Will there ever be a cure for chronic nausea? It can make pregnancy hell and leave some sufferers suicidal. But doctors still don’t fully understand how it works

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Being overwhelmed by the sensation that you’re going to get sick is one of the most debilitating experiences—pity, then, for people who live with nausea, severe for days, weeks, even months on end. feel seriously ill.

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Experts say that for many people living with a chronic illness, the nausea caused by it can be the worst part of their illness.

‘It’s so debilitating that it prevents people from living their daily lives,’ says Gareth Sanger, professor of neuropharmacology at the Blizzard Institute in Barents and the London School of Medicine and Dentistry.

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‘Research has found that patients are so desperate to escape chronic nausea that they say they would be willing to gamble even if they took a theoretical pill, which would have a 50/50 chance of either healing them or killing them. it’s so bad.’

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Experts say that for many people living with a long period of time, the nausea it causes may be the worst part of their illness.

Recent research found that a quarter of women affected by severe, persistent nausea and vomiting during pregnancy had suicidal thoughts as a result.

Persistent nausea is common, with one in eight people suffering regularly, and many others intermittently affected, according to experts, including consultant gastroenterologist Dr Adam Farmer at University Hospitals in the North Midlands.

Causes range from chemotherapy to persistent abdominal conditions (such as chronic dyspepsia). But it can also be a long-term effect of the winter vomiting virus and, unsurprisingly, has been linked to anxiety and depression – at least one study suggests that these conditions are such common triggers that patients are referred to their medications before they are sent. Should be screened for invasive tests for possible gastric causes.

Research published in General Hospital Psychiatry in 2002 found that patients with anxiety were three times more likely to suffer from prolonged nausea than people without the condition.

One theory is that brain chemicals released as a result of anxiety disrupt the balance of bacteria in the gut, with the knock-on effect of causing nausea.

Yet precisely because chronic nausea can be linked to psychological factors, it is sometimes not rigorously investigated, says Peter Whorwell, gastroenterologist at Withanshaw Hospital and professor of medicine at the University of Manchester. He adds: ‘This is a very challenging symptom to diagnose and treat because there are so many different possible causes.’

A recent survey of women suffering from hyperemesis gravidarum (HG), extreme nausea and vomiting in pregnancy, has revealed clear evidence of its sad effects. As well as revealing that a significant proportion of these women had suicidal thoughts, it was found that 5 percent said they had terminated their pregnancies because of the condition, reports the Journal of Obstetric Medicine.

HG affects 3.6 percent of pregnancies – Kate Middleton, Duchess of Cambridge, famously suffered it while carrying all three of her children.

The effects of such prolonged nausea may persist long after the sensations have ceased. According to a study of more than 200 moms published last year in the journal BMJ Open by researchers at Imperial College London, about 30 percent of women with HG suffered postpartum depression, compared to 7 percent of women who didn’t have HG.

Despite being so prevalent and disabling, there is no reliable treatment for HG-induced nausea. Professor Katherine Williamson from King’s College London, who led the latest HG study, says there is an ‘urgent need’ for further research into the reasons.

‘By answering these questions, we will be able to develop more effective treatments,’ she says.

The problem is that scientists still know very little about what exactly causes nausea, Professor Sanger says.

He told Good Health: ‘Now we can stop vomiting with drugs but you could be left with horrible unavoidable nausea symptoms. We thought it would be easier to prevent nausea than vomiting. The opposite has proved to be true.

While vomiting is a physical act that involves muscle and gut spasms, nausea is a sensation created by the nervous system and brain – and ‘science is still at the bottom of researching this’, he says.

‘What is known is that nausea sensations originate in the lowest, most primitive part of our brain,’ he explains, referring to the brainstem beneath the organ.

An area in the brainstem called the medulla oblongata receives sensory input from the rest of the body to produce feelings of nausea – these include motions that can cause illness from travel sickness and gut infections.

For example, this region coordinates the physiological function of vomiting as an early response to food poisoning. It also sends signals to areas of the higher part of the brain, including the insular cortex (associated with strong emotions such as fear), which produces the actual sensation of nausea.

One of the problems with the ‘cure’ of nausea is that the mechanism is protective – it has evolved to keep us from taking in something that could harm us.

Back in the 1980s, Professor Sanger led a team that created the first anti-disease drugs for cancer patients who were undergoing chemotherapy.

The drugs stopped patients’ vomiting by inhibiting the action of a receptor called 5-HT3, which is normally involved in transferring information along the gut and controlling the wave-like actions of food and waste through it.

But the results were disappointing. Professor Sanger says, ‘We thought that if we stop vomiting, then the nausea will also stop.’ ‘But Nausea was left behind unaffected.’ Some people are more prone to nausea than others. For example, women who vomit in the first trimester of pregnancy are more likely to vomit if they are given chemotherapy, while those under 50 are also more likely to experience nausea from chemotherapy. happens – but there is no explanation for it …

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