or computer work.

Listening to music or audiobooks does not cause these problems.

To get rid of unpleasant sensations, you can look at the horizon.

When on deck, try to keep your balance without holding on to anything. Jelte Bos from the Free University of Amsterdam says that this helps the central nervous system quickly adapt to new conditions.

When the first symptoms appear, he recommends drinking a carbonated cola.

If you’re planning the biggest vacation of your life on a big cruise ship, chances are you’ll be fine even without ginger drinks.

Passengers on these large, stable boats rarely complain of motion sickness because they barely feel the motion.

Surprisingly, how you feel can also depend on the shape of the boat.

Recently, a project called “Compass” (“Smart Approach to Reduce Symptoms of Motion Sickness and Improve Passenger Comfort and Safety in Sea Travel”) was implemented with EU funding.

His goal was to study different types of ships and how the three most important types of acceleration (longitudinal, transverse and vertical) affect motion sickness.

The project found that seasickness is caused by both horizontal and vertical acceleration. This means that on a passenger ship with a catamaran configuration, motion sickness is three times less than on a monohull.

It is because of the acceleration that we feel movement and we feel bad. The rough sea makes the ship move up and down and constantly change its speed.

According to Bos, the resulting vertical acceleration is a major contributor to seasickness.

“Also, if you’re above the ship’s center of rotation, you’ll move both lateral and longitudinal, resulting in horizontal acceleration and seasickness,” he adds.

Another factor influencing motion sickness may be the stability of the ship.

Image copyright, Getty Images

Image caption,

For those suffering from seasickness, sailing a small boat close to shore can be a safe bet

A ship’s maneuvers can be calculated based on its design. Taking into account weather conditions, this makes it possible to predict how much sickness passengers will get on board – and even before the ship is built.

According to Bos, catamarans generally list less than monohulls, simply because their hulls are wider.

However, catamarans are generally shorter than monohulls. This means that they rotate more on the vertical axis.

“Since the latter effect is usually less pronounced than the former, passengers on catamarans are less likely to get seasick than monohulls,” he says.

Bos thinks that if you don’t like big cruise ships and prefer rowing or sailing on inland waterways, you’ll probably be fine.

“People tend to be most sensitive to cycling about every six seconds. When navigating inland waterways in a small boat, the sway period is shorter and doesn’t affect us much.”

In general, the closer you are to the trees that Spike Milligan advised you to sit under, the less likely you are to get motion sickness.

Read the original of this article in English on the BBC Future website.

Concussion – causes, symptoms, diagnosis and treatment

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Concussion: causes, symptoms, diagnosis and treatment.

Definition

A concussion is a functionally reversible form of a closed craniocerebral injury without organic damage to the brain, resulting from a bruise, blow and, in rare cases, as a result of a sudden movement of the head.

Causes of a concussion

A concussion can be the result of a traffic accident, a fall, domestic, sports and industrial injuries, as well as injuries resulting from street fights and collisions during mass events, exposure to a blast wave. Even a seemingly minor head injury can lead to a concussion. Thus, the fact of the presence of an injury may already indicate a possible concussion.

The mechanism of concussion is not exactly known. Most likely, as a result of an injury, certain problems arise with the work of nerve cells in the brain (neurons). It is assumed that there is a functional disconnection between the brain stem and hemispheres. It is believed that due to concussion there is a temporary disruption of interneuronal connections. A slight displacement of the layers of the brain tissue may appear, their nutrition may worsen, and the connection between some brain centers will go wrong, which contributes to the development of functional disorders. At the same time, macroscopic and histological changes in the brain tissue are not detected.

Among all brain injuries, concussion ranks first in frequency. Most patients recover within 1-2 weeks.

If over time the patient’s condition continues to deteriorate, and more severe forms of traumatic brain injury are excluded, then it is necessary to look for other causes of the existing symptoms – psychological problems, mental illness, side effects of drugs or other concomitant diseases.

Disease classification

According to the International Classification of Diseases (ICD-10), concussion has the code S06.0. This nosology is one of the clinical forms of traumatic brain injury.

Depending on the severity of the patient’s condition and clinical symptoms, there are three degrees of concussion.

Mild concussion . The victim has no impairment of consciousness, but disorientation, headache, dizziness, nausea may occur during the first 20 minutes after the injury. Then the general state of health returns to normal. Perhaps a short-term increase in body temperature (37.1-38 ° C).

Moderate concussion . Although the victim does not lose consciousness, pathological symptoms such as headache, nausea, dizziness, and disorientation may be observed. All of them last more than twenty minutes. There may be short-term memory loss (amnesia), most often retrograde amnesia with loss of several minutes of memories preceding the injury.

Severe concussion . Necessarily accompanied by loss of consciousness for a short period of time, usually from several minutes to several hours. The victim does not remember what happened – retrograde amnesia develops. Pathological symptoms bother a person for 1-2 weeks after the injury (headache, dizziness, nausea, fatigue, disorientation, impaired appetite and sleep).

Symptoms of the concussion of the brain

Physical (somatic) symptoms :

• Dizziness, which, when changing the position of the body, turning or tilting the head is intensified – this is explained by a violation of blood circulation in the vestibular apparatus;
• throbbing headache;
• nausea;
• single vomiting;
• rapid breathing, tachycardia;
• blurred vision or double vision;
• flashing of flies or stars before the eyes;
• imbalance;
• hypersensitivity to light or noise;
• ringing, tinnitus.

Behavioral, emotional symptoms :

• drowsiness;
• increased fatigue or general weakness;
• irritability;
• depression;
• anxiety;
• excessive hours of sleep;
• difficulty falling asleep.

