saudigastro.com/patients/chronic-nausea
Category
Common
Red flags
6
This article is educational and does not replace your doctor's advice. Seek urgent care for any red-flag symptoms.
What is it?
Nausea is the unpleasant feeling that you may be about to vomit. It is called chronic when it lasts for weeks to months, or keeps coming back. Chronic nausea is a symptom, not a diagnosis. It can come from the digestive system, from medicines, from conditions elsewhere in the body, or from disordered brain-gut signalling (functional nausea and vomiting). Doctors first look for a cause that can be treated.
How common is it?
Nausea is one of the most common symptoms people bring to doctors. Long-lasting nausea is less common but can affect daily life, work and eating significantly.
Why does it happen?
Common causes include medicines (many can cause nausea, including some antibiotics, pain medicines and diabetes medicines), acid reflux, gastritis or ulcers, delayed stomach emptying (gastroparesis, where the stomach empties too slowly), gallbladder disease, pregnancy, kidney or liver problems, high calcium, thyroid disease, migraine, inner-ear problems, and anxiety or depression. Cannabis use can cause a pattern of repeated vomiting (cannabinoid hyperemesis). When no cause is found, functional nausea and vomiting is diagnosed.
Symptoms
- Persistent or recurring queasiness
- Vomiting in some people, not all
- Poor appetite, early fullness or bloating
- Nausea linked to meals, or to mornings, or to certain medicines
- Tiredness and reduced quality of life
- Worry about eating, which can lead to eating less
Red flags — seek urgent medical care
Repeated vomiting, unable to keep fluids down, very dry mouth, dizziness or passing little urine
Signs of dehydration. Go to the emergency department; this is especially urgent in children, older people, pregnant women and people with diabetes or kidney disease.
Vomiting blood or material that looks like coffee grounds, or black stools
Bleeding in the upper gut. Emergency.
Severe belly pain, a swollen hard belly, or being unable to pass wind or stool
Possible bowel obstruction or another surgical problem. Emergency.
Severe headache, confusion, stiff neck, or weakness on one side with vomiting
May indicate a brain problem. Call emergency services.
Unintended weight loss, difficulty swallowing, or yellow skin or eyes
Needs prompt medical assessment to look for a structural cause.
Chest pain, or nausea with sweating and breathlessness
May be heart-related. Call emergency services.
How is it diagnosed?
Your doctor will review your medicines and supplements, ask whether pregnancy is possible, and examine you. Blood tests can check for infection, anaemia, kidney, liver, thyroid, calcium and blood sugar problems. An upper endoscopy looks at the gullet, stomach and first part of the intestine for ulcers, inflammation or other disease. Imaging or a gastric emptying test (a scan or breath test that measures how fast food leaves the stomach) may be done. If everything is normal, functional nausea is likely. Your doctor chooses the tests that fit you.
Outlook — what to expect
The outlook depends on the cause. Many causes, such as medicines, reflux or ulcers, can be treated successfully. Functional nausea may last a long time, but symptoms usually can be controlled with the right combination of treatments.
Treatment
Habits & Lifestyle
Simple measures can help while the cause is being found. If you cannot keep fluids down, seek medical care rather than waiting.
- Keep a diary of nausea, meals, medicines and triggers
- Sip fluids regularly through the day, in small amounts
- Get fresh air, rest and avoid strong smells and warm, stuffy rooms
- Rinse your mouth and keep up oral hygiene if you vomit
- Do not stop prescribed medicines on your own; ask your doctor if one may be causing nausea
Diet
Eating little and often is usually better tolerated than large meals.
- Eat small, frequent, light meals and snacks
- Dry, plain and cold foods are often easier than hot, greasy or strongly flavoured ones
- Ginger, in food or tea, helps some people
- Avoid lying flat straight after meals; avoid alcohol and tobacco
- If eating is very limited for long, ask for a dietitian review to prevent weight loss and deficiencies
Medications
The right medicine depends on the cause, so do not self-treat for long. Your doctor decides what is safe, including during pregnancy and in children.
- Anti-sickness medicines (anti-emetics) are chosen by the cause and your other conditions
- Acid-reducing medicines help if reflux or ulcers are the cause
- Medicines that help the stomach empty may be used in gastroparesis
- Low-dose nerve-modulating medicines are sometimes used for functional nausea
- Some anti-sickness medicines have important side effects or interactions; take them only as prescribed
Procedures & Surgery
Procedures are mainly used to find or treat a cause.
- Upper endoscopy to look for ulcers, inflammation, narrowing or other disease
- Gastric emptying study if slow stomach emptying is suspected
- Treating an underlying cause, such as gallstone or kidney problems, may involve other procedures
- Psychological therapy and relaxation approaches can help functional nausea
Living with the condition
- Nausea can be exhausting and isolating; tell family and friends how you feel so they can support you.
- Eating little can lead to weight loss; keep track and share it with your doctor.
In the Saudi context
If you have ongoing nausea or vomiting, fasting during Ramadan may not be safe because of the risk of dehydration. Speak with your doctor before the month begins; illness is a recognised reason for not fasting.
Questions to ask your doctor
Save this list or print it before your appointment — doctors appreciate prepared patients.
- Could one of my medicines be causing the nausea?
- Which tests do I need to look for the cause?
- Which anti-sickness medicine is safest for me?
- Could this be functional nausea, and what are the treatments?
- When should I seek urgent help?
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Status: Approved for publication by SGA; individual clinician review is ongoing · Published 24/04/2026
For general education only; it does not replace your doctor’s advice. Individual clinician review of this guide is ongoing. SGA clinician? Review this guide