Nausea

Client: Sarah, 29-year-old female

Initial presentation: Sarah is a generally healthy individual with no significant medical history or food allergies, presents with chronic nausea lasting for the past 6 weeks.  The nausea is most pronounced in the mornings and mid-afternoons, without associated vomiting but accompanied by bloating after eating and occasional constipation. Sarah has tested negative for pregnancy.

She has no history of gastrointestinal issues, and her diet is irregular, often skipping meals, relying on fast food, and consuming 2-3 cups of coffee daily.

Sarah works in a stressful environment with long hours, leads a sedentary lifestyle, and takes ibuprofen occasionally for headaches.

Her vital signs are stable, with normal blood pressure, pulse, and weight, and her physical exam reveals no abdominal tenderness or distension, with normal bowel sounds.

Naturopathic assessment:

29-year-old woman presenting with nausea, low appetite, bloating and constipation likely caused by low nutritional intake, sedentary lifestyle, high caffeine intake, low stomach acid and high stress levels.

Upon discussing Sarah 's symptoms, the following key factors are highlighted:

Dietary habits: Skipping meals leads to low blood sugar levels, which could be contributing to nausea.  High caffeine intake may irritate the stomach lining and contribute to feelings of nausea, especially when taken on an empty stomach.  Low fibre and water intake with irregular meals can cause constipation and slow digestion.

Stress: Chronic stress from a high-pressure work environment is likely impacting her gastrointestinal system, leading to digestive dysfunction.  Stress can influence the gut-brain axis, exacerbating nausea and altering gut motility.

Digestive function: Occasional bloating and constipation suggest possible low stomach acid or decreased digestion function.  This can hinder proper nutrient absorption and lead to discomfort after meals.

Lifestyle: Sedentary lifestyle may contribute to poor digestion and overall sluggish metabolism, exacerbating symptoms of nausea.

Herbal formula

Ginger (Zingiber officinale): Known for its anti-emetic properties. 
Peppermint (Mentha piperita): Can help alleviate nausea and bloating. 
Chamomile (Matricaria chamomilla): Soothing to the stomach and digestive system. 
Milk Thistle (Silybum marianum): A bitter liver herb which helps support digestion and appetite.
Kawakawa (Piper excelsum): Anti-inflammatory, analgesic and a digestive aid helping to promote digestion and decrease digestive concerns. 

Additional recommendations:

• Eat regular, balanced meals: Sarah should avoid skipping meals and aim for 3 small meals a day that includes complex carbohydrates, protein and healthy fats.  This helps maintain stable blood sugar levels and supports digestion.
• Reduce caffeine intake: Gradually cut back on coffee to no more than 1-2 cups per day, replacing it with herbal teas like ginger, which are soothing for nausea.
• Hydration: Ensure adequate hydration, particularly with room temperature water or herbal teas.  Avoid drinking around meal time.
• Digestive enzymes: A high-quality digestive enzyme formula can be taken with meals to support optimal digestion, especially since Sarah reports bloating and discomfort after eating.
• Probiotics: Probiotic supplementation (with strains such as Lactobacillus acidophilus and Bifidobacterium bifidum) may help balance gut flora and support digestive health.
• Vitamin B6: Known for its ability to reduce nausea, especially in cases related to digestive disturbances.
• Slippery Elm (Ulmus rubra): Soothes the mucous membranes of the gastrointestinal tract, aiding in digestion and relieving nausea.  Powder mixed into water 30 mins before eating.
• Mindfulness and relaxation techniques: Teach the client stress management strategies, including diaphragmatic breathing and meditation to reduce the physiological effects of stress on the digestive system.
• Gentle exercise: Encourage daily walks or yoga to improve circulation and digestion.  Exercise helps alleviate stress and promote gut motility.
• Sleep hygiene: Ensure that Sarah gets 8-9 hours of restorative sleep per night to reduce stress and improve overall health.

Follow up:

After 3 weeks, the client reports a significant reduction in nausea. She has found that regular meals, a reduction in caffeine, and the introduction of the herbal formula has helped to calm her stomach.  Bloating and constipation have also improved with dietary adjustments and the use of digestive enzymes.  Stress management techniques, including yoga, have contributed to her overall well-being.