Figuring Out How to Keep It In – Understanding Nausea and Vomiting
Symptomatic manifestations of several diseases are always tricky to work with because most of these overlap in each disease category – proving to be more difficult than one would initially deduce from a more distant perspective.
Providing an accurate diagnosis is necessary to ensure that the patient’s treatment regimen is appropriate for the condition they are experiencing. Doing the same for one that could be as damaging as a sexually transmitted infection is even more crucial. Considering the stigma alone that surrounds this entire context, providing a conclusive diagnosis with what limited knowledge the public has regarding this area is hard enough as it is, but adding to that the confusion that arises from the overlapping manifestations of several diseases, STDs and non-STDs alike, are guaranteed to make everything even more challenging.
We could also tackle the issue of mild symptoms being determinants of several severe conditions that may or may not be sexually transmitted – making it harder to treat these conditions due to how late these conditions are usually recognized among patients. Although it is entirely possible that this is not always the case in all situations, it does occur commonly among the public, and, unfortunately, some people are not able to receive the help that they need simply because one fails to recognize the signs early on due to how “minor” and superficial they seem to the untrained eye. While physicians are trained to look deeper into these symptoms and integrate their basic knowledge with their observations, a layperson is not equipped with the resources or the ability for the healthcare system to operate under this assumption.
One particular symptom that can be categorized under this category of unfortunate truths is nausea and vomiting – one that is notorious for its connection with the digestive system but may be related to something more complex that could even involve the nervous and reproductive systems, i.e., the brain and the genitalia. While unbeknownst to many, nausea and vomiting may be associated with certain sexually transmitted infections, and the reason as to why it is not known to all is because the symptoms are too subtle and effective at mimicking other potential conditions that direct causation is not entirely established until a conclusive diagnosis is provided. To recognize whether being nauseated is associated with an underlying STD, discerning the associated symptom of most, if not all, potential conditions could greatly help develop a more detailed differential that could even help your physician narrow down the testing points for your next visit.
Although these two symptoms are commonly paired up together, contrary to some people's belief, nausea and vomiting are two different occurrences that are defined differently from each other. In essence, nausea is the sensation of uneasiness in the stomach, that sensation of your insides feeling like they are about to release something from your stomach, that knot that somehow signals a release of gastric contents are about to be expelled from your mouth – it is essentially that queasiness that comes before you vomit. On the one hand, vomiting is precisely what its name suggests – it is the action of releasing gastric content from your body following a nauseating sensation. They are not diseases on their own as they are more commonly known as common denominators in several conditions – presenting as a common symptom in several illnesses that it already became too hard to associate these two manifestations with just a few underlying conditions. Nausea and vomiting are essentially there from diseases to side effects due to medications. If not, it is a safe bet that they are bound to cause one sometime.
The problem regarding STDs is that the community has sensationalized the idea of something so mundane and ordinary among human beings to a concept that should be feared and covered in stigma. STDs are essentially infections, and the only difference that they have from, for example, a stye is that they are transmitted from one person to another through the exchange of bodily fluids and that they mainly affect the genitalia of an infected person – not that the causative microorganism is different, nor is it because the disease itself is horrendous that no one knows how to approach the condition, much less cure it. While it is a given that some STDs have lifelong consequences and the treatment for these conditions are not always readily available, labeling STDs as conditions that could only cause disfiguring and severe manifestations would only hold back our understanding of the condition instead of educating the public about how to approach the situation instead correctly. Nausea and vomiting are one instance where this stigma is further highlighted – showing how something so mundane and benign could be a sign of an underlying STD, and it does not mean that the disease’s progression would stop there. However, keep in mind that with the overlapping manifestations of several conditions, it is understandable that confusion might ensue. Staying rigid with this mindset, on the one hand, is not.
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To rule out other conditions as the cause of your nausea and vomiting, the following section outlines the potential reasons for such a manifestation among the non-STD conditions. While this might not be the most comprehensive list due to the vast possibilities that could be categorized under this section, these conditions are among the most common to cause such a presentation.
Motion sickness is perhaps a given in this particular situation, especially considering that it is the most notorious condition for causing this specific plethora of symptoms with almost no other related manifestations. Motion sickness, while poorly understood on a deeper level, is mainly caused by the disruption of the fluids in your ear – resulting in a specific distortion in your balance and causing disarray in the synchronicity of everything else that helps you maintain your bearing. There is no one way to prevent nausea caused by motion sickness, but some anti-emetic medications can help avoid vomiting following such an instance.