Cognitive symptoms :

• lethargy and incoordination;
• short-term confusion;
• slow incoherent speech;
• difficulty concentrating;
• memory difficulties.

Diagnosis of concussion

Diagnosis of concussion is established on the basis of history, examination and exclusion of more severe traumatic brain injury.

The doctor examines the entire body of the patient for abrasions, bruises, joint deformities, changes in the shape of the chest and abdomen, and bleeding.

In the first hours after a concussion, the victim’s pupils are dilated or constricted – a traumatic brain injury of any severity leads to disruption of the nerve pathways responsible for the functioning of the eyes. Pupillary reaction to light is normal. The victim complains of pain when moving the eyes to the sides, there is a small horizontal nystagmus (involuntary tremulous movements of the eyeballs), if the eyes are taken to the most extreme positions. There may be slight asymmetry of tendon reflexes, unsteadiness in the Romberg position (legs together, straight arms extended forward to a horizontal level, eyes closed). The level of consciousness is assessed on the Glasgow Coma Scale and is 14-15 points.

The list of laboratory tests includes:

• complete blood count;

Clinical blood test: general analysis, leukoformula, ESR (with microscopy of a blood smear in the presence of pathological changes)

Synonyms: Complete blood count, UAC. Full blood count, FBC, Complete blood count (CBC) with differential white blood cell count (CBC with diff), Hemogram.
Brief description of the study CBC: general a…

Up to 1 business day

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RUB 810

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General urinalysis (Urine analysis with sediment microscopy)

Method of determination

Determination of physical and chemical parameters is carried out on an automatic analyzer using the “dry chemistry” method.

Hardware microscope. ..

Up to 1 business day

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410 RUB

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Specific changes in the blood, urine and cerebrospinal fluid during concussion should be absent.

Instrumented diagnosis includes:

• x-ray of the skull – no skull fractures in concussion;

X-ray of the skull

X-ray examination of the skull to detect structural and integrity disorders of the skull bones of various nature.

RUB 2,290

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CT scan of the brain and skull

Scanning of the brain, skull and surrounding tissues, which allows diagnosing various pathologies.

RUB 4,890

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MRI of the brain

Safe and informative scanning of brain structures for the diagnosis of its pathologies.

RUB 5,640

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Electroencephalography (EEG)

EEG is a safe and painless method for studying the functional state of the brain.

RUB 3,090

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Transcranial Doppler Ultrasound

Ultrasound scanning to assess the consistency of cerebral blood flow.

RUB 2,690

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An MRI of the spine may be needed to rule out spinal problems.

Cervical spine MRI

Examination to assess the condition of the cervical spine.

RUB 5,990

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Differential diagnosis is carried out with a brain contusion, asthenic condition of the patient, psychoemotional lability, alcohol intoxication, vegetovascular dystonia, postconvulsive syndrome.

Which doctors to contact

If you have a concussion, you need to contact a traumatologist. He examines the patient, collects an anamnesis, checks reflexes, prescribes an x-ray of the skull, and if a more complex brain injury is suspected, he sends him for a consultation to
neurologist or neurosurgeon.

Indications for specialist consultation:

• consultation
  otorhinolaryngologist to exclude pathologies of the ear, throat, nose;
• consultation of an ophthalmologist in order to exclude or confirm violations of the visual apparatus;
• consultation
  therapist for the purpose of correcting the treatment of concomitant pathology;
• consultation
  surgeon, maxillofacial surgeon and other narrow specialists according to indications.

Treatment of a concussion

If a concussion is suspected, first aid must be given to the victim, providing him with complete rest. It is necessary to lay a person in a quiet darkened room, it is better to raise his head slightly. It is very useful to apply cold compresses to the head. Patients with a concussion should remain in bed for at least a few days.

If you have a concussion, you can not read, listen to loud music and watch TV. It is not recommended to drink a lot. Alcohol is strictly prohibited!

Within 12 weeks after the injury, the patient should be under the supervision of a doctor in order to assess their condition and fully return to daily activity. To date, there are no effective drugs that accelerate the recovery period.

Non-narcotic analgesics, tranquilizers, hypnotics, sedatives are used as medicines. As a rule, this is enough.

In some cases, drugs are used to relieve cerebral edema, suppress the gag reflex, as well as antihistamines. If any vegetative symptoms are excessively expressed, then, for example, b-blockers may be required (with severe tachycardia and hypertension). Conduct courses of nootropic and metabolic therapy.

Hospitalization is indicated within three days after the injury. The indication for emergency hospitalization is the fact of injury or the presence of severe cerebral and autonomic symptoms.

Complications

It must be remembered that a person who has suffered even a mild concussion may develop post-traumatic neurosis or other more serious complications, such as epilepsy. Approximately 3% of patients experience complications in the form of persistent asthenic syndrome, insomnia, migraines, intracranial hypertension and other conditions. Therefore, some time after recovery, you should definitely visit a neurologist and perform electroencephalography.

The consequences of a concussion of the brain can appear in a few years, significantly complicating the usual life.

The hardest thing is for those who, for one reason or another, did not seek medical help in time for the timely diagnosis of the problems that have arisen.

Prevention of a concussion

Prevention of a concussion is to follow the following rules: sports games;

Sources:

1. Big Medical Encyclopedia (BME), edited by Petrovsky B.V., 3rd edition, volume 24.
2. Mild traumatic brain injury: clinical guidelines / Potapov A.A., Likhterman L.B., Kravchuk A.D. etc. – M.: Association of Neurosurgeons of Russia, 2016. – 23 p.
3. Golovacheva V.A., Evzikov G.Yu. Management of a patient with a concussion. iDoctor 2014; 10(29): 60-63.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

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