From the Guidelines
Nausea in viral gastroenteritis is primarily caused by the infection and damage to the cells lining the stomach and intestines, triggering inflammation and activating the body's immune response, which releases chemicals that stimulate the vomiting center in the brain. This inflammation and immune response are key factors in the development of nausea and vomiting in patients with viral gastroenteritis, as noted in studies on the public health importance and outbreak management of viral gastroenteritis 1. The virus also disrupts normal digestive processes, causing food and fluids to move abnormally through the digestive tract, further contributing to nausea.
The exact mechanisms of nausea in viral gastroenteritis involve the release of toxins by infected intestinal cells, which can directly stimulate the chemoreceptor trigger zone in the brain, controlling nausea and vomiting. Additionally, the body's use of vomiting as a defense mechanism to expel the virus from the system plays a role in the development of nausea. According to more recent guidelines on norovirus outbreak management and disease prevention, symptoms of viral gastroenteritis, including nausea, typically resolve without treatment after 1–3 days in otherwise healthy persons 1.
To manage nausea in viral gastroenteritis, it is essential to stay hydrated with small sips of clear fluids and try bland foods like crackers or toast when able to eat. Over-the-counter medications like dimenhydrinate (Dramamine) or prescription antiemetics may be considered if nausea is severe. Given the potential for dehydration and electrolyte imbalance, especially in high-risk populations such as the elderly and young children, careful monitoring and appropriate medical intervention are crucial when managing viral gastroenteritis 1.
Key considerations in managing nausea in viral gastroenteritis include:
- Staying hydrated to prevent dehydration and electrolyte imbalance
- Eating bland foods when able to reduce nausea and vomiting
- Considering over-the-counter or prescription medications for severe nausea
- Monitoring for complications, especially in high-risk populations
- Understanding that most cases of viral gastroenteritis resolve within a few days without specific treatment, aside from supportive care.
From the Research
Causes of Nausea in Viral Gastroenteritis
- Nausea and vomiting in acute gastroenteritis are likely underlayed by elevated ketone bodies and stimuli initiated by gut mucosa damage produced by the enteral pathogen 2
- The exact cause of nausea in viral gastroenteritis is not fully understood, but it is thought to be related to the infection and inflammation of the gut 3, 4, 5, 6
Physiopathology of Nausea and Vomiting
- The physiopathology of nausea and vomiting in acute gastroenteritis involves the stimulation of the gut mucosa by the enteral pathogen, leading to the release of chemical mediators that trigger the vomiting reflex 2
- The type 3 serotonin receptor is thought to play a role in the development of nausea and vomiting in acute gastroenteritis, and antagonists of this receptor, such as ondansetron, have been shown to be effective in reducing vomiting and improving oral rehydration therapy 2, 3, 5
Management of Nausea and Vomiting
- The management of nausea and vomiting in acute gastroenteritis typically involves supportive care, including oral rehydration therapy and antiemetic medications such as ondansetron 3, 4, 5, 6
- Ondansetron has been shown to be effective in reducing vomiting and improving oral rehydration therapy in children with acute gastroenteritis, and is often prescribed to increase the success rate of oral rehydration therapy and minimize the need for intravenous therapy and hospitalization 3, 4, 2, 5, 6