The Pain-Nausea Connection: Why Does It Happen?
I have experienced extreme nausea and been triggered to vomit when my pain spikes sharply or has been high for a long duration of time. I've learned through experience that the link between chronic pain and gastrointestinal distress is complex, involving several interconnected pathways:
The Nervous System's Overload:
Chronic pain triggers a cascade of signals within the nervous system. This constant barrage can overwhelm the body's regulatory systems, including those that control digestion. Sometimes it means I still feel full after many hours have passed, or I spontaneously vomit and hope I made it to the toilet in time without painting my walls and floors with projectile vomit. I know, not a pretty site!
The vagus nerve, which plays a crucial role in digestion, is particularly sensitive to these signals. When overstimulated by pain, it can trigger nausea and vomiting. There's this certain pain I get that overwhelms my ankle as it shoots up my leg overwhelming my entire mental and physical being. These occur every time I am weight bearing, so with every step I take I have blinding pain shooting up my legs, which when this happens in an even worse way, it triggers me to projectile vomit. Other sharp pains in my legs have brought on vomiting too. You can be anywhere, doing anything...it was so bad at one point, I had to drive with a big mixing bowl in the passenger seat in case it happened while i was driving. I didn't want to puke all over myself on my way to an appointment or to pick up the kids. Sounds extreme, right? It would come on so suddenly though, whatever I was doing, and I had no control over it. It would just happen. I had many embarrassing moments when this was happening more frequently. It happened a few times when we were out for dinner, and I had to run to the toilet to vomit. Unfortunately I wouldn't always make it and one time vomited all over a table that had just been cleaned, and made a huge mess. I ran out of there in tears, puke all down the front of me, and beyond embarrassed. I was mortified, and even more so for embarrassing Paul and the kids.
The Brain's Role:
The brain's pain centers are closely linked to the areas responsible for nausea and vomiting.
The brainstem, specifically the area postrema, is a key player in the vomiting reflex. This region is highly sensitive to chemical changes and nerve signals, including those originating from pain pathways.
When you are in a lot of pain, your body releases stress hormones like cortisol and adrenaline. These hormones can also affect the digestive system, slowing down digestion and increasing nausea. Sometimes my pain is bad enough that I don't feel hungry, and have this "full" feeling in my stomach. Other times it shocks my body into vomiting.
Many medications used to manage chronic pain, such as opioids and NSAIDs, can have gastrointestinal side effects. Let's just say this is not fun, but given my pain and mental health, I'd rather have gastrointestinal side effects, than be in more pain.
Opioids, in particular, can slow down digestion, leading to constipation and nausea. NSAIDs can irritate the stomach lining, potentially causing nausea, vomiting, and even ulcers.
Inflammatory Responses:
Chronic pain conditions are often associated with inflammation.
Inflammatory mediators can affect the digestive system, contributing to nausea and vomiting.
Sharp Influx of Pain:
A sudden and severe increase in pain can trigger a powerful stress response in the body. This response activates the sympathetic nervous system, leading to the release of adrenaline and other stress hormones.
These hormones can 1 disrupt normal digestive function, causing the stomach to empty slowly or even contract forcefully, leading to nausea and vomiting. This is a protective reflex, as the body prioritizes dealing with the perceived threat (the sudden pain) over digestion.
While eliminating chronic pain altogether may not always be possible, several strategies can help manage the associated nausea and vomiting:
Medication Management:
Work closely with your doctor to optimize your pain medication regimen.
Discuss potential side effects and explore alternative medications or dosages.
Anti-nausea medications (antiemetics) can be prescribed to alleviate symptoms.
Dietary Adjustments:
Eat small, frequent meals to avoid overloading the stomach.
Choose bland, easy-to-digest foods, such as crackers, toast, and plain rice. I also suffer from gastro reflux so cannot eat anything spicy or with too much flavour as it causes bad heartburn. I love mashed potatoes. If garlic is roasted first, it doesn't give me heartburn.
Avoid fatty, greasy, or spicy foods, which can exacerbate nausea.
Stay hydrated by sipping clear liquids, such as water, ginger ale, or herbal tea. Ginger can have a soothing effect on the stomach.
Mind-Body Techniques:
Stress reduction techniques, such as deep breathing exercises, meditation, and yoga, can help regulate the nervous system and reduce nausea.
Acupuncture and acupressure may also provide relief.
Cognitive behavioral therapy (CBT) can help you manage the emotional and psychological aspects of chronic pain, which can indirectly reduce nausea.
Managing sharp influxes of pain:
If you know what triggers your sharp increases of pain, try to avoid those triggers.
If a flare up happens, try to lay down in a calm and quiet environment.
Use any prescribed fast acting pain medication immediately.
Use cold or hot packs on the area that is in pain.
Alternative Therapies:
Some people find relief through therapies like massage or physical therapy, which can help reduce muscle tension and pain.
Hydration:
Vomiting and nausea can lead to dehydration. Make sure to drink plenty of clear fluids.
If nausea and vomiting are severe or persistent, it's essential to consult with your doctor. They can help identify any underlying medical conditions and recommend appropriate treatment strategies. A pain management specialist can also be a valuable resource for developing a comprehensive pain management plan.
Living with chronic pain is challenging enough. Don't let nausea and vomiting add to your burden. By understanding the connection and implementing effective management strategies, you can improve your quality of life and find some much-needed relief.