11 Causes of Sudden Nausea That Comes and Goes In Waves: Explained In-depth.
Our content is not intended nor recommended as a substitute for medical advice by your doctor. Use for informational purposes only.
Sudden nausea that comes and goes in waves can be either due to:
- Female hormone fluctuations.
- Some medications such as antibiotics and pain medications.
- Functional dyspepsia.
- GERD, gastritis, or peptic ulcer disease.
- Gallbladder conditions such as gallstones.
- Part of migraine headache.
- Stress and anxiety.
- And others.
The table below provides some rapid clues to the possible causes of sudden nausea that comes and goes in waves.
|CAUSES OF NAUSEA||SOME CLUES|
|1. Female hormonal fluctuations||The nausea waves are concurrent with periods of hormonal changes such as:|
– During or just before the menses.
– During the ovulation (at the mid-cycle).
– early pregnancy (often morning nausea).
– Nausea while taking OCPs.
– During the onset of menopause.
|2. Medications.||– Always review your list of recent or chronic medications that trigger nausea.|
|3. Functional Dyspepsia||– Indigestion and early satiety after meals.|
– No history of peptic ulcer disease, gastritis, or GERD.
|4. GERD, gastritis, or peptic ulcer disease.||– Presence of typical symptoms of the disease (such as epigastric pain or heartburn).|
– The diagnosis may require endoscopy to spot ulcers or GERD.
|5. Gallbladder conditions||– Recurrent upper right abdominal pain associated with intense waves of nausea.|
– Abdominal ultrasonography shows stones inside the gallbladder.
|6. Gastroparesis.||– Long history of diabetes mellitus.|
– Early satiety, prolonged sense of fullness after eating.
– vomiting of undigested food.
|7. Inner ear problems.||– Presence of vertigo with the waves of nausea.|
|8. Part of migraine headache.||– Presence of typical migraine throbbing headache with or after nausea.|
|9. Stress and anxiety-related nausea.||– The waves of nausea are greatest in periods of psychological stress or anxiety.|
|10. Food intolerance or allergy.||– Sudden nausea follows ingestion of certain foods such as milk.|
– Associated with other intolerance symptoms such as cramps, bloating, gas, diarrhea, and anorexia.
|11. Other causes||– Motion sickness.|
– Painful conditions that trigger nausea such as toothache, menstrual pain, etc.
– Alcohol drinking.
– Brain tumors.
– Intraabdominal tumor or metastasis.
– Enlarged liver or spleen.
– chronic inflammatory diseases & others.
1 . Female hormones Fluctuations:
Sudden waves of nausea that comes and goes are common during periods of hormonal changes. However, nausea, loss of appetite, or even vomiting are greatest when there’s a massive fluctuation in your hormones.
For example, 50-90% of women will have waves of sudden nausea in the early pregnancy (reference).
Examples of periods of hormonal fluctuations:
- Pregnancy (especially the first three months).
- Menstruation (just before or during the menses).
- Taking oral contraceptive pills (OCPs).
- Diseases and conditions include dysmenorrhea, premenstrual syndrome, polycystic ovaries, etc.
- The onset of menopause (often between 45 to 50).
How to know if nausea is due to hormonal changes?
Sudden nausea is more likely to be due to hormonal changes if:
- It is linked to specific timing to your menstrual cycle (just before menstruation, during the period, during the ovulation period, or mid-cycle).
- It is episodic (comes and goes in waves).
- Other symptoms of dysmenorrhea or premenstrual syndrome include lower abdominal pain, anorexia, bloating, sore breasts, headache, fatigue, etc.
- Nausea improves after the period.
- Evidence of early pregnancy (test for pregnancy if you suspect nausea is due to pregnancy).
- Menstrual disturbances (as with polycystic ovary syndrome or during the onset of menopause).
- The nausea onset is related to taking OCPs or injectable hormonal contraceptives.
What to do:
- Consult your doctor if you are not sure about the cause of sudden nausea that comes and goes in waves.
