• Car Sickness, Motion Sickness, Sea Sickness
• Various Forms of Nausea: ]]>Acupressure/Acupuncture]]>, ]]>Ginger]]>
• Morning Sickness: ]]> Vitamin B 6]]>
• Post-surgical Nausea: ]]>Peppermint]]>
• Morning Sickness: Low-Fat Diet, ]]>Vitamin C]]>, ]]>Vitamin K]]>
Nausea can be caused by many factors, including stomach flu, viral infections of the inner ear (labyrinthitis), motion sickness, ]]>pregnancy]]> , and ]]>chemotherapy]]> . If you are continually nauseous, it can be more disabling than chronic pain. Successful treatment can make an enormous difference in your quality of life.
The sensation of nausea can originate in either the nervous system or the digestive tract itself. Most conventional treatments for nausea, such as Dramamine and Compazine, act on the nervous system, but products like 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 B 6 may be helpful for the nausea of pregnancy.
For information on treatments to reduce nausea during chemotherapy, read the article Cancer Treatment Support]]> .
Nausea and Vomiting of Pregnancy
For example, a ]]>double-blind, placebo-controlled]]> trial of 70 ]]>pregnant]]> women evaluated the effectiveness of ginger for ]]>morning sickness]]> . ]]>1]]> Participants received either placebo or 250 mg of powdered ginger 3 times daily for a period of 4 days. The results showed that ginger significantly reduced nausea and vomiting. No significant side effects occurred.
One study of 138 women and another of 291 women found ginger as effective for morning sickness as vitamin B 6 . ]]>58,59]]> Unfortunately, neither of these studies used a placebo group. Since there is only one study indicating that vitamin B 6 is effective (see above), it isn't quite ready to be used as a "gold standard" treatment. Comparing one unproven treatment to another without using a placebo group leaves much to be desired.
Note : Ginger has not been proven safe for pregnant women.
A double-blind, placebo-controlled study of 79 Swedish naval cadets found that 1 g of ginger could decrease vomiting and cold sweating without significantly decreasing nausea and vertigo. ]]>3]]> Benefits were also seen in a double-blind study of 36 individuals given ginger, dimenhydrinate, or placebo. ]]>4]]>
In addition, a double-blind comparative study that followed 1,489 individuals aboard a ship found ginger to be equally effective as various medications (cinnarizine, cinnarizine with domperidone, cyclizine, dimehydrinate with caffeine, meclizine with caffeine, and scopolamine). ]]>5]]> Another double-blind study found equivalent benefit of ginger at a dose of 500 mg every 4 hours and dimenhydrinate (100 mg every 4 hours) in a group of 60 passengers aboard a ship. ]]>6]]> Similar results were also seen in a small double-blind study involving children. ]]>7]]>
However, a 1984 study funded by NASA found that ginger was not any more effective than placebo at reducing the symptoms of nausea caused by a vigorous nausea-provoking method. ]]>8]]> Negative results were also seen in another study that used a strong nausea stimulus. ]]>9]]>
Put all together, these studies paint a picture of a treatment that is somewhat effective for motion sickness but cannot overcome severe nausea.
A British double-blind study compared the effects of ginger, placebo, and the drug metoclopramide in the treatment of nausea following gynecological surgery. ]]>10]]> The results in 60 women showed that both treatments produced similar benefits compared to placebo.
A similar British study followed 120 women receiving gynecological surgery. ]]>11]]> Whereas nausea and vomiting developed in 41% of participants given placebo, in the groups treated with ginger or metoclopramide (Reglan), these symptoms developed in only 21% and 27%, respectively. Benefits were also seen in a double-blind study of 80 people. ]]>51]]>
However, 3 other studies enrolling a total of about 400 people failed to find ginger more effective than placebo. ]]>12,13,60]]>
A 2004 article that reviewed all this evidence concluded that, on balance, evidence suggests that ginger is not effective for post-surgical nausea. ]]>61]]>
Warning : Do 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, there are theoretical concerns that ginger may affect bleeding.
For more information, including additional dosage and safety issues, see the full ]]>Ginger]]> article.
A single acupuncture point—P6—has traditionally been thought to be helpful for relief of various forms of nausea and vomiting. This point is located on the inside of the forearm, about 2 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.
