Hi Friends,
Dr. Tabibian here.
One of the most common symptoms or complaints I hear in clinic is nausea.
Some patients tell me they feel nauseated or queasy every single morning, others say it hits after meals, and still others can’t figure out a pattern at all.
What I want you to know is this: nausea isn’t “just in your head,” and it’s rarely something you just have to live with.
Today I’ll walk you through the most common causes and what you can do about them.
WHY YOU SHOULD READ THIS NOW
Nausea isn’t just a pregnancy symptom, nor is it always coming from your GI system. It can affect anyone, and often for reasons that are overlooked or not obvious.
GLP-1 medications like Ozempic are now a top cause of persistent nausea, and we’re seeing it in clinic every week. Other medications can cause nausea as well.
Many people live with daily nausea for years without answers. The good news? There are explanations, and there are solutions.
Today’s Opponent:
Nausea
We’ve all felt it: that queasy, unsettled feeling in your abdomen. But for some, nausea isn’t a passing annoyance. It can be daily, even debilitating. I’ve had patients describe feeling nauseated every single morning, sometimes for years, without ever figuring out why.
The truth is: nausea isn’t a diagnosis. It’s a symptom, with dozens of possible causes. And unless you dig into the “why,” you’ll only ever treat the surface, and often without much success.
6 of the Most Common Causes of Chronic Nausea
1. Stomach Emptying Problems
I.e. delayed gastric emptying or gastroparesis. GLP-1 agonists like Ozempic, Wegovy, and Mounjaro slow digestion to help achieve satiety. But that delayed emptying can leave food stagnating in your stomach, triggering nausea and even vomiting.
A 2024 JAMA study found that GLP-1 users had a threefold higher risk of gastroparesis compared to non-users, making GLP-1s a leading nausea culprit.
2. Reflux and Acid Irritation
Gastric acid washing up into the esophagus overnight can make mornings miserable. Silent reflux (acid without the classic heartburn) can cause daily queasiness. A 2017 clinical study in Alimentary Pharmacology & Therapeutics showed that gastroesophageal reflux disease (GERD) is one of the most common underdiagnosed triggers of chronic nausea.
3. Hormonal Shifts
Thyroid imbalances, adrenal dysfunction, or perimenopause can all bring waves of nausea that mimic GI problems.
4. Medication Side Effects
Beyond Ozempic, culprits include antibiotics, pain medications (NSAIDs, opioids), anti-depressants, and even certain vitamins when taken on an empty stomach.
5. Gut-Brain Connection
Anxiety, poor sleep, or chronic stress can directly trigger nausea. Your gut and brain are in constant conversation via the vagus nerve.
6. Chronic Cannabis Use
With regular, long-term cannabis use, the cannabinoids can paradoxically disrupt the body’s natural control of nausea/vomiting. A classic sign is that symptoms temporarily improve with hot showers because heat activates skin receptors that override the nausea pathways.
“Nausea is one of the most common symptoms I hear about in clinic, and it’s often under-investigated. If you’ve been told it’s ‘just stress,’ don’t stop there.
We can usually find a tangible medical reason, and a treatment that is actually effective.”
Medication Options
Sometimes lifestyle modifications aren’t enough. Here are common medications doctors (like me) use for nausea relief:
Over-the-counter (OTC):
Dramamine (dimenhydrinate) or meclizine — often used for motion sickness, sometimes helpful for general nausea.
Bismuth subsalicylate (Pepto-Bismol) — can coat and calm the stomach, especially when nausea is linked to indigestion.
Prescription:
Ondansetron (Zofran): a go-to anti-nausea medication, often very effective and well tolerated.
Metoclopramide (Reglan): helps move food out of the stomach faster, particularly useful in gastroparesis. However, this medication has unwanted side effects when used long-term.
Promethazine (Phenergan) or prochlorperazine (Compazine): older but effective anti-nausea agents, though they can cause drowsiness.
⚠️ These aren’t one-size-fits-all. Some work better depending on the cause (for example, Reglan for delayed emptying, Zofran for medication-induced nausea).
Always ask your doctor which is safest for your specific situation.
What Our Patients Say Helps
People struggling with chronic nausea often share strategies that provide real relief. While not cures, they can make symptoms more manageable:
Small, frequent meals instead of large ones
Low-fat, low-fiber foods (easier to digest, move faster through the stomach)
Ginger (tea, chews, or capsules) to settle the stomach
Peppermint tea or capsules (though some find this worsens reflux)
Electrolyte-rich fluids to combat dehydration
Acupressure wristbands (like Sea-Bands)
Upright positioning after meals and avoiding lying flat at night
Short walks to gently encourage digestion
Gut hypnotherapy
Certain neuromodulators when nausea is related to a gut-brain disorder or chronic cannabis use.
One patient of mine shared that she had been nauseous every morning for years. Pregnancy and other blood tests, diet changes, and even ENT visits brought no clarity.
It turned out to be gastroesophageal reflux that no one had thought to look for. Once diagnosed (in this case by endoscopy, which should inflammation in her esophagus) and treated, her nausea resolved.
“When a patient tells me they wake up nauseous every day, I immediately think about reflux or delayed stomach emptying. These are things we can test for. You don’t have to live with morning nausea as your ‘normal.’”
What To Tell Your Doctor
“I’ve been experiencing intermittent nausea, especially in the mornings, and sometimes with reflux symptoms. Could this be GERD or delayed stomach emptying? Should we check with imaging, perform an upper endoscopy, or adjust my medications (like Ozempic)?”
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