asthma with nausea

Overview

Asthma with nausea means having both asthma (a lung condition that makes breathing difficult) and feeling sick to your stomach or wanting to vomit. Nausea is not a typical asthma symptom, but it can happen during a severe asthma attack, as a side effect of some asthma medicines, or as a sign of another condition like acid reflux that often occurs with asthma.

Nausea is not a common or classic asthma symptom, but it does occur in some people, especially when asthma is not well controlled, during a severe attack, or as a side effect of medicines like oral steroids.

It can affect anyone with asthma, but it may be more noticeable in children (who often complain of stomach upset during attacks) and in older adults who take multiple medicines that can cause nausea.

Symptoms

Common symptoms

• Wheezing or whistling sound when breathing
• Shortness of breath, especially at night or early morning
• Chest tightness or pain
• Coughing, often worse at night or with exercise
• Nausea or feeling sick to your stomach
• Vomiting (in severe cases)

Symptoms in children

• Frequent coughing, especially during play or at night
• Complaints of a 'tummy ache' or not wanting to eat
• Nausea or vomiting during or after a coughing spell
• Seeming tired or irritable due to oxygen not reaching the body well

Symptoms in older adults

• Shortness of breath with little activity
• Nausea that may be confused with other health problems
• Dizziness or weakness as asthma worsens
• More severe coughing episodes with nausea

Causes

Main causes

• A severe asthma attack that puts extra stress on your body, triggering nausea
• Side effects of asthma medicines, especially oral corticosteroids or high doses of some inhalers
• Acid reflux (heartburn) which is common in people with asthma and can cause nausea and worsen breathing
• Anxiety or panic during an asthma attack, which can make you feel sick
• Infections like a cold or flu that both trigger asthma and cause nausea

Risk factors

• Uncontrolled asthma (frequent symptoms or flare-ups)
• Using rescue inhaler more than a few times a week
• Having a history of acid reflux or heartburn
• Taking oral steroids for asthma
• Having a respiratory infection like a cold or COVID-19
• Being under a lot of stress or feeling anxious

When to see a doctor

See a doctor urgently if:

• Nausea together with serious trouble breathing, even after using your reliever inhaler
• You cannot speak full sentences without stopping to breathe
• You feel your asthma medicines are not working
• You are vomiting and cannot keep fluids down
• Your lips or fingernails look blue or grey

Book a routine appointment if:

• You get nausea often with your asthma symptoms, even if mild
• You are concerned about side effects from your asthma medicines
• You have asthma and also have regular heartburn or nausea between meals

Diagnosis

A doctor will ask about your symptoms, how often they happen, and what triggers them. They will listen to your lungs and may do some simple breathing tests to see how well your lungs are working. They will also consider if nausea is from asthma, medicines, or an unrelated cause like acid reflux.

Tests that may be done

• Spirometry — a breathing test where you blow into a tube to measure how much air you can exhale and how fast
• Peak flow measurement — a handheld device to check how well air moves out of your lungs
• Allergy tests (if allergies trigger your asthma)
• Gastroesophageal reflux check if acid reflux is suspected

What to expect at your appointment

The diagnosis process is straightforward and usually done in your doctor's office. You will be asked to do some breathing tests and answer questions. If you have nausea with asthma, your doctor may also ask about your medicines and diet to rule out other causes. It may take one or two visits to get a clear picture.

Treatment

Treating asthma with nausea focuses on getting your asthma under good control and reducing any side effects from medicines. Your doctor will work with you to find the right treatment plan that manages both your breathing and the nausea.

Self-care at home

• Use your prescribed inhaler exactly as directed — do not skip doses
• Identify and avoid your asthma triggers (like pollen, smoke, or strong smells)
• If nausea is related to acid reflux, try eating smaller meals and not lying down right after eating
• Drink small sips of water if you feel nauseous, and rest in a calm environment
• Keep a symptom diary to share with your doctor

Medical treatments

Doctors may adjust your asthma medicines — for example, changing the type of inhaler, the dose, or the schedule — to reduce nausea. They may also prescribe medicines to control acid reflux if that is the cause. Treatment is always tailored to you and may include controller inhalers (used daily to prevent symptoms) and reliever inhalers (used when symptoms happen). Always follow your asthma action plan and never stop or change medicines without talking to your doctor.

When is surgery considered?

Surgery is not used to treat asthma or nausea related to asthma. In rare cases, if a person has severe acid reflux that does not improve with medicine and worsens asthma, a doctor might discuss a procedure for reflux. That discussion would be highly individual.

Living with this condition

Living with asthma and nausea means staying on top of your asthma management. Keep your reliever inhaler with you at all times. Learn to recognise early warning signs like feeling sick before breathing trouble starts. Work with your doctor to have a clear asthma action plan that includes what to do when nausea happens.

Lifestyle tips

• Avoid smoking and second-hand smoke
• Reduce exposure to dust mites, mould, and pet dander by keeping your home clean
• Manage stress with relaxation techniques like deep breathing or meditation
• Avoid strong perfumes, cleaning sprays, and air fresheners that can trigger both asthma and nausea
• Stay up to date with your vaccinations (flu and pneumonia) to prevent infections that can worsen asthma

Diet and exercise

Eat small, frequent meals to help prevent both asthma-related reflux and nausea. Avoid foods that trigger heartburn, like spicy or fatty foods, caffeine, and carbonated drinks. Regular exercise, like walking or swimming, is good for your lungs — but warm up slowly and stop if you feel breathless or sick. Always have your inhaler with you when you exercise.

Mental health and emotional wellbeing

Having asthma and recurring nausea can cause anxiety, especially if you worry about when the next attack might happen. Anxiety can also make both asthma and nausea worse. It is important to talk to your doctor or a counsellor if you feel stressed or scared about your condition. You are not alone.

Prevention

It is not always possible to prevent asthma with nausea, but keeping your asthma well-controlled is the best way to reduce the chances. This means taking your controller medicine regularly, avoiding triggers, and having a written asthma action plan. If you know certain medicines give you nausea, talk to your doctor about alternatives.

Vaccines

Getting the annual flu vaccine and the pneumonia vaccine (if recommended by your doctor) can help prevent respiratory infections that often trigger asthma attacks and associated nausea.

Screening programmes

There is no routine screening for asthma with nausea. However, if you have asthma and also have regular heartburn or nausea, your doctor may screen for acid reflux with a simple questionnaire or, if needed, a test like a pH probe.

Complications

If left untreated

• Severe asthma attack that requires emergency hospital care
• Dehydration from vomiting and not drinking enough fluids
• Electrolyte imbalances from persistent vomiting
• Reduced oxygen to vital organs, which can be life-threatening
• Chronic poor asthma control leading to long-term lung damage

Long-term outlook

With proper treatment and good self-care, most people with asthma can control their symptoms and lead active, full lives. Nausea related to asthma usually improves once the asthma is treated and triggers are managed. Work closely with your healthcare team to find what works best for you. There is every reason to be hopeful.

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