Feeling nauseous and sickness can be one of most under discussed aspect of gut conditions such as irritable bowel syndrome (IBS).
The truth is that digestive issues are varied. Even if you have been diagnosed with a condition, you may only be experiencing a small amount of the common symptoms. In regard to IBS, everyone has their own unique version of this condition. It can present at different times, in uniqure ways and have a variety of triggers.
This also means that there isn’t a ‘one size fits all’ approach to treatment. It’s about working to discover what that diagnosis means for you and your gut and how to get things back on track.
While the range of digestive symptoms can vary dramatically, these can offer clues as you what’s contributing to your condition. Along with the bloating, altered bowel patters (constipation or diarrhoea) and pain, the feeling of sickness or nausea is a very common aspect of digestive imbalances.
IBS comes in many shapes and forms. The major symptoms of common digestive disorders include recurrent abdominal pain and bloating, heartburn, diarrhoea, and constipation. These symptoms can often improve of resolve after going to the toilet but commonly return soon after. It’s also not uncommon to go through periods where symptoms are far more manageable but then have times where they worsen, such as during a flare-up.
Nausea, however, may not always be something we think about when talking about IBS but it commonly comes along with these other symptoms.
Waking up feeling sick or having little to no appetite can be another disruptive element of digestive issues. Not only is it a very unpleasant feeling, it can take a lot of the joy out of eating and socialising. It’s these small things, like going out for dinner, that digestive symptoms disrupt the most.(Source: NHS)
Perhaps surprisingly, it’s this ongoing feeling of nausea that some find the most frustrating. In other situations, if there is the feeling of sickness, actually being sick resolves the issue. In these longer standing digestive situations there isn’t the need to be sick. Just the feeling that persists.
This can often be worse in the morning. Not feeling ready to eat until lunch time is not uncommon.
As IBS symptoms often include abdominal pain and unpredictable reactions to food there can also be apprehension around mealtime. Some describe this as food anxiety which causes a lack of appetite and the feeling of butterflies in the stomach which may feel similar to nausea. (Source: WEBMD)
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The body like to give us clues that something isn’t quite right. If there’s a ache in a muscle or a joint then perhaps we need to rest it. A sharp pain in our finger, perhaps we have a splinter buried in there. In IBS, the body is also sending these messages that there’s an imbalance in the digestive system.
Even in those without digestive issues, eating a food that doesn’t agree with us can lead to nausea. However, in IBS the gut is in such a sensitive state which can lead it to over respond to almost any food. Inflammation and sensitivity in the nerves that line the gut are 2 key factors that contribute to the sensation of nausea. Constant nausea or feeling the need to vomit is another sign that something is out of balance. (Source: NCBI)
Altered motility (movement of food) through the intestines can also lead to the symptom of nausea. In IBS and in particular SIBO (Small intestinal bacterial overgrowth) there can be an imbalance in the beneficial bacteria, particularly in the one’s the produce a beneficial compound called Butyric Acid. One of the roles of Butyric acid is to regulate the nerves that support muscle function to push the digested food downward through the digestive tract. When these bacteria are out of balance and our butyrate producing bacteria are not present in sufficient quantities, we can see the gut slowing down. This can also impact the stomach. Slow emptying of the stomach is known as gastroparesis. If this partly digested food isn’t moving through at the correct speed then it can begin to trigger nausea and feelings of sickness. (Source: NCBI)
Our emotional state also impacts these sensations. It’s not uncommon to feel nauseous when under a great deal of stress, even in those without digestive issues. A job interview or a first date are perhaps 2 situations where this is most familiar. Digestive issues can also make us feel more anxious and more sensitive to stress. (Source: ABOUT IBS)
This is what we can call a ‘top-down’ communication. A message sent from the brain (top) to the gut (down) leading to the sensation in the gut. This communication takes place via the gut-brain axis. A communication pathway where messages are sent along the vagus nerve. This nerve sends messages from the brain to the gut and also from the gut back to the brain. (Source: PSYCHSCENEHUB)
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Now that we know that nausea is a very common aspect of IBS. What can we do to stop it?
Beating the feeling of sickness falls into 2 categories;
- Getting relief from the symptoms of nausea
- Addressing the underlying imbalance in the gut
When looking to tackle digestive issues both of these categories can be worked on simultaneously.
As mentioned, alterations in the gut can lead to a disturbance in muscle function along the digestive tract. This can lead to spasms, inflammation and increased pain perception.
Herbal teas are a great option and have a soothing action on these muscles to help calm the feeling of sickness. One of the first choices is ginger. This acts as an antispasmodic to calm the muscles in the intestines and also as a prokinetic. This means it improves the gastric motility (movement) in the small intestine. (Source: SCIENCE DIRECT) This can be taken as a tea but also capsules and even chewing on ginger root can be effective.
