Nausea and Vomiting

Nausea is the queasy, unsettled feeling that you might vomit. Vomiting (emesis) is the forceful expulsion of stomach contents through a coordinated reflex involving the vomiting centre in the brainstem. Most nausea and vomiting is short-lived and self-limiting — viral gastroenteritis, motion sickness, pregnancy, a hangover, an overfull stomach, anxiety, medication. In traditional Chinese medicine, all of these are forms of rebellious Stomach qi: energy that should descend instead rises up. Pressing PC 6 (Neiguan) on the inner wrist is the single most effective acupressure point for nausea, with substantial trial evidence in post-operative, chemotherapy, pregnancy and motion-sickness nausea. Persistent or severe vomiting needs medical assessment.

Nausea and vomiting are among the most universal symptoms in medicine — almost everyone experiences them at some point, and over a hundred conditions can cause them. This page covers the medical anatomy (what is actually happening when you feel sick or throw up), the wide range of causes, when nausea and vomiting need urgent medical care, the traditional Chinese medicine view (rebellious Stomach qi and its underlying patterns), and the acupressure points, food therapy, Chinese herbal formulas and acupuncture treatments that genuinely help.

On this page

What are nausea and vomiting?
Types of vomiting
Causes of nausea and vomiting
What the timing tells you
When to seek urgent medical help
The TCM view: rebellious Stomach qi
TCM patterns and their presentations
Pressure points for nausea (PC 6 and more)
Food therapy and what to eat after vomiting
Chinese herbs and ginger
Acupuncture for chronic nausea
Specific situations — pregnancy, chemo, post-op, migraine
Frequently asked questions

1. What are nausea and vomiting?

Nausea is the unpleasant sensation that you may be about to vomit — usually with sweating, increased saliva, pallor, yawning and an unsettled feeling in the upper stomach. It is generated by signals reaching the brainstem from the gut, the inner ear (vestibular system), the chemoreceptor trigger zone (which detects toxins in the blood) and the higher cortex (anxiety, anticipation, smell, sight).

Vomiting (emesis) is the forceful expulsion of stomach contents through the mouth. It is a complex reflex coordinated by the vomiting centre in the medulla. The sequence is: deep breath, closure of the airway, relaxation of the lower oesophageal sphincter, strong contraction of the abdominal muscles, and reverse peristalsis. It is the body's evolutionary response to suspected ingested toxins.

Retching is the involuntary attempt to vomit without bringing anything up — "dry heaves". Regurgitation is the effortless return of food into the mouth without the muscular effort of vomiting.

The brain pathway behind vomiting also explains the associated symptoms many people notice: cold sweats, racing heart, then a feeling of relief after vomiting (parasympathetic rebound), occasional shaking (release of catecholamines), tearfulness or anxiety (limbic system involvement), and the brief sense of feeling better.

2. Types of vomiting

Acute vomiting — sudden onset, usually viral gastroenteritis, food poisoning, hangover, migraine, motion sickness.
Chronic vomiting — ongoing for more than a week, needs medical assessment.
Cyclical vomiting — recurrent episodes of severe vomiting separated by symptom-free intervals.
Projectile vomiting — forceful, traveling some distance, classically associated with raised intracranial pressure or pyloric stenosis in infants.
Bilious vomiting — yellow-green from bile, suggests vomiting after the stomach has emptied or intestinal obstruction.
Coffee-ground vomiting — dark, granular, suggests partially digested blood; needs urgent assessment.
Haematemesis — bright red blood in vomit; medical emergency.
Faeculent vomiting — brown, foul-smelling; bowel obstruction; emergency.
Psychogenic vomiting — triggered by anxiety, stress, emotional distress.

