Generality
Morning sickness is a feeling of discomfort felt in the stomach just a few minutes after waking up.
This unpleasant disorder is quite common and can affect people of all ages.
When morning sickness persists, it is always good to consult your doctor for appropriate tests and possible therapeutic interventions.
What's this
Morning sickness is a sense of general malaise, not well defined, which is felt at the level of the throat (pharynx) and stomach. This manifestation typically occurs a few minutes after waking up and may be accompanied by a desire to vomit. In some cases, however, it is precisely the feeling of nausea that causes awakening.
Causes
Morning sickness is a symptom attributable to various triggering conditions and reactions.
At the origin of the disorder, there are various stimuli, which act on the nervous center of the vomitus, located in the medulla oblongata. These stimuli activate the nerve endings distributed along the digestive tract (pharynx, stomach and small intestine) or other centers of the central nervous system (brainstem or vestibular system).
A particular type of morning sickness is pregnancy.
During the first three months of pregnancy, waking up with nausea is a problem that many pregnant women have in common; from a certain point of view, this malaise can be considered "normal".
During gestation, the cause of morning sickness is a sharp increase in some hormone levels (chorionic gonadotropin, estrogen and progesterone), which stimulate the center of nausea located in the brain. Sometimes, the disorder can also occur in the last quarter, along with acid regurgitation and slowing of digestion, due to the pressure of the enlarged uterus that compresses the stomach.
Usually, morning sickness is preceded by a feeling of emptiness in the stomach and can be triggered by the sight or smell of particular foods or substances.
Premenstrual syndrome and pregnancy
- Morning sickness may be part of the symptoms of premenstrual syndrome . Many women experience this unpleasant feeling of sickness due to the hormones (estrogen and progesterone) that regulate the cycle.
- On the other hand, if you have had unprotected intercourse and your period is slow to arrive, the cause of the disorder could be the onset of a pregnancy . In this case, to ascertain the suspicion, it is possible to carry out a self-examination with the sticks available at the pharmacy. If the pregnancy test proves to be negative, even if repeated several times, and the nausea persists or menstruation did not arrive, it is better to go to the doctor.
- If during pregnancy the illness is severe and lasts a long time, it is advisable to consult a doctor. In fact, episodes of morning sickness followed by severe and frequent vomiting may indicate the onset of a hyperemesis gravidarum .
Other possible causes
Waking up in the morning with nausea is a feeling that can commonly depend on bad eating habits.
The disturbance could be triggered, in particular, by:
- Dyspepsia (digestive difficulties), especially in case of excessive food intake the night before;
- Alcohol abuse;
- Low-calorie diet;
- Ingestion of contaminated food (especially during travel).
Morning sickness may be related to the presence of specific gastrointestinal disorders, such as:
- Gastroesophageal reflux;
- Biliary or renal calculus;
- Chronic gastritis;
- Gastric or duodenal ulcer;
- Gastrointestinal microbial or viral infections (gastroenteritis);
- Alve alterations;
- Pancreatic disorders;
- Hepatitis and cirrhosis.
The nausea on awakening may also depend on:
- Hypoglycemia;
- Low pressure;
- Cervical osteoarthritis;
- Migraine;
- Sinusitis;
- Decompensated diabetes;
- Iron deficiency;
- Damage to sight or hearing;
- Intoxications (smoking, industrial toxins etc.);
- Food allergies and intolerances;
- Influence.
Morning sickness can also be induced by:
- Extreme fatigue;
- Strong emotions;
- Inhalation of particular odors.
Even the stimuli coming from the ear labyrinth can cause malaise upon waking up, as can be felt in labyrinthitis or when the receptors of the vestibular system are stimulated by accelerated movements, as happens during trips by car, boat, bus or airplane. These forms - more frequent in children over three years and in young women - are called motion sickness or travel sickness.
Taking certain drugs can induce a sense of morning sickness, as a side effect; these include chemotherapy, opiates, digitalis, anesthetics, oral contraceptives and antibiotics.
Other causes could be purely psychic: the malaise upon awakening can be the expression of a rejection of unwanted situations, impositions or events. In some cases, then, morning sickness signals the presence of depressive states or anxiety disorders.
