Natural treatments for nausea

• DEFINITION: Treatment of nausea caused by motion sickness, pregnancy, surgery, and other factors.
• PRINCIPAL PROPOSED NATURAL TREATMENTS:
• OTHER PROPOSED NATURAL TREATMENTS

Introduction

Nausea can be caused by many factors, including stomach flu, viral infections of the inner ear (labyrinthitis), motion sickness, pregnancy, and chemotherapy. Unceasing nausea can be more disabling than chronic pain. Successful treatment can enormously impact an affected person’s quality of life.

The sensation of nausea can originate either in the nervous system or in the digestive tract itself. Most conventional treatments for nausea, such as Dramamine and Compazine, act on the nervous system, but products such as Pepto-Bismol soothe the digestive tract directly.

Principal Proposed Natural Treatments

The herb ginger has become a widely accepted treatment for nausea of various types. Vitamin B₆ may be helpful for the nausea of pregnancy.

Ginger. Limited scientific evidence suggests that the herb ginger can be helpful for various forms of nausea. A natural component in ginger is gingerol. This substance assists in more efficient digestion and can help with symptoms of nausea that come from morning sickness during pregnancy and also chemotherapy. Ginger can be consumed in various forms such as in tea.

Nausea and vomiting during pregnancy. Four double-blind, placebo-controlled studies enrolling at total of 246 women found ginger more effective than placebo for the treatment of morning sickness. For example, a double-blind, placebo-controlled trial of seventy pregnant women evaluated the effectiveness of ginger for morning sickness. Participants received either a placebo or 250 milligrams (mg) of powdered ginger three times daily for four days. The results showed that ginger significantly reduced nausea and vomiting. No significant side effects occurred. Benefits were also seen in a double-blind, placebo-controlled trial of twenty-seven women, and in a poorly designed double-blind, placebo-controlled trial of twenty-six women.

One study of 138 women and another of 291 women found ginger as effective for morning sickness as vitamin B6. Neither of these studies, however, used a placebo group. Because only one study indicates that vitamin B₆ is effective, this vitamin should not yet be considered as a gold standard treatment. Comparing one unproven treatment to another without using a placebo group is inadequate for determining effectiveness. It should be noted that ginger has not been proven safe for pregnant women.

Motion sickness. A double-blind, placebo-controlled study of seventy-nine Swedish naval cadets found that 1 gram of ginger could decrease vomiting and cold sweating without significantly decreasing nausea and vertigo. Benefits were also seen in a double-blind study of thirty-six persons given ginger, dimenhydrinate, or placebo.

In addition, a double-blind comparative study that followed 1,489 people aboard a ship found ginger to be just as effective as various medications (cinnarizine, cinnarizine with domperidone, cyclizine, dimehydrinate with caffeine, meclizine with caffeine, and scopolamine). Another double-blind study found equivalent benefit of ginger at a dose of 500 mg every four hours and dimenhydrinate (100 mg every four hours) in a group of sixty passengers aboard a ship. Similar results were also seen in a small double-blind study involving children.

However, a 1984 study funded by the National Aeronautics and Space Administration found that ginger was not any more effective than placebo at reducing the symptoms of nausea caused by a vigorous nausea-provoking method. Negative results were also seen in another study that used a strong nausea stimulus. These studies, in effect, show that the foregoing treatments are somewhat effective for motion sickness but are not effective for severe nausea.

Postsurgical nausea. A British double-blind study compared the effects of ginger, a placebo, and the drug metoclopramide in the treatment of nausea following gynecological surgery. The results in sixty women showed that both treatments produced similar benefits compared with a placebo.

A similar British study followed 120 women receiving gynecological surgery. Whereas nausea and vomiting developed in 41 percent of participants given placebo, in the groups treated with ginger or metoclopramide (Reglan), these symptoms developed in only 21 percent and 27 percent, respectively. However, three other studies enrolling about four hundred people failed to find ginger more effective than placebo. A 2004 article that reviewed all this evidence concluded that, on balance, ginger is not effective for postsurgical nausea.

One should not use ginger either before or immediately after surgery or labor and delivery without a physician’s approval. Not only is it important to have an empty stomach before undergoing anesthesia, but there are theoretical concerns that ginger may affect bleeding.

Acupressure and acupuncture. A single acupuncture point, P6, has traditionally been thought helpful for relief of various forms of nausea and vomiting. This acupuncture point is located on the inside of the forearm, about two inches above the wrist crease. Most studies have investigated the effects of pressure on this point (acupressure) rather than needling. The most common methods involve a wristband with a pearl-sized bead in it situated over P6. The band exerts pressure on the bead while it is worn, and the user can press on the bead for extra stimulation.

Although the research record is mixed, on balance it appears that P6 stimulation offers benefits for various types of nausea. This approach has been studied in anesthesia-induced nausea, the nausea and vomiting of pregnancy, and other forms of nausea.

Anesthesia-induced nausea. General anesthetics and other medications used for surgery frequently cause nausea. About eight controlled studies enrolling a total of more than 750 women who had gynecological surgery found that P6 stimulation reduced postsurgical nausea compared with placebo. On the negative side, a double-blind, placebo-controlled study of 410 women undergoing gynecological surgery failed to find P6 acupressure more effective than fake acupressure. (Both were more effective than no treatment). A small trial of acupuncture in gynecological surgery also failed to find benefit, as did three studies of acupressure for women undergoing cesarean section. Studies of acupuncture or acupressure in other forms of surgery have produced about as many negative results as positive ones.

Nausea and vomiting during pregnancy. Several controlled studies have evaluated the benefits of acupressure or acupuncture for morning sickness. The results for acupressure have generally been more positive than for acupuncture.