3. Causes of nausea and vomiting

More than a hundred conditions can cause nausea and vomiting. The most common include:

Gastrointestinal — viral gastroenteritis (the "stomach bug"), food poisoning, gastritis, peptic ulcer, gallstones, pancreatitis, appendicitis, hepatitis, gastroparesis, bowel obstruction, irritable bowel syndrome.
Pregnancy — morning sickness in the first trimester (50–80% of pregnancies), hyperemesis gravidarum (severe form).
Inner ear and vestibular — motion sickness, vestibular migraine, benign positional vertigo, Ménière's disease, labyrinthitis.
Migraine — nausea and vomiting accompany 60–80% of migraine attacks.
Toxins and substances — alcohol (and hangover), food poisoning, drug overdose, chemical exposure.
Medication — chemotherapy, opioids, antibiotics, iron supplements, NSAIDs, anaesthetics, GLP-1 agonists (Ozempic, Mounjaro), metformin.
Post-operative — nausea and vomiting affect 25–30% of patients after general anaesthesia.
Metabolic — uncontrolled diabetes (ketoacidosis), Addisonian crisis, thyroid storm, electrolyte imbalance.
Renal and hepatic — kidney failure, liver failure, uraemia.
Neurological — raised intracranial pressure, brain tumour, head injury, meningitis, stroke (especially of the brainstem or cerebellum).
Psychogenic — anxiety, panic, stress, eating disorders, post-traumatic stress.
Cardiac — inferior myocardial infarction (heart attack) may present with nausea and vomiting rather than chest pain.
Endocrine — Addison's disease, hypercalcaemia, hyperthyroidism.
Cancer — advanced malignancy, particularly with chemotherapy, radiotherapy or bowel involvement.
Cyclic vomiting syndrome — recurrent episodes of severe vomiting; sometimes linked to migraine biology.
Functional / dyspepsia — persistent low-grade nausea with normal investigations.

4. What the timing tells you

Morning vomiting — pregnancy, raised intracranial pressure, alcohol withdrawal, post-nasal drip, gastritis, kidney failure (uraemia). "Throwing up every morning" warrants medical assessment to identify the cause.
Vomiting on an empty stomach — gastric or duodenal ulcer, gastritis, bile reflux, pregnancy, mood/anxiety-driven.
Vomiting soon after eating — gastric outlet obstruction, peptic ulcer, gastritis, food poisoning, food intolerance.
Vomiting hours after eating — gastroparesis, bowel obstruction, gastric outlet obstruction.
Vomiting that wakes you from sleep — raised intracranial pressure, bowel obstruction, gastroparesis — needs medical assessment.
Cyclic vomiting — periods of severe vomiting alternating with normal intervals.
Anticipatory or anxious vomiting — before exams, travel, public speaking, dental visits, chemotherapy.

5. When to seek urgent medical help

Vomiting is usually self-limiting but can occasionally signal serious illness. Seek prompt medical assessment if any of the following apply:

Vomiting blood (bright red, coffee-ground, or with streaks) — medical emergency.
Severe, sudden abdominal pain with vomiting — possible appendicitis, pancreatitis, obstruction, perforation.
Vomiting with severe headache, stiff neck, photophobia, confusion, or fever — suspect meningitis or raised intracranial pressure.
Vomiting after head injury — possible concussion or bleed.
Projectile vomiting in a baby — possible pyloric stenosis.
Signs of dehydration — very little urine, very dark urine, dizziness on standing, dry mouth, sunken eyes, lethargy, confusion.
Unable to keep down any fluids for more than 24 hours.
Vomiting in a person with diabetes — risk of ketoacidosis.
Vomiting with chest pain, shortness of breath or sweating — consider heart attack.
Vomiting in pregnancy with ketones, weight loss or inability to keep fluids down — possible hyperemesis gravidarum.
Vomiting that has lasted more than a week or is recurrent.
Significant unexplained weight loss with vomiting.

Call 999 or attend A&E for any vomiting with chest pain, neurological symptoms, severe headache, blood, severe abdominal pain or signs of serious dehydration.

6. The TCM view: rebellious Stomach qi

In traditional Chinese medicine, the Stomach's job is to receive food and drink and to send it downward to the Small Intestine. Stomach qi should descend. When something disrupts this descent — food retention, dampness, phlegm, heat, cold, emotional stress, or weakness of the Spleen — the qi rises instead. This rising movement produces hiccups, belching, acid reflux, nausea, retching and vomiting. The classical name is Stomach qi ni — "rebellious" or counterflow Stomach qi.

The treatment principle is straightforward: harmonise the Stomach, descend the rebellious qi, and resolve whatever is causing the obstruction. The underlying pattern matters — the same nausea can arise from heat or cold, excess or deficiency — and the herbs, acupuncture points and dietary advice differ for each.

