What that sick feeling in the pit of your stomach really means – and when to get help

IF there’s anything worse than vomiting, it’s feeling like you’re going to but not.

When you feel that ‘sick feeling in the pit of your stomach’, it is often because you are worried or anxious. 

Feeling sick is one of the many symptoms of a panic attack, too.

You may not considered that you have anxiety before.

But there are half a dozen other reasons you may be experiencing nausea, and if there are other symptoms, it’s usually possible to work out the cause.

Dr Tom Jenkins, an NHS GP and Founder of Centoreze, says that if you have nausea without any other symptoms, and have no significant medical conditions, then you could safely monitor it at home. 

“However any unexplained symptoms that are additional to nausea, or nausea symptoms that last more than two to three days ought to be discussed with a healthcare practitioner,” he tells Sun Health.

Dr Jenkins says home self-care measures include: “Getting plenty of fresh air, drinking ginger or peppermint tea, eating smaller and more frequent meals, and avoiding strong-smelling or greasy foods.” 

However, some situations may require clinical advice or treatment. 

This includes if you are pregnant and have severe nausea or vomiting that affects your ability to eat, drink, or function; if you have diabetes and have vomiting – especially if you have high blood sugar levels, fruity-smelling breath, or signs of dehydration; and if you have severe abdominal pain, fever, blood in your vomit or stool, or signs of dehydration. 

You may also require treatment if you do not feel better in a few days, if your sickness keeps coming back, if you have other symptoms or if you have a history of cancer or are receiving cancer treatment.

Let’s take a look at what different types of nausea mean…  

Nausea with dizziness

Feeling sick alongside a feeling of unsteadiness can be caused by motion sickness or vertigo.

“It’s caused by a mismatch between the signals that the brain receives from the eyes, ears, and other sensory organs,” explains Dr Jenkins. 

“To prevent or relieve travel sickness, choose a seat that reduces motion, such as the front of a car or the middle of a boat and look at a fixed point on the horizon or close your eyes and breathe slowly.” 

It’s best to avoid reading, watching screens, or focusing on moving objects and aim to get some fresh air by opening a window or going outside.

Before travel, opt for light meals or snacks and avoid spicy, fatty, or alcoholic foods and drinks. 

Suck on ice cubes or frozen fruit lollies to ease nausea and keep hydrated and when eating, eat bland, soft, and easy-to-digest foods, such as crackers, toast, rice, apples or bananas.

Dr Tom JenkinsNHS GP

Dr Jenkins adds: “Try ginger, which may help with nausea, in the form of tablets, biscuits, or tee.

“Use acupressure bands, which apply pressure to a point on the wrist that may reduce nausea.

“And take over-the-counter medicines that can prevent or treat motion sickness, such as meclizine or promethazine.”

Other less common causes of nausea and dizziness include Ménière’s disease, an inner ear condition affecting balance and hearing; and stroke.

See a GP if your body feels numb, you experience blurred vision, you find it hard to hear or speak, or your dizziness doesn’t go away.

Nausea with a headache 

There are a dozen different types of headaches that you can experience.

When a headache accompanies your nausea, Dr Jenkins explains: “This could be caused by migraine, tension headache, cluster headache or sinusitis (a swelling of the sinuses).” 

If you’re dealing with a migraine, try to relax and lie down in a dark room. Stay hydrated with water and apply a cool compress onto your forehead.

Tension headaches are very common and can be related to stress, fatigue or muscle tension – so get some rest, take some painkillers and consider massaging the neck muscles.

Cluster headaches can feel very painful and aren’t usually treatable with simple paracetamol – prophylactic medications such as beta-blockers may be better.

Dr Samantha Wild, Women’s Health Clinical Lead and GP, Bupa Health Clinics says: “Cluster headaches usually happen at the same time of day or year, and make you feel restless. 

“You might also experience sweating, a runny or blocked nose, eye-watering and reddening, and changes to your eyes like eyelid drooping or a smaller pupil on the side you’re experiencing the pain.” 

She adds: “If you notice a change in your vision, wake up with headaches in the middle of the night, or find that they’re worse in the morning, it’s important to speak to a GP.”

If your headaches and nausea don’t wear off, or get gradually worse, see your GP.