For example, a double-blind, placebo-controlled study of ninety-seven women found evidence that wristband acupressure may work. Participants wore either a real wristband or a phony one that appeared identical. Both real and fake acupressure caused noticeable improvement in more than one-half of the participants. However, women using the real wristband showed better results in terms of the duration of nausea. The intensity of the nausea symptoms was not significantly different between groups. These results are consistent with previous studies of acupressure for morning sickness. However, two studies failed to find benefit for severe morning sickness.

One large trial of acupuncture instead of acupressure failed to find benefit. This single-blind, placebo-controlled study of 593 pregnant women with morning sickness compared the effects of traditional acupuncture, acupuncture at P6 only, acupuncture at “wrong” points (sham acupuncture), and no treatment. Women in all three treatment groups (including the fake acupuncture group) showed significant improvements in nausea and dry retching compared to the no-treatment group. However, neither form of real acupuncture proved markedly more effective than fake acupuncture.

Motion sickness. Studies are conflicting on whether acupressure is helpful for motion sickness.

Vitamin B₆. A large double-blind study (with almost 350 people) suggests that 30 mg daily of vitamin B₆ can reduce the sensation of nausea in morning sickness.

Other Proposed Natural Treatments

Preliminary studies suggest peppermint oil may be able to reduce postoperative nausea. Multivitamin-multimineral tablets have also shown promise, possibly because of their vitamin B₆ content. On the basis of studies conducted in the 1950s, a combination of vitamin K (at the enormous dose, for vitamin K, of 5 mg daily) and vitamin C (25 mg daily) is sometimes recommended for morning sickness.

Researchers associate lemon (Citrus Limon) with reducing nausea and vomiting as related to pregnancy. A blind study found a significant decrease in nausea and vomiting among pregnant women who participated in a controlled use of lemon essential oil aromatherapy when they felt nauseated. Women who partook in the study and were among those exposed to lemon reported significant decreases in nausea on the second and fourth day of the exposure. Sipping lemon water is also tied to reducing nausea, though few studies support this claim.

Changes in behavioral patterns, such as in dietary intake, may also be a natural remedy for nausea. Eating smaller meals, but more frequently than the traditional three daily sittings, can prove beneficial. Replacing foods that are harder to digest can do likewise. Bland foods such as crackers, bananas, and baked potatoes can serve as these replacements. Consuming liquids frequently, instead of simply while eating, can also address symptoms of nausea. An alternative remedy for symptoms is aromatherapy. Breathing peppermint oil and lemon have been suggested to be effective in this regard. Muscle relaxation and breathing exercise can also be considered.

Bibliography

Borrelli, F., et al. “Effectiveness and Safety of Ginger in the Treatment of Pregnancy-Induced Nausea and Vomiting.” Obstetrics and Gynecology, vol. 105, 2005, pp. 849-56.

Duggal, K. N., et al. “Acupressure for Intrathecal Narcotic-Induced Nausea and Vomiting after Caesarean Section.” International Journal of Obstetric Anesthesia, vol. 7, 2004, pp. 231-36.

Gan, T. J., et al. “A Randomized Controlled Comparison of Electro-Acupoint Stimulation or Ondansetron Versus Placebo for the Prevention of Postoperative Nausea and Vomiting.” Anesthesia and Analgesia, vol. 99, 2004, pp. 1070-75.

Habib, A. S., et al. “Transcutaneous Acupoint Electrical Stimulation with the ReliefBand(R) for the Prevention of Nausea and Vomiting during and after Cesarean Delivery under Spinal Anesthesia.” Anesthesia and Analgesia, vol. 102, 2006, pp. 581-84.

Heazell, A., et al. “Acupressure for the In-Patient Treatment of Nausea and Vomiting in Early Pregnancy.” American Journal of Obstetrics and Gynecology, vol. 194, 2006, pp. 815-20.

Manusirivithaya, S., et al. “Antiemetic Effect of Ginger in Gynecologic Oncology Patients Receiving Cisplatin.” International Journal of Gynecological Cancer, vol. 14, 2004, pp. 1063-69.

Miller, K. E., and E. R. Muth. “Efficacy of Acupressure and Acustimulation Bands for the Prevention of Motion Sickness.” Aviation, Space, and Environmental Medicine, vol. 75, 2004, pp. 227-34.

"Nausea and Vomiting: Causes and Treatment” Cleveland Clinic, 9 Aug. 2023, my.clevelandclinic.org/health/symptoms/8106-nausea--vomiting. Accessed 23 Sept. 2024

"Nausea and Vomiting.” Mayo Clinic, 8 Apr. 2022, www.mayoclinic.org/symptoms/nausea/resources/sym-20050736?p=1#. Accessed 23 Sept. 2024

Roscoe, J. A., et al. “Acustimulation Wrist Bands Are Not Effective for the Control of Chemotherapy-Induced Nausea in Women with Breast Cancer.” Journal of Pain Symptom Management, vol. 29, 2005, pp. 376-84.

Slattery, Emma. "Ginger Benefits.” Johns Hopkins Medicine, 2023, www.hopkinsmedicine.org/health/wellness-and-prevention/ginger-benefits. Accessed 23 Sept. 2024

Smith, C., et al. “A Randomized Controlled Trial of Ginger to Treat Nausea and Vomiting in Pregnancy.” Obstetrics and Gynecology, vol. 103, 2004, pp. 639-45.

Yavari Kia, Parisa et al. “The Effect of Lemon Inhalation Aromatherapy on Nausea and Vomiting of Pregnancy: A Double-Blinded, Randomized, Controlled Clinical Trial.” Iranian Red Crescent Medical Journal, vol. 16, no. 3, 2014, pp. e14360, doi:10.5812/ircmj.14360 Accessed 23 Sept. 2024