Abdominal pain during early pregnancy

Dizziness with nausea – the reason for compulsory treatment to the doctor. This condition can be a symptom of numerous diseases, from simple and non-dangerous to fatal without treatment. Every person at least once in his life has encountered a similar sensation, but only persistent and painful dizziness becomes an occasion to visit a specialist. In this article we will answer the question of why dizzy and nauseous, periodically or constantly, of women and men, when it is physiologically inevitable, and when it is a symptom of disease.

What is dizziness?

When dizzy – this symptom is often understood as different states. All the symptoms combined by this term can be divided into 4 clinical groups (see how patients describe a condition called “dizzy”).

Systemic (vestibular) dizziness

Systemic dizziness – a sense of self-falling, rotational movements, swaying of objects of the environment. Usually this symptom is accompanied by other unpleasant sensations:

  • Nausea
  • Vomiting
  • Excessive sweating
  • Hearing loss
  • Oscillopsy (when surrounding objects seem to fluctuate)

In this case, the head is spinning due to the defeat of the vestibular system at any of its levels.

Faint state

This is a sense of imminent loss of consciousness, nausea. Usually combined with nausea, pallor, rapid pulse, darkening of the eyes, excessive sweating. This type of vertigo is associated with a drop in pressure or heart disease.


This dizziness, rarely combined with nausea. The precariousness of the gait and instability of posture, manifested in a standing position, deterioration in the dark are the main signs of such a state.

Psychogenic vertigo

This is a typical condition for depression, anxiety disorders and other mental disorders. Accompanied by this symptom nausea, heaviness in the head and various difficult to describe sensations (fog in the head, a feeling of viscosity, as if intoxicated and

How is the sense of balance formed?

The main organ system responsible for the position of a person in space and a sense of balance is the vestibular apparatus.

The peripheral part of the vestibular system is located in the temporal bone and is closely connected with the organ of hearing. The apparatus consists of a system of sacs and semicircular canals, which are filled with liquid endolymph, surrounded by perilymph and enclosed in a bone maze. Inside the pouches and channels are receptors that capture the slightest vibrations of the endolymph and the special membrane. Depending on the direction and strength of these oscillations, receptors transmit a pulse through the nerve fibers to the brain. Passing through the cerebellum and the medulla, the impulses cause unconscious control of body position. The thalamus and the cerebral cortex form a conscious reaction to the acceleration and position of a person in space. In addition, the above-mentioned parts of the brain form vestibulo-visceral reactions. This is a response of internal organs to overload or improper functioning of the body of balance. These reactions include nausea, vomiting, rapid pulse, arrhythmia.

If a defect occurs at some level of regulation (trauma, inflammation and

Why dizzy and sick of a healthy person?

Fasting, adherence to strict low-calorie diets

This condition is very often the case for women who are on a strict diet for weight loss, so popular today. Lack of calories, lowering blood sugar levels leads to the fact that a woman is dizzy when she gets up. Also, fasting or long breaks in eating can be accompanied by nausea. Dizziness from nutritional deficiencies can occur in men, women working in offices with irregular schedules, businessmen. If they are immersed in work and forget about the normal mode, when good nutrition is replaced by rare snacks.

Adrenaline rush

Today, every person is faced with an abundance of stress – stressful situations at work, performance in public, reports, job interviews, exams, air travel, etc. In the body, during stress, excitement, a large amount of adrenaline – stress hormone enters the blood, while vessels narrow blood pressure rises and the brain is worse supplied with oxygen, so dizzy. Reducing anxiety and stress normalizes a person’s condition.

Fast movement, rotation, sharp turns

When a person moves quickly in a circle, for example, when riding on a carousel, during sharp turns and bends – the brain section responsible for balance does not have time to adequately respond and restructure, a person waits for movement in one direction, and it happens in another. Adolescents are especially susceptible to sudden changes in body position.

Changing the focus of the eye

When a person is at a height and looks into the distance for a long time, the eye muscles relax, and when you look at objects that are close – your head is spinning, or rather, you get the feeling that these objects rotate.


If you feel dizzy, first of all you should exclude the side effects of medications taken, since many drugs have such side effects:

  • antibiotics, anti-tuberculosis drugs, antifungal agents
  • antitussives
  • diuretics
  • blood pressure lowering drugs
  • statins
  • sedatives, antidepressants
  • contraceptive pills, drugs to increase potency
  • worms tablets
  • some antihistamines 1-2 generations, etc.

Carefully read the instructions and inform your doctor about it, especially if nausea occurs in addition to dizziness.

Bad habits

“Why when I smoke dizzy?” Is a frequent question to the doctor. This is explained by the fact that nicotine narrows the blood vessels of the brain, especially at the time when the smoker quits smoking or there is a big break between smoking (see what modern cigarettes are made of). Also, dizzy and nauseous – with a hangover, when a person gets up from the vertical position.


