Patients often describe nausea as having a queasy feeling in their stomach and, in some, the sensation can be quite life-altering. Some children describe this as feeling “sick to their stomach” or simply “don’t feel good.” Nausea is relatively common in children, and not all episodes of nausea are associated with vomiting. In most causes, the nausea will resolve on its own.
It is important to understand that nausea is a symptom and not a disease. There are many reasons for why a child may feel nauseous.
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What Causes Nausea in Children?
Common causes of nausea include:
— Viral or bacterial infections
— Food poisoning
— Motion sickness
— Anxiety and stress
— Overeating
— Dehydration
— Constipation
— Acid reflux
— Inflammatory bowel disease (Crohn’s disease, colitis)
— Irritable bowel syndrome
Less common causes include:
— Kidney stones
— Pancreatitis
— Gallbladder issues
— Appendicitis
— Stomach ulcers
Nausea may be acute or chronic. Acute nausea occurs in the setting of an infection, like viral or bacterial gastroenteritis, and therefore would be associated with vomiting and diarrhea. Acute infections, such as urinary tract infection or pneumonia, may trigger nausea in some children. Sometimes, it may occur in the setting of acute inflammation in the abdomen as in appendicitis. It may also be seen associated with motion sickness
.
Emotional states like nervousness, extreme anxiety, depression and anger also may be associated with nausea.
Rarely, kidney stones may be associated with pain and nausea. Acute inflammation of the pancreas, though not that common in children, may be associated with upper abdominal pain and nausea. Gallbladder related problems (cholecystitis) as cause of nausea is uncommon in children but may be considered by your child’s provider.
Sometimes, nausea can be chronic and can become debilitating in a small subset of children. Chronic nausea may be secondary to acid reflux and esophagitis (inflammation of the food tube) and ulcers in the stomach. It may also occur in the setting of inflammatory bowel disease like Crohn’s disease or colitis (inflammation of large bowel) in some. But in many, a clear cause may not be found and may occur following an infection. In some, no triggers may be found, and patients may have a heightened gastro-intestinal sensitivity as in irritable bowel syndrome (IBS).
Chronic nausea may also be triggered by medications, including chemotherapy, and may also be seen in children who receive radiation to their abdomen. Rarely, chronic pancreatitis may be a trigger for nausea.
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How Would My Child’s Nausea Be Evaluated?
Call your doctor if the nausea persists and your child has:
— A fever
— A stiff neck or neck pain
— Severe headaches
— Vomits more than a few times
— Bloody bowel movements
— Severe abdominal pain
It is important to remember that nausea is a symptom. Evaluations look for underlying reasons for nausea.
Acute nausea often does not need much evaluation unless associated with additional persistent symptoms. A good history and physical examination is all that is needed. If associated with intense pain the right lower part of the abdomen, your child’s provider may order imaging to look for appendicitis, along with blood tests as appropriate. Occasionally, a blood lipase level to look for pancreatitis may be ordered.
Your child’s provider often relies on a good and detailed history and physical examination to guide evaluation and management if nausea is persistent or chronic. If your child has significant abdominal pain, diarrhea, blood in stools or weight loss, the provider may order blood tests to look for suggestion of inflammatory bowel disease.
If your child is growing fine and/or has normal bowel movements, constipation or occasional diarrhea, then your child’s symptoms may be related to irritable bowel syndrome (IBS), stress, anxiety or other related illnesses. Tests may include blood tests to look at some of the causes mentioned above, scans like ultrasound or CT scan of the abdomen and endoscopes as seen appropriate by your child’s provider.
[READ: Best Medicines for Heartburn, Nausea and Digestive Issues]
What Are the Best Nausea Remedies and Medication?
Acute nausea gets better when the underlying trigger improves. In the case of acute gastroenteritis, for example, it involves management of dehydration — and using an antinausea medication if advised by your child’s provider. Avoid drinks that are carbonated or that contain caffeine.
Some common over-the-counter nausea remedies include:
— Dramamine Nausea
— Emetrol (liquid)
— Nauzene Kids
— Pepto Bismol Chewables
In addition, natural home remedies that may relieve nausea include:
— Eating ginger
— Drinking ginger or peppermint tea
— Smelling peppermint essential oil
— Acupuncture and acupressure
— Taking slow, deep breaths
[READ: Chronic Diarrhea in Young Children]
Chronic nausea
When it come to chronic nausea, the neural processing of nausea is poorly defined. Our limited understanding of the mechanism makes managing of chronic nausea particularly challenging. It is always important to ensure that a possible underlying medical etiology is ruled out with good history and physical examination and appropriate testing.
The challenge is the management of chronic nausea where there is no clear underlying cause. In these situations, the key would be to have realistic expectations and work with providers to improve your child’s quality of life.
Antinausea medications may have limited efficacy in this setting. Optimizing bowel movements may help some, if constipation is an associated symptom.
Your child’s doctor may discuss the need to start other medications to help reduce the perception of nausea. Though the intention in these setting is to not treat depression or anxiety, your child could benefit if those problems coexist.
Seeking the help of a psychologist for cognitive behavioral therapy or hypnotherapy has been shown to help a subset of patients. Microcurrent therapy, acupuncture, meditation, yoga and similar approaches have not been studied effectively in chronic nausea, but some patients have reported benefits.
Overall, a multiprong approach may be required in some patients. The key, however, is to avoid overmedicating and then dealing with the side effects. Therefore, it is important to have an honest discussion with your child’s provider regarding realistic goals and ensuring that your child gets back to routine life.
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What Helps With Nausea in Children? When to Be Concerned originally appeared on usnews.com