Nausea with diarrhoea 

If you’re pooing regularly but it’s watery and you’re suffering from bloating, you likely have diarrhoea. 

Dr Jenkins says that nausea with diarrhoea could be caused by infections such as gastroenteritis, food poisoning, traveller’s diarrhoea or colitis (where the colon and rectum become inflamed).

He recommends drinking small amounts of clear fluids frequently and slowly rather than too much at once. 

“Nausea can interfere with fluid intake and increase the risk of dehydration, which can worsen the condition,” says Dr Jenkins.

“Therefore, managing nausea is an important part of the treatment of gastroenteritis.

“Suck on ice cubes or frozen fruit lollies to ease nausea and keep hydrated and when eating, eat bland, soft, and easy-to-digest foods, such as crackers, toast, rice, apples or bananas.

“Try to keep your head elevated and still and use aromatherapy, such as peppermint, ginger, or lemon, to soothe nausea. You can inhale the scent of these herbs or oils, or add them to your tea or water.

“If nausea persists or becomes severe, or if you have signs of dehydration, such as dry mouth, thirst, reduced urine output, dizziness, or weakness, seek medical attention as soon as possible.”

More persistent causes of diarrhoea include irritable bowel syndrome, inflammatory bowel disease and coeliac disease.

It could also be down to a lactose intolerance, gallstones or an intestinal obstruction. 

Nausea that comes on in waves 

Feeling queasy one minute, and fine the next? 

“This could be caused by pregnancy (especially in the first trimester),” says Dr Jenkins. 

The Duchess Kate Middleton famously suffered from severe vomiting, also known as hyperemesis gravidarum, during all three of her pregnancies.

Dr Jenkins says: “Morning sickness can be unpleasant and interfere with your daily life, but it usually does not harm your baby or your health.

“[But] hyperemesis gravidarum requires urgent medical attention and sometimes hospitalisation.” 

If you are being sick frequently and cannot keep food down due to morning sickness, you may have hyperemesis gravidarum and should tell your midwife or doctor, or contact the hospital as soon as possible. 

This is because there is a risk you may become dehydrated.

Dr Jenkins says morning sickness can be managed by following some self-care measures, such as resting, avoiding triggers, eating small and frequent meals, drinking fluids, and trying ginger or acupressure. 

If these don’t help, your doctor or midwife may prescribe you some anti-nausea medications that are safe to use in pregnancy. 

He says: “Some studies suggest that taking vitamin B6 supplements may help reduce nausea and vomiting in pregnancy. 

“However, the optimal dose is not well established and it is worth discussing this option with your GP first.”

Dr Wild says other reasons for nausea that comes in waves include “infections like gastroenteritis, cancer treatments (like chemotherapy and radiotherapy), motion sickness, migraines, low blood sugar, fasting, exhaustion, alcohol and vertigo”.

“You should work with a health professional to establish the cause, and whether you need any treatment.”

Nausea with bloating and/or heartburn 

It’s not nice when you’re going through nausea as well as a distended – sometimes painful – stomach or a pain in the chest, caused by issues like bloating or acid reflux.

Dr Wild says: “Digestive disorders, like irritable bowel syndrome (IBS) and indigestion, are most likely to cause bloating and nausea. 

“These symptoms usually arise after eating, as your body struggles to digest certain foods or ingredients in your food. 

“You might also have an upset stomach, constipation and excessive gas, alongside feeling sick and bloated.” 

She says that if you’re suffering from these symptoms for more than a week and it’s making daily life more difficult, start making a food diary to help spot the potential links between what you’re consuming and when your symptoms flare up. 

“This may help you to avoid certain food or drinks to help ease your discomfort,” says Dr Wild.

“Always speak to a health professional to see what else can be done to help you. Your GP may refer you to a food and nutrition specialist to undergo intolerance, blood or breath tests to pinpoint what’s causing the flare-ups.”

Dr Wild warns: “Avoid home tests – these aren’t proven to be an accurate way of diagnosing.

“Speaking to a GP can also help to rule out other conditions that can cause bloating, such as ovarian cancer.” 

Nausea after eating could also be a food allergy or intolerance, including celiac disease (gluten allergy) and lactose intolerance.