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• Car Sickness; Motion Sickness; Sea Sickness
Principal Proposed Natural Treatments
• VARIOUS FORMS OF NAUSEA: Acupressure/Acupuncture; Ginger
• MORNING SICKNESS: Vitamin B6
Other Proposed Natural Treatments
• POST-SURGICAL NAUSEA: Peppermint; Aromatherapy
• 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.
Inhaling a blend of oils including ginger, spearmint, peppermint, and lavender may be as effective as anti-nausea medications or pain relievers for nausea and vomiting after surgery or discharge. The results were from a randomized trial with 221 adults who were having surgery.75
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
In a review of 12 randomized trials with 1,205 patients having a tonsillectomy, perioperative acupuncture was compared to usual care and sham acupuncture for postoperative nausea. Acupuncture was associated with improvements in nausea, vomiting, and pain postoperatively for up to 48 hours. Patients also used less medications to ease pain. However, the effect of acupuncture dissipated after 96 hours. Though the results are promising, the data was not evaluated enough to make a strong conclusion on the future of postoperative acupuncture.74
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 B6 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
References [ + ]
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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.
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Last reviewed December 2015 by EBSCO CAM Review Board
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