Nausea, vomiting and dizziness in women in the mornings are classic signs of short term pregnancy. They are associated with the so-called toxicosis. This is a special condition in which the placenta formed and the growing embryo cause changes in the future mother’s body. Therefore, with such a malaise, you need to do a home pregnancy test, donate blood for hCG or undergo an ultrasound. I must say that mild toxicosis is a harmless condition. To relieve symptoms, it is recommended to take a small amount of food in the morning without getting out of bed. Citrus juices help during the day. Severe toxicosis with vomiting more often 10 times a day is treated only in the hospital.


The unpleasant condition that occurs when driving on water, land or air transport is the so-called seasickness. It manifests a sense of loss of balance, and poor health. Before an attack, irritability, a feeling of a full stomach, nausea, dizziness, dizziness, yawning, belching. Motion sickness can occur in all people, but often in women with migraine headaches.

There are many ways to prevent motion sickness:

  • located in the car closer to the center, on the ship – on the lower deck
  • look into the horizon
  • wear sunglasses or close your eyes
  • avoid strong odors and alcohol
  • restrict head movements
  • do not read or work with your phone and tablet
  • take pills for motion sickness

Pathological causes

A decrease in hemoglobin levels in the blood can lead to multiple symptoms. You get dizzy when you get up, nausea, pallor, cold hands and feet, calf muscle cramps, digestive disorders – this is not a complete list of the consequences of anemia. To exclude it, tests for hemoglobin, red blood cells and ferritin are necessary. If a clear deficiency or latent iron deficiency is found, then iron preparations are prescribed (Sorbifer, Ferrretab, see iron preparations for anemia) for at least three months.

Benign paroxysmal positional vertigo

The term DPPG is a fairly common reason why dizzy and nausea appears. It is associated with 20% of all complaints about this, and in older patients – and all 50%. The basis of the disease is the formation of calcium carbonate crystals in the inner ear. Contribute to this head injury, surgery and ear infections, as well as age-related changes in the body. Almost always DPPG combined with nausea. The main distinguishing feature of this condition are:

  • appearance or aggravation of symptoms when changing positions (laying or getting out of bed, for example)
  • deterioration in dropping and lowering of the head (when washing hair in a beauty salon, during yoga)
  • bouts of dizziness more often short-term, may be present for several weeks, then disappear. After a certain time, the symptoms recur.

For the diagnosis of DPPG test using Nilen-Baran. From a standing posture, you need to quickly lie down with your head thrown back at 45 ° and rotated 45 °. Then repeat the test with the head in the middle position and when turning in the opposite direction. A sign of DPPG is the appearance of dizziness and nystagmus during this test. Nystagmus is a quick movement of the eyeballs, in this state it is short-term and decreases with each repetition of the test.

Treatment of benign positional dizziness is necessary if the symptoms are painful and last more than 2 months. If the exacerbations are short-lived, then you can only limit your activities for this period. For example, sleep at night on high pillows, get up gradually, try not to tilt or throw your head back. If patience to wait out attacks is not enough, then you can consult a doctor (vertebrologist, otonevrologu) for special maneuvers.

Epley’s maneuver is one such treatment. It is based on the transfer of calcifications from the sensitive part of the inner ear to the insensitive. For this, the patient successively replaces several positions, being in each of them for 30-60 seconds. The doctor monitors the appearance of nystagmus, asks if his head is spinning and allows him to change his position. After several attempts, DPPG usually retreats, if not forever, then for a long time.

Osteochondrosis of the cervical spine

Today, almost all persons over 25 years of age suffer from this disease to varying degrees – this is a disease of civilization and a low-active lifestyle. Osteochondrosis of the cervical spine 3-4 degrees is accompanied by periodic dizziness.

High or low blood pressure

A sharp increase in blood pressure, in addition to dizziness, is accompanied by headache, weakness, tinnitus, redness of the face, etc. With a drop in blood pressure, a person may also feel that his head is spinning, his eyes are darkened, besides, nausea, headaches, cold sweat.

Head injury

Falls, accidents, sports injuries and violence often result in damage to the head and brain. The consequences of such injuries range from mild malaise to coma and death. The category of light injuries include concussion. Its symptoms are:

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  • short-term loss of consciousness (often, but not always)
  • headache
  • dizziness, shakiness when walking
  • nausea and vomiting
  • weakness, slight confusion (spell, pause before answering the question)

Very often, injured people, especially teenagers, do not pay attention to these symptoms. Indeed, the main treatment for concussion is rest and bed rest. But often under such harmless symptoms lurking brain tissue, intracranial hemorrhages and increasing edema are hidden. All this potentially leads to serious consequences: stunning, coma, and sometimes death. Therefore, after any head injury, accompanied by the slightest indisposition and severe dizziness, you should consult a doctor.

