• Car Sickness; Motion Sickness; Sea Sickness
Principal Proposed Natural Treatments
• VARIOUS FORMS OF NAUSEA: Acupressure/Acupuncture; Ginger
• MORNING SICKNESS: Vitamin B 6
Other Proposed Natural Treatments
• 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.
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.
Studies are conflicting on whether acupressure is helpful for motion sickness. 39,64
For more information, including safety issues, see the full Acupuncture article.
Vitamin B 6
A large double-blind study (with almost 350 people) suggests that 30 mg daily of vitamin B 6 can reduce the sensation of nausea in morning sickness. 42 For more information, including dosage and safety issues, see the full Vitamin B 6 article.
Other Proposed Natural Treatments
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
1. Vutyavanich T, Kraisarin T, Ruangsri R. Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet Gynecol . 2001;97:577-582.
2. Fischer-Rasmussen W, Kjaer SK, Dahl C, et al. Ginger treatment of hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol . 1990;38:19-24.
3. Grontved A, Brask T, Kambskard J, et al. Ginger root against seasickness: a controlled trial on the open sea. Acta Otolaryngol (Stockh) . 1988;105:45-49.
4. Mowrey DB, Clayson DE. Motion sickness, ginger, and psychophysics. Lancet . 1982;1:655-657.
5. Schmid R, Schick T, Steffen R, et al. Comparison of seven commonly used agents for prophylaxis of seasickness. J Travel Med .1994;1:203-206.
6. Riebenfeld D, Borzone L. Randomized double-blind study comparing ginger (ZintonaW) and dimenhydrinate in motion sickness. Healthnotes Rev . 1999;6:98-101.
7. Careddu P. Motion sickness in children: results of a double-blind study with ginger (ZintonaW) and dimenhydrinate. Healthnotes Rev . 1999;6:102-107.
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.
9. Stewart JJ, Wood MJ, Wood CD, et al. Effects of ginger on motion sickness susceptibility and gastric function. Pharmacology . 1991;42:111-120.
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.
11. Phillips S, Ruggier R, Hutchinson SE. Zingiber officinale (ginger):— an antiemetic for day case surgery. Anaesthesia . 1993;48:715-717.
12. Arfeen Z, Owen H, Plummer JL, et al. A double-blind randomized controlled trial of ginger for the prevention of postoperative nausea and vomiting. Anaesth Intensive Care . 1995;23:449-452.
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.
20. Harmon D, Gardiner J, Harrison R, et al. Acupressure and the prevention of nausea and vomiting after laparoscopy. Br J Anaesth. 1999;82:387-390.
21. Harmon D, Ryan M, Kelly A, et al. Acupressure and prevention of nausea and vomiting during and after spinal anaesthesia for caesarean section. Br J Anaesth. 2000;84:463-467.
22. Alkaissi A, Stalnert M, Kalman S. Effect and placebo effect of acupressure (P6) on nausea and vomiting after outpatient gynaecological surgery. Acta Anaesthesiol Scand. 1999;43:270-274.
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.
24. Dundee JW, Chestnutt WN, Ghaly RG, et al. Traditional Chinese acupuncture: a potentially useful antiemetic? Br Med J (Clin Res Ed). 1986;293:583-584.
25. Stein DJ, Birnbach DJ, Danzer BI, et al. Acupressure versus intravenous metoclopramide to prevent nausea and vomiting during spinal anesthesia for cesarean section. Anesth Analg. 1997;84:342-345.
26. Allen DL, Kitching AJ, Nagle C. P6 acupressure and nausea and vomiting after gynaecological surgery. Anaesth Intensive Care. 1994;22:691-693.
27. Fan CF, Tanhui E, Joshi S, et al. Acupressure treatment for prevention of postoperative nausea and vomiting. Anesth Analg. 1997;84:821-825.
28. Agarwal A, Pathak A, Gaur A. Acupressure wristbands do not prevent postoperative nausea and vomiting after urological endoscopic surgery. Can J Anaesth. 2000;47:319-324.
29. Lewis IH, Pryn SJ, Reynolds PI, et al. Effect of P6 acupressure on postoperative vomiting in children undergoing outpatient strabismus correction. Br J Anaesth. 1991;67:73-78.
30. Schwager KL, Baines DB, Meyer RJ. Acupuncture and postoperative vomiting in day-stay paediatric patients. Anaesth Intensive Care. 1996;24:674-677.
31. Schlager A, Boehler M, Puhringer F. Korean hand acupressure reduces postoperative vomiting in children after strabismus surgery. Br J Anaesth. 2000;85:267-270.
32. Schlager A, Offer T, Baldissera I. Laser stimulation of acupuncture point P6 reduces postoperative vomiting in children undergoing strabismus surgery. Br J Anaesth. 1998;81:529-532.
33. Barsoum G, Perry EP, Fraser IA. Postoperative nausea is relieved by acupressure. J R Soc Med. 1990;83:86-89.
34. Norheim AJ, Pedersen EJ, Fonnebo V, et al. Acupressure treatment of morning sickness in pregnancy. A randomised, double-blind, placebo-controlled study. Scand J Prim Health Care . 2001;19:43-47.
35. de Aloysio D, Penacchioni P. Morning sickness control in early pregnancy by Neiguan point acupressure. Obstet Gynecol . 1992;80:852-854.
36. Hyde E. Acupressure therapy for morning sickness. A controlled clinical trial. J Nurse Midwifery . 1989;34:171-178.
37. Belluomini J, Litt RC, Lee KA, et al. Acupressure for nausea and vomiting of pregnancy: a randomised, blinded study. Obstet Gynecol . 1994;84:245-248.