7. TCM patterns and presentations

Food retention — nausea and vomiting of undigested food with foul belching, abdominal distension, no appetite, foul stool. Common after overeating, rich food, or a bug. Tongue: thick coat.
Damp-phlegm in the middle — persistent low-grade nausea, vomiting of clear thin fluid or phlegm, heavy head, fogginess, sticky mouth, no thirst, loose stool. Tongue: thick white coat.
Damp-heat in the middle — nausea with bitter taste, vomiting of yellow bitter fluid, thirst with no desire to drink, foul-smelling stool, urinary symptoms. Tongue: thick yellow coat.
Liver qi invading the Stomach — stress-related nausea with belching, sighing, chest and hypochondrium distension, irritability. Often worsens with PMS or anxiety. Tongue: normal coat with red sides; wiry pulse.
Stomach heat — vomiting soon after eating, especially of hot or sour fluid, intense thirst, hunger, bad breath, mouth ulcers. Tongue: red with yellow coat.
Cold in the Stomach — vomiting of clear watery fluid (or just clear saliva), worse with cold foods or drinks, relieved by warmth, cold extremities, pale face. Tongue: pale with white coat.
Stomach yin deficiency — dry retching with little vomit, dry mouth, slight thirst with sips of water, hunger but no appetite, mouth ulcers. Common in older adults, after illness, in anorexia. Tongue: red with little coat.
Spleen qi deficiency — persistent low-grade nausea worse with tiredness, bloating after eating, soft stools, fatigue. Often the underlying constitutional pattern. Tongue: pale with teethmarks.
Phlegm-damp from Spleen deficiency with Heart-Shen disturbance — nausea with anxiety, palpitations, foggy head. The "anxious nausea" picture.

8. Pressure points for nausea

PC 6 (Neiguan) — the primary nausea point

Neiguan is on the inner forearm, three finger-widths above the wrist crease, between the two tendons. It is the most studied acupressure point in medicine, with high-quality evidence in:

Post-operative nausea and vomiting (PONV) — multiple Cochrane reviews confirm benefit.
Chemotherapy-induced nausea — reduces severity and frequency.
Morning sickness — safer first-line option in pregnancy.
Motion sickness — the basis of sea-band wristbands.

How to use it: press firmly with the thumb of the opposite hand for 1–2 minutes; repeat every 15–30 minutes as needed. Press both wrists. Pressure should be firm enough to feel a slight ache but not painful. Sea-bands hold continuous pressure on this point.

ST 36 (Zusanli) — strengthens the Stomach

Zusanli sits four finger-widths below the lower edge of the kneecap, one finger-width lateral to the shin bone. It is the master point for the Stomach and digestive tract. It harmonises Stomach qi, strengthens the Spleen, and grounds rebellious qi. Press for 1–2 minutes on both legs.

CV 12 (Zhongwan) — the centre of the stomach

CV 12 sits four finger-widths above the navel, on the midline. It is the "alarm" point of the Stomach. Light pressure or a warm hand placed gently over CV 12 settles nausea, particularly cold-pattern nausea (vomiting of clear fluid, relieved by warmth). Gentle warmth or moxa here is helpful.

CV 22 (Tiantu) — for hiccups and rising sensations

CV 22 is in the hollow at the base of the throat, just above the breastbone. Gentle inward and downward pressure for 30 seconds can settle severe hiccups or a rising-up sensation. Be very gentle — this is over the trachea.

LI 4 (Hegu) — general digestive and nausea relief

Hegu is in the web between thumb and index finger. Useful as a general anti-nausea point, particularly with headache. Avoid in pregnancy.

LV 3 (Taichong) — for stress-related nausea

Taichong is on the top of the foot, between the first and second toe bones. Calms Liver qi and helps stress-driven nausea (the "anxious nausea" pattern).

Yintang — for anxious nausea

Between the eyebrows. Calms the spirit. Helpful for anticipatory, anxious or psychogenic nausea.