- Try home remedies for nausea, such as ginger, peppermint, fennel, or cinnamon.
- Eat bland foods and avoid high-fat foods.
- Take an over-the-counter anti-nausea medication.
- Consult your doctor about the method of contraception if you think the waves of nausea are linked to hormonal contraceptive pills.
Medications are a common cause of sudden nausea that comes and goes in waves without apparent reason. Doctors and patients often overlook medications as a cause of nausea.
Medications used for both chronic and acute health conditions may lead to nausea. For example:
- Analgesics (such as ibuprofen, ketolorac) and anti-gout medications.
- Drugs That are used to treat heart diseases and hypertension (such as Angiotension
- Cancer chemotherapy medications.
- Oral contraceptive pills.
- Antibiotics such as Azithromycin, cephalosporins, etc.
- Medications treat neurological disorders, such as anti-parkinsonian drugs and anticonvulsants.
- Anti-asthma medications.
- Radiation therapy.
- IBD medications.
- Over-dose of vitamin supplements (common nowadays).
The complete list of drugs causing nausea is mentioned in this guide.
3. Functional dyspepsia.
Functional dyspepsia is widespread and an underdiagnosed condition.
Many people experience waves of sudden nausea without definite stomach or esophageal disease.
Functional dyspepsia (Also known as non-ulcer dyspepsia) affects up 3to 30% of people (reference).
- After eating, a sense of fullness (severe enough to impact your regular activities).
- Unable to finish a regular-size meal (early satiety).
- Nausea that may come and go in waves (often after meals).
- Discomfort, pain, or burning in the upper central abdomen (the epigastric area).
- The symptoms are not continuous, But it has to occur at least one day per week for the past three months.
How is functional dyspepsia diagnosed?
- The diagnosis is symptom-based (depending on the ROME IV’s clinical criteria).
- No test diagnoses functional dyspepsia (it depends on the exclusions of other diseases that cause similar symptoms, such as peptic ulcer disease, GERD, etc.).
- Your doctor may require some laboratory and imaging investigation to exclude such diseases. Also, You may undergo endoscopy to exclude peptic ulcers.
Isolated sudden nausea without epigastric discomfort or pain is unlikely to be functional dyspepsia.
4. GERD, gastritis, or peptic ulcer disease.
Nausea is one of the most common symptoms of a stomach or esophageal inflammation. The inflammation of the stomach (gastritis) is most commonly related to the use of medications or H. Pylori infection.
Gastritis may progress to ulcers (a breakdown in the lining of the stomach or duodenum).
Gastroesophageal reflux (acid reflux), gastritis, and peptic ulcer disease are common conditions. These conditions are widespread3 causes of nausea that comes and goes in waves.
The features of this disease are explained below. The definitive diagnosis of gastritis and peptic ulcer disease often requires endoscopy.
Symptoms of gastritis and peptic ulcer disease (reference):
- Epigastric pain (in the central upper abdomen).
- The pain may increase after meals with gastric ulcers.
- Paradoxically, you may get relief from pain after eating if you have duodenal ulcers.
- Nausea that comes and goes in waves.
- Sometimes, vomiting.
- Lack of appetite.
- The pain may be absent or minimal, and the patient may complain of non-specific symptoms such as waves of sudden nausea or anorexia.
- Bleeding of peptic ulcers may cause black stool or vomiting of blood.
Symptoms of GERD (reference):
- Heartburn: burning sensations in the front of the chest and the upper abdomen.
- Regurgitation of food particles or sore fluid into the throat.
- Attacks of sudden nausea or vomiting come and go.
- Lack of appetite (anorexia).
5. Gallbladder conditions.
The gallbladder is a sack-like structure attached to the liver in the right upper abdomen. It serves as a storage site for bile (which aids in fat digestion and absorption).
The most common gallbladder problem is the formation of stones. Stones inside the gallbladder are called gallstones.
Gallstones may be entirely asymptomatic or cause mild non-specific symptoms such as sudden nausea that comes and goes in waves.
Nausea, dyspepsia, or pain often occurs after fatty or large meals.