38. Carlsson CP, Axemo P, Bodin A, et al. Manual acupuncture reduces hyperemesis gravidarum: a placebo-controlled, randomized, single-blind, crossover study. J Pain Symptom Manage . 2000;20:273-279.
39. Hu S, Stritzel R, Chandler A, et al. P6 acupressure reduces symptoms of vection-induced motion sickness. Aviat Space Environ Med. 1995;66:631-634.
40. Shen J, Wenger N, Glaspy J, et al. Electroacupuncture for control of myeloablative chemotherapy-induced emesis: A randomized controlled trial. JAMA . 2000;284:2755-2761.
41. Dundee JW, Ghaly RG, Fitzpatrick KTJ, et al. Acupuncture prophylaxis of cancer chemotherapy-induced sickness. J R Soc Med. 1988;82:268-271.
42. Vutyavanich T, Wongtra-ngan S, Ruangsri R. Pyridoxine for nausea and vomiting of pregnancy: a randomized, double-blind, placebo-controlled trial. Am J Obstet Gynecol . 1995;173:881-884.
43. Tate S. Peppermint oil: a treatment for postoperative nausea. J Adv Nurs . 1997;26:543-549.
44. Merkel RL. The use of menadione bisulfite and ascorbic acid in the treatment of nausea and vomiting of pregnancy. Am J Obstet Gynecol . 1952;64:416-418.
45. Signorello LB, Harlow BL, Wang SP, et al. Saturated fat intake and the risk of severe hyperemesis gravidarum. Am J Epidemiol . 1996;143(suppl 2):S25.
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.
47. Smith C, Crowther C, Beilby J. Acupuncture to treat nausea and vomiting in early pregnancy: a randomized controlled trial. Birth. 2002;29:1-9.
48. Keating A, Chez RA. Ginger syrup as an antiemetic in early pregnancy. Altern Ther Health Med. 2002;8:89-91.
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.
51. Pongrojpaw D, Chiamchanya C. The efficacy of ginger in prevention of post-operative nausea and vomiting after outpatient gynecological laparoscopy. J Med Assoc Thai . 2003;86:244-250.
52. Boehler M, Mitterschiffthaler G, Schlager A. Korean hand acupressure reduces postoperative nausea and vomiting after gynecological laparoscopic surgery. Anesth Analg . 2002;94:872-875.
53. Kim KS, Koo MS, Jeon JW, et al. Capsicum plaster at the Korean hand acupuncture point reduces postoperative nausea and vomiting after abdominal hysterectomy. Anesth Analg . 2002;95:1103-1107.
54. Alkaissi A, Evertsson K, Johnsson VA, et al. P6 acupressure may relieve nausea and vomiting after gynecological surgery: an effectiveness study in 410 women. Can J Anaesth . 2002;49:1034-1039.
55. Weightman WM. Traditional Chinsese acupuncture as an antiemetic. Br Med J . 1987;295:1379-1380.
56. Werntoft E, Dykes AK. Effect of acupressure on nausea and vomiting during pregnancy. A randomized, placebo-controlled, pilot study. J Reprod Med . 2001;46:835-839.
57. Roscoe JA, Morrow GR, Bushunow P, et al. Acustimulation wristbands for the relief of chemotherapy-induced nausea. Altern Ther Health Med . 2002;8:56-57,59-63.
58. Sripramote M, Lekhyananda N. A randomized comparison of ginger and vitamin B 6 in the treatment of nausea and vomiting of pregnancy. J Med Assoc Thai . 2003;86:846-853.
59. Smith C, Crowther C, Willson K, et al. A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol . 2004;103:639-645.
60. Eberhart LH, Mayer R, Betz O, et al. Ginger does not prevent postoperative nausea and vomiting after laparoscopic surgery. Anesth Analg . 2003;96:995-998.
61. Morin AM, Betz O, Kranke P, et al. [Is ginger a relevant antiemetic for postoperative nausea and vomiting?] Anasthesiol Intensivmed Notfallmed Schmerzther . 2004;39:281-285.
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.
63. Duggal KN, Douglas MJ, Peteru EA, et al. Acupressure for intrathecal narcotic-induced nausea and vomiting after caesarean section. Int J Obstet Anesth . 2004;7:231-236.
64. Miller KE, Muth ER. Efficacy of acupressure and acustimulation bands for the prevention of motion sickness. Aviat Space Environ Med . 2004;75:227-234.
65. Betz O, Kranke P, Geldner G, et al. Is ginger a clinically relevant antiemetic? A systematic review of randomized controlled trials. Forsch Komplementarmed Klass Naturheilkd . 2005;12:14-23.
66. Borrelli F, Capasso R, Aviello G, et al. Effectiveness and safety of ginger in the treatment of pregnancy-induced nausea and vomiting. Obstet Gynecol . 2005;105:849-856.
67. Manusirivithaya S, Sripramote M, Tangjitgamol S, et al. Antiemetic effect of ginger in gynecologic oncology patients receiving cisplatin. Int J Gynecol Cancer . 2004;14:1063-1069.
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.
69. Duggal KN, Douglas MJ, Peteru EA, et al. Acupressure for intrathecal narcotic-induced nausea and vomiting after caesarean section. Int J Obstet Anesth . 2004;7:231-236.
70. Ho CM, Tsai HJ, Chan KH, et al. P6 acupressure does not prevent emesis during spinal anesthesia for cesarean delivery. Anesth Analg . 2006;102:900-903.
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.
72. Heazell A, Thorneycroft J, Walton V, et al. Acupressure for the in-patient treatment of nausea and vomiting in early pregnancy: a randomized control trial. Am J Obstet Gynecol . 2006;194:815-820.
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 August 2013 by EBSCO CAM Review Board
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