Chamomile tea has also been shown to be very effective is reducing nausea. Even in situations such as chemotherapy it has shown to significantly improve symptoms (Source: PUBMED). As well as acting to calm the muscles in the digestives system, it also works on the central nervous system to support and balance the stress response (Source: NCBI). Since we know that stress and our emotional state play a role in how our digestive system behaves this can support both areas.
Peppermint is another tea I recommend in clinic. While this helps to calm the muscles in the gut to reduce feelings of sickness, it also helps to support the nerves that line the gut. In digestive conditions, especially IBS, there is an element of what is known as visceral hypersensitivity. This is where the nerves that line the gut become overly sensitive which can contribute to pain and nausea. Peppermint can help to calm these overly sensitive nerves (Source: PUBMED). This can be troublesome for people with heartburn however and would best be avoided if reflux is an issue for you.
Helpful Herbal Teas
When we are thinking about underlying issues there are several areas that can contribute to IBS and feeling nauseous. Some of the most common include;
- Carbohydrate intolerance
- Lactose intolerance
- Low grade inflammation
- SIBO (Source: MDPI)
Carbohydrate intolerances is perhaps the most common. This can occur for 2 main reasons. This can either be due to poor absorption in the small intestine due to genetic issues. These genetic issues we would call this a primary intolerance. There can also be a secondary intolerance where the issue is as a consequence of something else. For example, due to an imbalance in the bacteria in the small intestine as is seen in SIBO. In primary intolerances dietary avoidance is key. In secondary intolerances, it’s about addressing the underlying issue.
The small intestine is meant to contain a certain number of beneficial bacteria. However, given the right circumstances, these levels can rise as lead to general symptoms of IBS, including nausea.
Low grade inflammation can also contribute to nausea but increasing nerve sensitivity in the gut. This can result from food poisoning, antibiotic use and also elevated levels of proinflammatory bacteria in the gut. This also has knock on effect to how well food moves through the small intestine as it’s being digested (Source: PEARL NATURAL HEALTH).
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A key foundational area to support when looking to address symptoms of IBS, such as nausea, is the central nervous system and the stress response. While we know that anxiety and stress often come hand in hand with IBS in can be a chicken or the egg situation. The digestive symptoms can make feel more anxious but then the anxiety is triggering or worsening the symptoms in the gut. (Source: WEBMD). This can be a viscous cycle. Even if the stress feels as though it’s purely coming from the gut there may is still the need to address both areas. This is to calm the gut and to calm the brain.
One of the most well researched areas of the gut-brain connection in IBS is through gut directed hypnotherapy. This is a calming practise similar to a guided meditation which has been shown to be an effective treatment in digestive issues such as IBS (Source: RESEARCH GATE).
Managing stress levels is also a key area to support in regards the food that we eat. The more stressed or emotionally reactive we feel, the less in control of our food choices we are.
This is particularly true when it comes to alcohol intake. While it can be a helpful tool to destress in the short term, the impact it has on our gut is well documented. 2 ways it does this is though decreasing small bowel transit time which sets the scene for digestive imbalances and bacteria overgrowths. It can also impact the gut lining. Higher intakes leading to increased permeability of the gut wall which is also know as leaky gut ((Source: MEDICAL NEWS TODAY), (Source: NCBI)). There are 2 key areas that are going to contribute to ongoing digestive issues.
As well as nausea, IBS can lead to symptoms outside of the digestive tract. The feeling of light-headedness or being dizzy are also another aspect of this condition.
While it may not be exactly clear why digestive conditions lead to this feeling of unsteadiness. It may however, be due to a combination of increased sensitivity in the gut, reduced blood flow, pain and cramping as well as dehydration. Dehydration may be a key component, especially if you experience looser bowel movements and aren’t replenishing your fluid intake. Also, if you’re constipated this can be an indicator of inadequate fluid intake. (Source: AVOGEL)
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Conclusion / Key Takeaways
I hope this have given you some actionable tips to start tackling both the symptoms and potential root causes of nausea.
There are 3 main areas that can be focussed on to get the symptoms of IBS under control.
- Calming herbal teas to help calm the muscles in the gut
- Relaxing breathing practices to calm the mind.
- Most importantly, addressing the underlying issue. This may involve working with an experienced practitioner to help you identify and address the underlying issue.
Author: Martin Cohen
DipCNM mBANT mCNHC
I am a member of the professional body BANT (British Association for Applied Nutrition and Nutritional Therapy) and the CNHC. In addition, I have also reached the occupational standards of the NTC (Nutritional Therapy Council), which has strict codes of practise and ethics.
In such a developing and exciting field I am remain focused on keeping up with emerging research. My continued growth and development as a practitioner comes through peer-reviewed research and regularly attending accredited seminars and conferences around the country.