However, the typical biliary colic is more severe and has characteristic features such as:
- Constant severe pain in the right upper abdomen and/or the epigastric area.
- The pain builds up gradually till it reaches maximum intensity after an hour or so. Then, it decreases slowly until it fades away.
- Intense nausea just before or during the pain is very common with biliary colics.
- The pain may spread to the back of the right shoulder.
- Vomiting may occur in severe cases with intense pain.
6. Gastroparesis (especially in diabetic patients.
Gastroparesis is a term that refers to the slow motility (contractions) of your stomach. Gastroparesis can occur due to a variety of diseases. But the commonest risk factor is diabetes mellitus.
Other risk factors include abdominal or esophageal surgery, certain medications, Parkinson’s syndrome, multiple sclerosis, hypothyroidism, etc.
- Prolonged sense of fullness for several hours after eating.
- Discomfort and bloating in the upper central abdomen.
- Prolonged waves of nausea that comes after meals don’t go away until several hours pass.
- Poor appetite.
- Weight loss.
- Poor blood sugar control in patients with DM.
- Vomiting of undigested food.
- Early satiety.
7. Ear problems (vertigo).
The Vestibulo-cholera nerve supplies your inner ear. It is a nerve responsible for both hearing (cochlear part) and equilibrium (the vestibular part).
A disease affecting the inner ear and/or the vestibulocochlear nerve may cause vertigo and nausea.
Causes of vertigo include:
- Diabetes mellitus.
- Prolonged bed rest.
- Head injuries.
- Certain medications.
- A sense of spinning, tilting, or swaying.
- Loss of balance.
- Sudden nausea (comes and goes with the attacks.
- Vomiting is a severe case.
- The ringing of the ears or hearing loss.
If the waves of nausea come with vertigo, you have to consult your doctor to define its cause.
8. Food intolerance or allergy.
- Food intolerance is difficulty digesting certain types of foods (often due to a deficiency or absence of certain digestive enzymes).
- Food allergy is a less common but more severe form of food reaction (it occurs when certain foods trigger immune reactions leading to intolerance and allergy symptoms.
Both food intolerance and food allergies can cause unexplained waves of sudden nausea. The most common type is lactose intolerance (found in milk and dairy products).
Other common foods that trigger intolerance or allergy symptoms include:
- Fructose is found in most fruits, honey, and others.
- Artificial sweeteners such as aspartame.
- Amines intolerance.
- Caffeine intolerance.
For example, people with lactose intolerance may suffer from attacks of sudden nausea, bloating, and gas every time they drink milk or eat any dairy product.
Symptoms of food intolerance.
- Abdominal pain.
- Bloating and/or distension.
- Waves of nausea that come after eating the offending food.
- Food allergy causes the above symptoms plus allergic symptoms such as skin rashes, headaches, and swollen lips or face.
9. Stress, anxiety, or reactions to certain smells.
The gut is tightly related to our inner psyche and mood. Moreover, many theories link famous gut diseases such as irritable bowel syndrome and functional dyspepsia to stress and anxiety (reference).
Stress and anxiety situations may affect your appetite and cause symptoms such as:
- Chronic or recurrent abdominal pain.
- Chronic or recurrent diarrhea.
- Loss of appetite.
- Waves of sudden nausea and/or vomiting (especially in highly stressful situations).
- And others (anxiety and stress can cause almost any gastrointestinal symptom),
If the waves of nausea come and go with stress or anxiety attacks, consider discussing this issue with your doctor.
- Motion sickness: the waves of nausea (or even vomiting) occur when you are in a boat, car, or any moving object.
- Acute attacks of nausea may be due to infection (gastroenteritis).
- Painful conditions may trigger waves of sudden nausea, especially if the pain is recurrent over a long period, such as back pain, menstrual pain, etc.
- Alcohol drinking.
- Brain tumors.
- Chronic constipation.
- Intraabdominal cancers such as pancreatic cancer.
- Chronic inflammatory diseases such as Crohn’s disease, celiac disease, etc.