Meniere’s disease

A disease that inexplicably increases the pressure of the endolymph in the inner ear often causes dizziness with nausea. There are 4 main symptoms that distinguish this condition:

  • hearing loss
  • episodic dizziness
  • tinnitus
  • feeling of tearing in the ears

Vertigo in Meniere’s disease lasts from several minutes to several hours, often accompanied by agonizing frequency and vomiting. Sometimes there are sudden falls with a saved mind. More than half of patients with time, attacks are reduced, self-healing occurs. But sometimes persistent changes in the inner ear cause a decrease and even loss of hearing. Therefore, with a persistent course of the disease, operations are carried out to eliminate the excessive pressure of the endolymph. To prevent seizures, you must stop smoking, some foods (coffee, chocolate) and avoid sudden movements of the head.

Anxiety disorders

The combination of personal characteristics and external stresses sometimes leads to anxiety disorders. One of them, which is not so rare, is a panic attack. It can be triggered by any mild infection, conflict in the family or at work, alcohol and caffeine use, and other factors. Signs of panic disorder include:

  • dizziness
  • nausea, vomiting, abdominal pain
  • rapid pulse, feeling of “jumping out” heart
  • shortness of breath
  • fear of death

All of these signs can appear in various combinations. Sometimes they are so strong that they lead to hospitalization. A panic attack is diagnosed if it does not detect any abnormalities in the internal organs. This is an exception diagnosis. When confirmed anxiety disorder, the doctor prescribes antidepressants and other drugs that remove the attack and prevent the emergence of new attacks. Read more on the symptoms and treatment of panic attacks.

Vestibular migraine

The disease associated with an inadequate response of the vessels of the brain is familiar to many people. Women of childbearing age are more likely to suffer from migraine attacks, although a certain percentage of men and adolescents are found among patients. The main signs of migraine are:

  • repetitive throbbing headaches, nausea, and dizziness
  • more often one-sided localization of pain
  • nausea, photophobia and intolerance to sounds
  • the duration of the attack from several minutes to several days
  • provoked by menstruation, eating chocolate

Diagnosis is carried out on the complaints of the patient, taking into account the family predisposition and the absence of major changes on MRI of the brain.

After confirming the diagnosis of migraine dizziness, the doctor will prescribe a therapy: antidepressants (amitriptyline), calcium channel blockers (verapamil), diet restriction (chocolate, monosodium glutamate, smoked meats, caffeine, alcohol).

Vestibular Neuronitis

The defeat of the vestibular system with a viral infection causes a malfunction in its work. Symptoms of neuronitis is considered to be a combination of dizziness, nausea, loss of balance and nystagmus. Such attacks are short-lived and completely disappear after a few weeks. It is believed that the most common cause of neuronitis is the activation of herpes simplex virus type 1. Immediately before the attack, patients note a slight fever and other signs of viral infection.

The doctor makes a diagnosis of vestibular neuronitis after a thorough examination. If all serious causes (stroke, tumors, multiple sclerosis) are excluded, then tests like Nilen-Barani are performed. For the treatment used hormonal drugs (prednisone) in a certain dosage, which allows to reduce the discomfort and speed up recovery.

Multiple sclerosis

Multiple sclerosis is a disease of the nervous system, in which there is a gradual destruction of the sheath of nerves. The causes of the disease are unknown, but the autoimmune process plays a definite role. The affected areas of the nerves do not perform their functions, which leads to a variety of symptoms:

  • dizziness
  • loss of sensation in different parts of the body
  • optic neuritis
  • the pains
  • depression or euphoria
  • memory and attention impairment
  • convulsions
  • motor impairment

The disease proceeds in the form of exacerbations and periods of calm, gradually leading to disability. The main diagnostic method remains MRI of the brain, which revealed lesions. Medicine cannot cure the disease completely. But there are drugs (for example, interferons) that can slow the progression of multiple sclerosis. Sometimes during exacerbations, corticosteroids and other medications are used. It is important to strictly follow the recommendations of the doctor to delay the disability.

Transient Ischemic Attacks and Stroke

Disruption of blood flow between the spinal cord and the brain (in the vertebrobasilar artery) often leads to dizziness and other prominent symptoms:

  • dizziness with nausea and weakness
  • double vision
  • sudden hearing loss
  • numbness or tingling on the face
  • fainting
  • numbness and paralysis of the arm or leg, opposite the numb part of the face
  • hoarseness
  • swallowing disorders

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Diagnosis of stroke is performed using imaging of the brain (by MRI, CT, ultrasound). Additionally, blood pressure is measured, a blood test for clotting is taken and the vessels passing through the neck are examined.