Associated symptoms
Morning sickness may occur suddenly and may be a transient malaise or persist for longer periods of time.
Often, this disorder is associated with:
- Occurrence of involuntary contractions of the muscles of the gastric wall, pharynx and esophagus;
- Extremely abundant salivation;
- Disgust for food or some odors.
Morning sickness may precede vomiting but is not necessarily followed by this. Other concomitant events include:
- Increased heart rate;
- Skin pallor;
- Dizziness;
- Cold sweats.
Diagnosis
For a correct identification of the causes triggering the episodes of morning sickness, it is necessary to draw up a medical history (information is collected about the presence of concomitant diseases, therapies, eating habits and lifestyle, stress and personal situations).
The physical examination involves the palpation of the abdomen to assess the sensation of pain that can derive from it and to identify the presence of any masses and swellings.
At this point, the doctor prescribes some assessment tests or directs the patient to a specialist gastroenterologist for a more thorough check.
Based on the suspected diagnosis, investigations include:
- gastroscopy;
- X-ray of the digestive tract;
- 24-hour pH-value;
- Blood analysis;
- Ultrasound;
- Breath test;
- Computed tomography (TAC);
- Pancreatic enzymes dosage;
- Colonoscopy.
Treatment
Treatment of morning sickness may vary depending on the triggering condition.
In general, if the disorder is transient and without medical causes, no special therapies are required.
Bad digestion
Eating certain foods before going to bed can cause nausea when you wake up. In general, to avoid worsening the problem, you should avoid eating for about three hours before bedtime.
To limit the dyspepsia it is indicated:
- Improve your eating habits;
- Eliminate excessively fatty foods, which can slow down the emptying of the stomach;
- Eat small and frequent meals, which include light and fresh foods, cooked simply and easily digested;
- Avoid excessively stressful situations;
- Eliminate alcoholic beverages and cigarette smoke.
Motion sickness (car sickness)
The drugs most often used are antihistamines, in tablets or chewing gum, to be taken about half an hour before the trip. If possible, it is best to start in the afternoon, as the disorders appear more often in the morning.
In the passenger compartment of the car, turn on the air conditioning to reduce the temperature, eliminate odors and not smoke.
Before traveling, eat something light and solid, like some dry biscuit or a breadstick.
Nausea gravidica
The majority of cases of nausea gravidica do not require special medical treatment: even if for those who suffer it is a great annoyance, the disorder does not cause damage or consequences for the expectant mother and the child.
Morning sickness in pregnancy can be counteracted by eating small, frequent meals, so you never stay on an empty stomach. These precautions apply especially in the morning, when the nausea is stronger. The disorder tends to get worse, in fact, when the stomach is empty or the blood sugar level is low.
Useful foods, to be eaten even when awake, are crackers, biscuits or rusks, which absorb excess gastric juices. The consumption of fatty foods and coffee should be avoided.
Furthermore, it is advisable not to try eating foods that end up increasing the feeling of nausea.
Ginger can be effective in preventing nausea and gravidomic vomiting, but should not be abused.
It should be remembered that if morning sickness becomes severe and disabling, it is necessary to consult your gynecologist. He can decide to deal with this disorder by using specific drugs and, in the most serious cases, he can indicate a treatment with hospitalization, for the administration of intravenous fluids and medicines for vomiting.
Prevention
If the nausea appears in the morning, when the stomach is empty and the blood sugar level is lower, it is good to eat something in bed before getting up (eg crackers or dry biscuits).
Other tricks include:
- Adopt a varied and balanced diet, avoiding fried, spicy or extremely fatty foods;
- Reduce the burden of the evening meal, trying to anticipate it as much as possible and respecting the rhythms of digestion;
- Stop smoking and limit the intake of alcohol, alcohol and coffee;
- Eat slowly, chewing each bite for a long time;
- Prefer simple dishes that are not too elaborate, nor too seasoned;
- In the morning, do not wear belts or clothes that are too tight at the waist, because they tend to increase abdominal pressure;
- Practice regular physical activity;
- Do not lie down immediately after the evening meal;
- Stay well hydrated and rest properly, improving the quality of sleep;
- Avoid stressful occasions, especially during meals.
