Can IBS cause nausea? Dietitian guide and management plan

If you’re often feeling queasy, you may be wondering ‘can IBS cause nausea?’

When we think of Irritable Bowel Syndrome (IBS), symptoms like abdominal pain and bloating come to mind.

However, another significant symptom associated with IBS that deserves attention is nausea. 

Throughout this blog, we’ll navigate the nuances of nausea’s role within IBS, including understanding the science underpinning why the two might be linked.

What is nausea?

Nausea is characterized by a queasy feeling in the stomach and sometimes accompanied by an urge to vomit (1). 

Nausea can be more than just a casual discomfort for individuals with IBS, ranging from mild annoyance to severe distress.

How common is nausea in IBS?

Nausea is not officially recognized as one of the common symptoms of IBS, however it is reported in up to 50% of people with IBS (2, 3).

According to studies, more people with IBS experience nausea than the general population (3, 4). However, its occurrence differs based many factors including gender and subtype of IBS.

For example, rates of nausea are higher in women than men, with 49% women with IBS in one study reporting nausea, compared to 18% men with IBS (5).

If you’re experiencing persistent or severe nausea in the context of IBS, it’s advisable to consult a healthcare professional for proper evaluation and management.

Can IBS cause nausea – what does the science say?

Navigating the intersection between IBS and nausea requires us to dive into the mechanisms that intertwine these two seemingly distinct symptoms. 

As we probe deeper, three main theories have been proposed by scientists:

1. Visceral hypersensitivity
2. Gut motility issues
3. Inflammation

1. Visceral Hypersensitivity – a cause of nausea in IBS

Increased gut sensitivity, aka visceral hypersensitivity, might play a role in the connection between IBS and nausea. 

The gut-brain axis, a complex communication network between the digestive system and the brain, could differ in individuals with IBS, leading to an exaggerated perception of discomfort. 

This hypersensitivity might contribute to the uneasy sensation of nausea, linking it to the realm of IBS symptoms (6, 7, 8).

2. Gut Movement

Interestingly, fluctuations in gut movement (gut motility) might also be implicated in the occurrence of nausea. 

The intricate balance of contractions and relaxations could impact the sensation of nausea by affecting how food and digestive substances move through the digestive tract.

3. Inflammation

Inflammation, often associated with various health conditions, has been a topic of interest in the IBS landscape. 

According to research, low-grade inflammation might contribute to IBS symptoms, including nausea (9, 10).

Diagnosing the cause of nausea

Nausea is a symptom of many other conditions. Diagnosing the source of nausea, especially within the context of IBS, can be perplexing. 

Consulting with your doctor is extremely important to find the exact cause of your nausea.

Common causes of nausea include (11, 12):

• Stomach bug/gastroenteritis
• Gastroesophageal Reflux Disease (GERD)
• Vertigo
• Motion sickness
• Stress

The occurence can also vary based on other medical conditions and it is a common side effect of some medications.

How to treat nausea in IBS

In order to find the best management for your nausea you need to work with your doctor to get a diagnosis. Treatments vary depending on what the root cause is.

In this section we provide information around the different approaches to manage nausea in IBS. Please note that these may not work if you nausea is not caused by your IBS.

Dietary approaches to manage nausea in IBS

Can you use the low FODMAP diet to treat nausea in IBS?

The role of diet in IBS is undeniable, with the low-FODMAP diet proven to alleviate various IBS symptoms by identifying trigger foods and adopting a diet that suits your sensitivities.

However, there is no research to show whether the low FODMAP diet effects nausea specifically.

It is recommended that you try the low FODMAP diet only in conjunction with a registered dietitian to ensure you can follow the intricacies of the diet while avoiding any deficiencies.

Can hydration effect nausea?

Dehydration can exacerbate nausea, so maintaining proper hydration levels is vital (13).

It can slow down the movement of food and waste through the gastrointestinal tract, leading to issues like constipation and bloating which can contribute to the sensation of nausea.

Dehydration also reduces blood volume and can lead to lower blood pressure. 

When blood volume is insufficient, the body might divert blood from the digestive system to prioritize essential organs, which can negatively impact digestion and trigger nausea.

Can natural remedies cure IBS-related nausea?

Specific natural remedies like ginger or dietary supplements have been used traditionally for their potential anti-nausea effects. However, there is no science to back up most of the claims.

There is some evidence behind these claims, with some studies suggesting ginger as an effective, inexpensive and safe treatment for nausea(14, 15, 16). 

However, the available studies are mostly in nausea associated with chemotherapy or pregnancy, so we don’t know whether this translates to other causes of nausea.

Discussing their use with a healthcare provider is essential as there is not extensive research in the area.

Medications

There are some medications available which target different mechanisms in the body that contribute to nausea. 

Remember that the suitability of these medications can vary based on individual circumstances, so it’s essential to consult with a healthcare provider for personalized recommendations.

Some options that your doctor may explore with you are:

• Antispasmodic medications – these help soothe gut spasms that might trigger nausea. 
• Prokinetic medications – help improve gastrointestinal motility and transit. Examples include metoclopramide and domperidone.
• Anti-emetics – these are ‘anti-sickness’ medications. 
• Serotonin Receptor Antagonists e.g., ondansetron and granisetron – These block specific serotonin receptors in the gut and brain that can trigger nausea and vomiting.

However, it is also worth noting that many other medications, such as loperamide, have nausea listed as one of the main side effects (17).

Stress management

As highlighted earlier, stress can sometimes be the cause of nausea. Therefore, employing appropriate stress management techniques may help keep nausea under wraps.

Cognitive behavioral therapy

Stress and anxiety can play a role in the feeling of nausea. As such, Cognitive Behavioral Therapy (CBT) may positively impact symptoms of nausea by indirectly treating this (18).

While CBT doesn’t directly target the physical causes of IBS, it aims to break down the negative psychological cycle that can influence the experience of symptoms. 

It’s important to note that trained mental health professionals conduct CBT, and effective treatment requires a collaborative effort between the therapist and the individual seeking help. 

While CBT can be effective, it’s not a quick fix and may require several sessions to see significant results.

You can read in more detail about whether CBT works for IBS in our blog: Does CBT work for IBS?

Mindfulness relaxation techniques

Others may find that embracing mindfulness and meditation can be your secret weapon. Apps and online resources offer a plethora of guided meditations tailored to busy lives. 

From breathing exercises during your commute to short mindfulness breaks at your desk, incorporating mindfulness can help ease stress, potentially reducing nausea episodes.

Some studies have shown this to be the case, but are often done on small sample sizes (19, 2021).

Physical activity

Regular physical activity has been linked to improved digestion and stress reduction, pivotal in managing IBS and its symptoms (22).

Whether it’s a yoga session, a jog in the park, or a home workout routine, finding a fitness routine that resonates with you can contribute to overall well-being and symptom relief.

Your journey toward IBS-related nausea relief is inherently unique. What works for one might be less effective for another. This underscores the significance of an individualized approach. 

Collaborate closely with your healthcare provider to tailor strategies that align with your specific symptoms, triggers, and preferences.

You can read more about whether exercise can affect the gut in our post: Does exercise improve gut health?

Summary

Nausea is a common symptom reported in people with IBS. However, it is also a feature of many other conditions, so speaking to your doctor is key.

Increased gut sensitivity, gut dysmotility, and inflammation have been proposed as linking factors between IBS and nausea. 

You can tackle IBS-induced nausea head-on through medications, as well as with dietary strategies and stress management techniques.