During the early pregnancy stages, expecting mothers are familiar with the term known as “morning sickness.” It has been coined due to its tendency to recur in the morning commonly, but professionals do not entirely know its cause and the exact mechanism. Accordingly, it is precipitated by an unexpected drop in blood pressure or an increase in certain pregnancy hormones such as human chorionic gonadotropin hormone – causing severe vomiting, dehydration, and even weight loss.
According to studies, the correlation of nausea with intense chronic pain is more of a biological response to the sensation that is being experienced by the body than psychological. Nausea is a non-specific symptom, and it, therefore, does not precipitate from one singular cause only. Nausea following an intense sensation of pain is primarily rooted in the nervous system being in a hyperactive state – resulting in your body adjusting several parameters of your systems such as your blood pressure, heart rate, and such, to trigger a combination that could then add up to resemble nausea, along with other associated symptoms with nervous system hyperactivity.
Chemicals are present worldwide, all over your home, and all over the environment. Chemicals have been extensively integrated into humanity’s everyday life that it is impossible to say that you have never encountered one. Something as simple as baking soda or sodium bicarbonate can be considered a chemical, but it is formulated in non-toxic formulations. Toxic chemicals, particularly toxic chemical fumes, on the one hand, cause several symptoms and manifestations following its inhalation. It may cause presentations such as nausea, headache, dizziness, cough, shortness of breath, irritation of the eyes, nose, and throat, and upper chest pain.
Fear and stress are psychological factors that can effectively influence the body’s response and status in the blink of an eye. Although emotional and psychological parameters are sometimes construed as insignificant by untrained eyes, these factors could effectively cause biological presentations that could sometimes be mistaken with other conditions. Specifically, stress and fear can increase one’s heart rate, blood pressure, and respiratory rate, causing what is known as “anxiety nausea.” Some people describe it as an indescribable churn in the stomach that could sometimes even send some people to the bathroom to the point where dry heaving and vomiting are likewise possible.
The mildest and common form of gallbladder disease among humans is biliary colic. This condition is often associated with intermittent pain that can be described as a gripping or gnawing pain in the upper right abdomen near the rib cage. It is said that the pain radiates to the upper back, and it may also spread into the breastbone area. Due to the intense pain that is often observed by affected patients, nausea and vomiting are effectively associated due to the associated response of the body to the resulting pain of the condition.
Also known as foodborne illness, food poisoning is caused by consuming food items contaminated with infectious organisms such as bacteria, viruses, parasites, or their respective toxins that could cause untoward responses within the body. The symptoms of food poisoning would often appear hours after eating the contaminated food, and these symptoms may be comprised of nausea, vomiting, and diarrhea. Such cases are usually self-limiting, but some instances, especially severe ones where the causative microorganism is rather aggressive, will require a consultation with the physician for a more thorough treatment regimen to remove the microorganism from the body.
Concussion cases may indeed cause nausea, and some may even result in instances of chronic nausea that, while rare, is still evidently possible based on the available evidence. Patients would usually encounter short-term cycles of nausea following an acute case of concussion, which could be attributed to several reasons. However, please note that concussions are not always as evident as most people make them out to be. They may occur even without hitting the head directly or experiencing a loss of consciousness due to the impact.
Encephalitis is considered a rare infection of the brain, and it is mainly characterized by the inflammation of the brain due to the presence of a virus or a bacterium or due to medicine being taken that may or may not be simultaneously associated with an immune system malfunction. Essentially, encephalitis is rare due to the inherent sterility of the brain’s environment, but it is still highly possible, especially in at-risk individuals. The most common symptoms of encephalitis are fever, headache, joint pain, muscle weakness, nausea, and a stiff neck, but it may also be associated with behavior changes, confusion, dizziness, memory issues, and sensitivity to light.
A blockage in the intestinal tract, particularly the small bowel region, affects its ability to move digested food and stomach acids to the colon – resulting in presentations such as nausea, vomiting of dark green bile, bloating, and severe constipation.
Appendicitis is essentially a blockage or obstruction of the appendix – causing it to be inflamed and infected and subsequently burst if the blockage is not immediately addressed. Appendicitis cases would often present with abdominal pain, low fever, nausea, vomiting, loss of appetite, constipation, diarrhea, and difficulty in passing gas.
To have a deeper understanding of what specific sexually transmitted conditions can precipitate such a pattern of symptomatic manifestations, the following outline highlights the potential conditions and their associated presentations, diagnosis, and management strategies if necessary.