9. Food therapy and what to eat after vomiting

The order of reintroduction matters more than the specific foods. After acute vomiting:

First 30 minutes — nothing by mouth; let the stomach settle.
Hours 1–2 — sips of plain water, oral rehydration salts, weak ginger tea or flat sparkling water. Small frequent sips, not big drinks.
Hours 2–6 — if tolerated, dry plain crackers, plain toast, plain rice, banana, applesauce.
From 12 hours — light bland warm food: rice congee, miso soup, plain noodles, scrambled egg, plain chicken broth.
Avoid for 24–48 hours: dairy, fatty food, fried food, raw food, alcohol, coffee, strong spices, rich sauces, citrus.

Chinese food therapy emphasises warm, gentle, easy-to-digest food. Rice congee with a few slices of fresh ginger is the classical recovery food — bland, warming, hydrating, easy on the Stomach. Adding pinches of dried tangerine peel (chen pi) or a small piece of fresh ginger enhances the descending and digestive effect.

Foods that gently descend Stomach qi: ginger, dried tangerine peel (chen pi), fennel, cardamom, mint, congee, white rice, plain noodles, miso, bone broth, banana, apple, papaya.

Foods that aggravate nausea: cold raw foods, ice drinks, dairy (especially cold), fried and oily food, alcohol, coffee on empty stomach, strong-smelling food, excess sugar.

10. Chinese herbs and ginger

Ginger is the most evidence-supported natural anti-nauseant. Randomised trials show fresh ginger reduces nausea in pregnancy, motion sickness, post-operative recovery and mild chemotherapy nausea by 30–50% versus placebo, comparable to dimenhydrinate but without sedation.

Fresh ginger tea — 2–3 thin slices in hot water for 10 minutes.
Crystallised ginger — chew a small piece, repeat hourly.
Ginger capsules — 500–1000 mg of dried ginger, 30 minutes before travel or nausea trigger.
Avoid high-dose ginger with anticoagulants or with severe gallstone disease.

Classical Chinese formulas for nausea and vomiting, prescribed according to pattern:

Xiao Ban Xia Tang — the simplest, most direct formula for vomiting of clear fluid (just ginger and pinellia).
Er Chen Tang — phlegm-damp with persistent low-grade nausea.
Huo Xiang Zheng Qi San — travel-related nausea, vomiting and diarrhoea; gastroenteritis; food poisoning.
Ju Pi Zhu Ru Tang — nausea and hiccups with Stomach heat or yin deficiency.
Ban Xia Hou Po Tang — anxious nausea with a "lump in the throat" sensation.
Wu Zhu Yu Tang — vomiting of clear fluid with headache, especially top-of-head ache.
Xiao Chai Hu Tang — nausea with bitter taste, alternating fever and chills, post-viral nausea.
Li Zhong Wan — cold-pattern vomiting with watery clear fluid, cold extremities.
Bao He Wan — food retention with foul belching, abdominal distension, vomiting of food.
Zhu Ye Shi Gao Tang — residual heat after febrile illness with thirst, dry retching and weakness.

Key single herbs: Sheng Jiang (fresh ginger), Ban Xia, Chen Pi, Zhu Ru, Huo Xiang.

11. Acupuncture for chronic nausea

For chronic functional nausea, persistent post-viral nausea, recurrent migraine nausea, gastroparesis, post-chemotherapy nausea or pregnancy-related nausea, a course of acupuncture treating the underlying pattern reduces severity and frequency. Treatment goals:

Harmonise Stomach qi and descend rebellious qi (PC 6, ST 36, CV 12).
Strengthen Spleen and Stomach (ST 36, SP 6, BL 20, BL 21).
Resolve damp and phlegm (ST 40, SP 9).
Move Liver qi if stress-driven (LV 3, GB 34).
Calm the spirit (Yintang, HT 7, PC 6).

A typical initial course is 6–8 weekly sessions, with maintenance as needed.

12. Specific situations

Morning sickness in pregnancy

PC 6 acupressure (and sea-bands) plus ginger (up to 1 g/day) are the safest and most evidence-supported first-line interventions. Acupuncture has substantial trial evidence for nausea in pregnancy. Avoid LI 4 during pregnancy. Avoid Chinese herbs containing Ban Xia, Da Huang and Wu Zhu Yu during pregnancy — safer alternatives are Sheng Jiang, Huo Xiang and Chen Pi. See also acupuncture for morning sickness.

