From the Guidelines
Morning nausea is most commonly caused by pregnancy-related hormonal changes, specifically elevated levels of human chorionic gonadotropin and estrogen, as well as changes in GI motility 1. To address morning nausea, several strategies can be employed:
- Eating a light snack before getting out of bed, such as crackers or dry toast, can help raise blood sugar and settle the stomach
- Staying hydrated by drinking water throughout the day is essential
- Avoiding strong smells and greasy foods in the morning can also be beneficial
- Trying ginger tea or ginger supplements (250-500mg capsules) can provide natural nausea relief, as recommended by the American College of Obstetricians and Gynecologists (ACOG) 1
- If symptoms persist or worsen, consulting a doctor to rule out underlying conditions such as hyperemesis gravidarum (HG) is crucial Morning nausea can also be due to other factors such as low blood sugar, acid reflux, anxiety, or medication side effects, but in the context of pregnancy, hormonal changes and GI motility alterations are the primary causes 1.
From the Research
Causes of Morning Nausea
- Morning nausea can be caused by various factors, including gastrointestinal infections, endocrine conditions, central nervous system disorders, psychiatric causes, toxin exposure, metabolic abnormalities, and obstructive or functional gastrointestinal causes 2, 3
- Pregnancy is a common endocrinologic cause of nausea and must be considered in any woman of childbearing age 2, 3
- Chemotherapy-induced nausea and vomiting (CINV) is another cause of morning nausea, especially in cancer patients who receive chemotherapy of moderate or high emetogenic potential 4
- Other potential causes of morning nausea include radiation therapy, surgical anesthesia, and certain medications 2
Diagnosis and Evaluation
- A comprehensive history and physical examination can often reveal the cause of nausea and vomiting, making further evaluation unnecessary 3
- Basic laboratory testing, such as urinalysis, urine pregnancy testing, complete blood count, comprehensive metabolic panel, amylase and lipase levels, thyroid-stimulating hormone level, and stool studies with cultures, may be necessary to determine the underlying cause of morning nausea 2
- Imaging studies, such as abdominal radiography, ultrasonography, and computed tomography, may also be necessary in some cases 2
Specific Conditions
- Gastroparesis is a condition that can cause chronic nausea and vomiting, and a gastric emptying study may be recommended if this condition is suspected 2
- Functional gastrointestinal disorders, such as abdominal pain-related functional gastrointestinal disorders, can also cause chronic nausea and vomiting 5
- Psychiatric causes, such as anxiety and depression, can contribute to morning nausea and should be considered in the evaluation and treatment of this condition 6, 5