Nausea and Motion Sickness

Nausea and Motion Sickness

Nausea  is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit. It often, but not always, precedes vomiting. A person can suffer nausea without vomiting. Nausea is a non-specific symptom, which means that it has many possible causes. Some common causes of nausea are motion sickness, dizziness, migraine, fainting, gastroenteritis (stomach infection) or food poisoning. Nausea is a general term describing a queasy stomach, with or without the feeling that you are about to vomit. Almost everyone experiences nausea at some time, making it one of the most common problems in medicine. Nausea is not a disease, but a symptom of many different disorders.

Symptoms of Nausea
Nausea is difficult for many people to describe. It is a very uncomfortable, but not painful, feeling that is felt in the back of the throat, the chest or the upper abdomen. The feeling is associated with distaste for food or an urge to vomit. When the body prepares to vomit, the following sequence may occur:

• The muscular ring between the esophagus and stomach (esophageal sphincter) relaxes.
• The abdominal muscles and diaphragm contract.
• The windpipe (larynx) closes.
• The lower portion of the stomach contracts.

When a person vomits, the stomach contents are expelled through the esophagus and mouth. As a result of these body actions, when you have nausea you experience retching. Retching is repeated rhythmic contractions of respiratory and abdominal muscles that occur without your control. You may or may not vomit. Profuse sweating sometimes accompanies nausea.

Prevention  For Nausea
Some causes of nausea are not easily prevented. While the cause of your nausea is being determined, you can minimize episodes of nausea by following some basic guidelines:

• Eat small meals every few hours so your stomach won't feel full.
• Try to avoid bothersome odors such as perfume, smoke or certain cooking smells.
• If you have had nausea for weeks to months, consider keeping a food diary to help identify foods that cause nausea.
• Avoid eating any food that smells or appears spoiled or has not been refrigerated properly.
• If you are prone to motion sickness, avoid reading in a moving vehicle. Also, try to sit in the part of the vehicle with the least movement (near the wings of an airplane or in the center of a boat). Ask your doctor about taking anti-nausea drugs before traveling.
• Avoid alcohol.

If you take medications for nausea, including over-the-counter types, avoid drinking alcohol which may make you more ill. Always read the label before taking anti-nausea medication, because some motion sickness medications can cause significant drowsiness.

Treatment for Nausea
Nausea does not always require treatment, but sometimes treatment is helpful. There are several things you can do on your own to help, including:

• Drink beverages that settle the stomach, such as ginger ale or chamomile tea.
• Avoid caffeinated colas, coffees and teas.
• Drink clear liquids to avoid dehydration (if vomiting is associated with nausea).
• Eat small, frequent meals to allow the stomach to digest foods gradually.
• Eat foods that are bland and simple for your stomach to digest, such as crackers or unbuttered bread, rice, chicken soup and bananas.
• Avoid spicy foods and fried foods.

Some over-the-counter medications can help to relieve nausea, including:
• Chewable or liquid antacids, bismuth sub-salicylate (Pepto-Bismol) or a solution of glucose, fructose and phosphoric acid (Emetrol). These medicines help by coating the stomach lining and neutralizing stomach acid.

• Dimenhydrinate (Dramamine) or meclizine hydrochloride (Bonine, Dramamine II). These medications are helpful for treating or preventing motion sickness and are thought to block receptors in the brain that trigger vomiting.

Motion sickness is a common problem in people traveling by car, train, airplanes and especially boats. Motion sickness can start suddenly, with a queasy feeling and cold sweats. It can then lead to dizziness and nausea and vomiting. Your brain senses movement by getting signals from your inner ears, eyes, muscles and joints. When it gets signals that do not match, you can get motion sickness. For example, down below on a boat, your inner ear senses motion, but your eyes cannot tell you are moving. Where you sit can make a difference. The front seat of a car, forward cars of a train, upper deck on a boat or wing seats in a plane may give you a smoother ride. Looking out into the distance - instead of trying to read or look at something in the vehicle - can also help.

Symptoms of Motion Sickness
A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign.

The symptoms overall of motion sickness include nausea, vomiting, and dizziness (vertigo). Other common signs are sweating and a general feeling of discomfort and not feeling well (malaise).

Mild symptoms are categorized as headache, mild unease and yawning. More serious symptoms include nausea, vomiting, pallor, sweating, drooling, short breath, dizziness and drowsiness.

The symptoms of motion sickness appear when the central nervous system receives conflicting messages from the other four systems: the inner ear, eyes, skin pressure receptors, and the muscle and joint sensory receptors.

What are the causes of Motion Sickness?
Motion is sensed by the brain through three different pathways of the nervous system that send signals coming from the inner ear (sensing motion, acceleration, and gravity), the eyes (vision), and the deeper tissues of the body surface (proprioceptors).

When the body is moved intentionally, for example, when we walk, the input from all three pathways is coordinated by our brain. When there is unintentional movement of the body, as occurs during motion when driving in a car, the brain is not coordinating the input, and there is thought to be dis-coordination or conflict among the input from the three pathways. It is hypothesized that the conflict among the inputs is responsible for motion sickness.

The cause of motion sickness is complex, however, and the role of conflicting input is only a hypothesis for its development. Without the motion-sensing organs of the inner ear, motion sickness does not occur, suggesting that the inner ear is critical for the development of motion sickness.

Visual input seems to be of lesser importance, since blind people can develop motion sickness. Motion sickness is more likely to occur with complex types of movement, especially movement that is slow or involves two different directions (for example, vertical and horizontal) at the same time.

The conflicting input within the brain appears to involve levels of the neurotransmitters (substances that mediate transmission of signals within the brain and nervous system) histamine, acetylcholine, and norepinephrine. Many of the drugs that are used to treat motion sickness act by influencing or normalizing the levels of these compounds within the brain.

Treatment of Motion Sickness
• Always ride where your eyes will see the same motion that your body and inner ears feel.
• In a car, sit in the front seat and look at the distant scenery.
• On a boat, go up on the deck and watch the motion of the horizon.
• In an airplane, sit by the window and look outside.
• Also, in a plane, choose a seat over the wings where the motion is minimized.
• Do not read while traveling if you are subject to motion sickness, and do not sit in a seat facing backward.
• Do not watch or talk to another traveler who is having motion sickness.
• Avoid strong odors and spicy or greasy foods that do not agree with you (immediately before and during your travel). Medical research has not yet investigated the effectiveness of popular folk remedies such as "soda crackers and 7 Up" or "cola syrup over ice."
• Ginger has been studied in the treatment of motion sickness; however, it is not yet clear how effective it is.
• Take one of the varieties of motion sickness medicines before your travel begins, as recommended by your physician.

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