Chemotherapy-induced nausea

PC 6 acupressure (or wristbands), ginger and acupuncture have all been shown to reduce chemotherapy-related nausea and vomiting alongside standard anti-emetic medication. Acupuncture has been integrated into many UK oncology centres as a supportive option. Always inform your oncology team.

Post-operative nausea

PC 6 stimulation (acupressure, sea-bands or acupuncture at the start of anaesthesia) reduces post-operative nausea and vomiting (PONV). Multiple Cochrane reviews confirm the effect.

Migraine-related nausea

Nausea accompanies 60–80% of migraine attacks. PC 6, LV 3 and GB 20 acupressure help during an attack. Preventive acupuncture reduces the frequency of attacks and therefore of migraine nausea.

Motion and travel sickness

See the dedicated motion sickness page for the full protocol.

Hangover

See hangover for the full kudzu/ginger/congee plan.

Anxious or anticipatory nausea

Yintang, PC 6 and LV 3 acupressure plus slow nasal breathing (4-second inhale, 6-second exhale) settle anticipatory nausea before exams, dental appointments, public speaking, travel and chemotherapy.

13. Frequently asked questions

Why do I feel better after throwing up?

Because the brain and gut go through a sharp swing of autonomic activity during vomiting — sympathetic surge before, parasympathetic rebound after. The rebound brings relief, calm, sometimes sleepiness. The stomach also no longer contains the irritant. The relief is real but temporary; if the underlying cause is still active, nausea returns.

Why am I throwing up every morning?

The common causes are pregnancy, raised intracranial pressure, alcohol the night before, post-nasal drip, gastritis, anxiety, kidney failure (uraemia) and acid reflux. Persistent morning vomiting needs medical assessment to identify the cause.

Why am I vomiting on an empty stomach?

Most often gastritis, peptic ulcer, bile reflux, pregnancy, anxiety, or alcohol-related. If clear watery vomit — consider TCM cold-Stomach pattern. If bitter yellow vomit — bile reflux or damp-heat. Worth investigating if persistent.

What does vomit feel like just before it happens?

A waterbrash of saliva, sweating, paleness, racing heart, yawning, deep breaths, a "rising" feeling in the chest and throat, sometimes a salty taste in the mouth.

Is it better to vomit or hold it in?

If your body is trying to expel something (food poisoning, toxin, infection), letting it happen is usually right. If the nausea is from motion sickness, anxiety or migraine, settling it with PC 6 acupressure and ginger is the better path because vomiting itself causes dehydration, oesophageal irritation and exhaustion. Never deliberately induce vomiting unless a Poisons Information service has advised it for a specific ingestion.

Why does pressing the wrist help nausea?

Stimulating PC 6 (Neiguan) modulates the vagus nerve, vestibular pathways and the chemoreceptor trigger zone via central pathways. The mechanism is not fully understood, but the trial evidence across post-operative, chemotherapy, pregnancy and motion-sickness nausea is solid.

How long does the nausea after acupuncture last?

Mild nausea after a treatment is uncommon; if it does occur it usually settles within an hour. Drinking water, eating something light and resting help.

Can stress cause vomiting?

Yes. Anxiety, panic, anticipatory stress and trauma can trigger nausea and vomiting via the brain–gut axis. TCM frames this as Liver qi invading the Stomach — tension and emotional pressure pushing Stomach qi upward instead of downward.

What is the difference between nausea, retching and vomiting?

Nausea is the unpleasant sensation that you might vomit. Retching is the involuntary attempt without bringing anything up. Vomiting is the forceful expulsion of stomach contents.

What is the medical term for throwing up?

Emesis. Vomiting is the everyday term; emesis is the medical term; the act itself is also called regurgitation when it is effortless rather than forceful.

Why do I shake after throwing up?

The sympathetic nervous system surge during vomiting releases adrenaline and other catecholamines, which cause transient tremor, racing heart, sweating and shakiness. It usually settles within 10–20 minutes after the episode.

References

To discuss persistent nausea, vomiting or related digestive concerns, contact me or book a consultation at my Wokingham clinic.