The difference between stroke and transient disorder in persistence of symptoms. With TIA, blood circulation in the spasmodic artery is quickly restored, and well-being improves. But hemorrhage or necrosis of the brain due to ischemia is a serious pathology. Urgent administration of anticoagulants can stop the process and even reverse it. But it often takes years to restore all the functions of the body.

Brain tumors

Brain tumors affecting the vestibular pathways are one of the most serious causes of dizziness and nausea. If a malignant or benign lesion is located in the bridge-bristle angle, then the above symptoms are always present, especially with vestibular schwannomas. They are often accompanied by headache, ringing in the ears and hearing loss, double vision.

The main way to diagnose brain tumors is MRI or CT. With a confirmed diagnosis, they try to remove the tumor surgically, if possible. Sometimes limited to radiation and chemotherapy. The outcome of the disease depends on the degree of malignancy of the tumor, its size and location.


Inflammation of the inner ear caused by viruses, bacteria or fungi, leads to severe dizziness, nausea and hearing loss. The bone maze, which is responsible for the sense of balance, has a close connection with the middle ear on the one hand and the brain on the other. Therefore, an infection that begins as otitis media may well penetrate deeper, causing damage to the vestibular apparatus, and then inflammation of the brain. Therefore, you need to know the symptoms of labyrinthitis, so as not to delay the visit to the doctor.

  • acute onset of illness
  • more often unilateral otitis, with meningitis – bilateral
  • dizziness with hearing loss to one or both ears
  • nausea, vomiting
  • temperature rise
  • often – clear or purulent discharge from the ear, pain in the ear and the temple area

Diagnose a labyrinthitis on a characteristic clinical picture. When inflammation of the viral nature of sometimes enough bed rest and observation. In case of bacterial damage, antibiotics are prescribed, and the eardrum is opened for outflow of pus. In advanced cases, an operation is performed to open the mastoid process and remove purulent effusions. Feeling nauseous and dizzy goes gradually, with the restoration of hearing. Since the labyrinth is the risk of persistent hearing loss and cerebral complications, self-treatment in this case is unacceptable.

Questions asked by the doctor at the reception

  • How to describe your condition without using the word “dizziness”?
  • When feeling falling in which direction you “throws”?
  • Is there a feeling of fear at the moment of dizziness?
  • Is this symptom permanent or intermittent? Are the episodes fast or long?
  • Dizziness begins abruptly or gradually?
  • Were there any head and neck injuries in the past?
  • How does a symptom behave when sitting, lying, standing, turning the head?
  • Is there a loss or decrease in hearing? Tinnitus?
  • Were there any signs of ARVI in the last week before the onset of the disease?
  • How often is a headache?
  • What medications do you take all the time, or were you taking for the first time before an attack?

Diagnosis of the causes of dizziness and nausea

  • Medical examination
  • Tests for determining nystagmus, loss of balance and hearing loss
  • Ultrasound of the vertebrobasilar arteries with doppler
  • MRI and CT of the brain for tumors, injuries, circulatory disorders
  • Blood test for hemoglobin and ferritin levels
  • Blood test for pregnancy with nausea and dizziness in women

Reasons for emergency treatment to the doctor

  • The combination of nausea, dizziness and temperatures above 38 C.
  • Confused consciousness
  • Severe headaches
  • High blood pressure
  • Unrestrained vomiting

Therapy for such an unpleasant condition depends on the cause of it.

  • Meniere’s disease is sometimes treatable with betahisthistine. A low-salt diet and diuretics are also recommended.
  • in case of circulatory disorders in the area of ​​the vertebrobasilar artery, antiplatelet agents (aspirin) and anticoagulants are prescribed. Hypotensive therapy (with hypertension) and statins are often needed to lower cholesterol.
  • with severe nausea and vomiting associated with dizziness, prochlorperazin, tietilperazin are prescribed. Acceptance of such drugs is possible only with acute dizziness, after examination by a doctor, and only a short course.
  • in case of damage to the inner ear and paroxysmal dizziness, the special exercises described above are effective. Benefit also brings repeated repetition of situations that reinforce the symptom. As a result, the brain adjusts and begins to control dizziness. Not everyone can endure this method, especially if it is necessary to work and do household chores.
  • Panic attacks require psychotherapy, antidepressants and other drugs that affect mental health and the nervous system.
  • at home before a visit to the doctor treatment methods are limited. You can restrict head movements, take a comfortable position, drink some citrus juice, open windows for air access. Drugs for nausea and vomiting can mask important symptoms, so it is not recommended to take them until an accurate diagnosis.
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