Syphilis is one of the sexually transmitted diseases notorious for its tendency to develop several subsequent complications and conditions once the disease itself is not addressed for quite some time while the causative microorganism infects the patient. Syphilis is caused by the microorganism known as Treponema pallidum, and the disease itself is transmitted through direct contact with the sores developed by the condition known as chancres. Syphilis can be divided into four stages: primary stage, secondary stage, latent stage, and tertiary Syphilis. The most notable feature is the appearance of painless, firm, and round sores known as chancres in the primary stage. These usually resolve independently without any treatment, but the infection continuously progresses despite these sores being healed without any intervention.
The secondary stage occurs when the condition is not addressed immediately – causing the appearance of a rough, red, or reddish-brown rash in the palms of the hand and soles of the feet. In addition to that, it is likewise coupled with other systemic symptoms such as fever, swelling of the lymph glands, sore throat, headaches, and patchy hair loss.
Without any treatment, the disease will then continue to its latent stage where it remains asymptomatic – quietly replicating until the viral load is sufficient enough to cause tertiary Syphilis or the stage where the infection now affects other organs such as the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints.
Treponemal tests are usually indicated as the mainline diagnostic procedure for Syphilis due to its ability to detect treponemal antibodies – antibodies that appear earlier than non-treponemal antibodies but remain throughout the lifespan of the infected person. As such, non-treponemal tests are likewise indicated to confirm the previous diagnosis, especially if the patient has been previously infected and cured of Syphilis.
According to the Centers for Disease Control and Prevention, the following treatment options are recommended for the management of Syphilis infections:
Hepatitis A is an infection of the liver that is vaccine-preventable – indicating that there is a vaccine to prevent the contraction of such a condition from the stool and blood of infected individuals. It is incredibly contagious in the sense that highly close contact, sexual intercourse (particularly oral-anal sex), and consumption of contaminated products could easily transmit the virus, causing fatigue, nausea, stomach pain, and jaundice that could last for up to 2 months. Apart from these, infected patients may likewise experience fever, dark urine, light-colored stools, joint pain, vomiting, and loss of appetite throughout the disease’s duration.
Your physician would usually request for a blood sample that could then be tested in a laboratory to confirm your diagnosis, along with the list of symptoms that they will be collecting from you.
There is no medical treatment for Hepatitis A as it is usually self-limiting, but physicians recommend adequate rest, nutrition, and fluids, especially if the case is not so severe to warrant medical care. On the one hand, vaccination is recommended to avoid contracting the virus as much as possible from other low-risk means.
Hepatitis C, similar to Hepatitis A, is a liver infection caused by the hepatitis C virus. The most common mode of transmission of HVC is through the shared use of needles with an infected patient or by being birthed by an HCV-positive pregnant woman. However, a patient may also contact HCV through sexual intercourse with an infected person, sharing items contaminated with infectious blood, invasive procedures, and unregulated tattooing. Commonly, patients infected with HCV will present with the following symptoms:
Most infected people will be asymptomatic, but symptomatic patients may start to observe these presentations around 2-12 weeks from the time of exposure.
According to the Centers for Disease Control and Prevention, universal Hepatitis C screening is available in hospitals and various institutions for you to take advantage of to know your HCV status and have the condition addressed imperatively. Blood tests that can be used to detect the presence of the virus may include:
According to the Centers for Disease Control and Prevention, the pharmaceutical approach to treating Hepatitis C infections is through direct-acting antivirals or DAA. However, your physician may likewise provide a medical evaluation to assess your status thoroughly, administer Hepatitis A and B vaccination, screen and provide necessary interventions regarding the patient’s alcohol consumption, and evaluate and test for HIV risk. This process would usually include a comprehensive counseling session that aims to inform the patient of the various habits that they should discontinue following this infection, such as excessive alcohol consumption, unhealthy diet, avoiding donation of bodily fluids, the low risk for sexual transmission of the virus, and the ways through which their infection may be transmitted to their partners or other individuals entirely.
Yes, Syphilis can be completely cured with the help of the proper antibiotic treatment.
In some cases, the latent period may be as brief as one year, but some instances can go on for almost 5 to 20 years undetected due to the lack of symptoms.
Hepatitis A is considered the most contagious type due to its ease of transmission and the variety of ways by which it can be transmitted from person to person.
While the actual life expectancy is not necessarily known for Hepatitis C patients, studies show that untreated infections usually result in a 15-year decrease in life expectancy compared to those without the disease.
No. The only vaccines available for Hepatitis are Hepatitis A and B.
ARUP Laboratories
American Journal of Public Health
World Health Organization
Written by Mark Riegel, MD
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