General anesthetics and other medications used for ]]>surgery]]> frequently cause nausea.
At least 8 controlled studies enrolling a total of more than 750 women undergoing gynecologic surgery found that P6 stimulation reduced post-surgical nausea as compared to placebo. ]]>20-25,52,53]]>
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). ]]>54]]> A small trial of acupuncture in gynecological surgery also failed to find benefit ]]>26]]> , as did three studies of acupressure for women undergoing C-section. ]]>68-70]]>
Studies of acupuncture or acupressure in other forms of surgery have produced about as many negative results as positive ones. ]]>27-33,46,55,62,63]]>
Nausea and Vomiting of 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 97 women found evidence that wristband acupressure may work. ]]>34]]> Participants wore either a real wristband or a phony one that appeared identical. Both real and fake acupressure caused noticeable improvement in more than half of the participants. However, women using the real wristband showed better results in terms of the duration of nausea. Intensity of the nausea symptoms was not significantly different between groups.
These results are consistent with previous studies of acupressure for morning sickness. ]]>36,37,56]]> However, two studies failed to find benefit failed to find benefit for severe morning sickness. ]]>71-72]]>
However, 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. ]]>47]]> 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.
Other Proposed Natural Treatments
Preliminary studies suggest peppermint]]> oil may be able to reduce ]]>post-operative]]> nausea. ]]>43]]>]]>Multivitamin/mineral tablets]]> have also shown promise, possibly due to their vitamin B 6 content. ]]>49,50]]>
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. ]]>44]]>
8. Stott JR, Hubble MP, Spencer MB. A double-blind comparative trial of powdered ginger root, hyosine hydrobromide, and cinnarizine in the prophylaxis of motion sickness induced by cross coupled stimulation. AGARD Conf Proc . 1985;1-6.
10. Bone ME, Wilkinson DJ, Young JR, et al. Ginger root—a new antiemetic. The effect of ginger root on postoperative nausea and vomiting after major gynaecological surgery. Anaesthesia. 1990;45:669-671.
13. Visalyaputra S, Petchpaisit N, Somcharoen K, et al. The efficacy of ginger root in the prevention of postoperative nausea and vomiting after outpatient gynaecological laparoscopy. Anaesthesia . 1998;53:506-510.
23. Ho CM, Hseu SS, Tsai SK, et al. Effect of P-6 acupressure on prevention of nausea and vomiting after epidural morphine for post-cesarean section pain relief. Acta Anaesthesiol Scand. 1996;40:372-375.
46. Chu YC, Lin SM, Hsieh YC, et al. Effect of BL-10 (tianzhu), BL-11 (dazhu) and GB-34 (yanglinquan) acuplaster for prevention of vomiting after strabismus surgery in children. Acta Anaesthesiol Sin. 1998;36:11-16.
49. Czeizel AE, Dudas I, Fritz G, et al. The effect of periconceptional multivitamin-mineral supplementation on vertigo, nausea and vomiting in the first trimester of pregnancy. Arch Gynecol Obstet. 1992;251:181-185
50. Ussher JM, Dewberry C, Malson H, et al. The relationship between health related quality of life and dietary supplementation in British middle managers: a double blind placebo controlled study. Psychol Health. 1995;10:97-111.
62. Gan TJ, Jiao KR, Zenn M, et al. A randomized controlled comparison of electro-acupoint stimulation or ondansetron versus placebo for the prevention of postoperative nausea and vomiting. Anesth Analg . 2004;99:1070-1075.
68. Habib AS, Itchon-Ramos N, Phillips-Bute BG, 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. Anesth Analg . 2006;102:581-584.
71. Hsu E, Pei V, Shofer FS, et al. A prospective randomized controlled trial of acupressure vs. sham for pregnancy-related nausea and vomiting in the emergency department. Acad Emerg Med . 2003;10:437.
73. Roscoe JA, Matteson SE, Morrow GR, et al. Acustimulation wrist bands are not effective for the control of chemotherapy-induced nausea in women with breast cancer. J Pain Symptom Manage . 2005;29:376-384.
Last reviewed April 2009 by EBSCO CAM Medical Review Board]]>
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