Hepatitis C Symptoms - Nausea

While a large number of people who are diagnosed with chronic hepatitis C (HCV) experience little to no symptoms and are asymptomatic throughout the disease’s progression, others indicate that they’ve encountered symptoms such as fatigue, joint pain, muscle aches, and nausea. The frequency and severity of each symptom varies with the individual patient, and although most will list fatigue as their number one complaint, nausea still persists for both patients undergoing therapy as well as those not yet prescribed a treatment regimen. Because nausea can last throughout diagnosis and as treatments are prescribed, it remains a concern for many folks with HCV.

Most who experience nausea would describe it as feeling sick to the stomach, and that feeling can range from a mild queasiness to an overwhelming urge to vomit. Similarly, someone can experience nausea-related digestive symptoms without feeling sick to the stomach, such as pain in the abdomen, loss of appetite, pale or clay-colored stool, or a darkening of the urine.

Nausea, liver disease, and hep c

In a recent cross-sectional study comparing nausea across 53 patients with chronic liver disease and 64 patients with HCV, it was found that patients who were infected with HCV had a much higher prevalence of nausea and abdominal pain than those with chronic liver disease not related to HCV. Compared to participants with other types of liver disease (18.9%), patients with hepatitis C had a higher prevalence of nausea (43%), a higher mean alanine aminotransferase (ALT) level (62.8 vs. 85.5 IU), and higher total bilirubin levels (0.58 vs. 0.76). It was also found that emotional distress and overall GI irritation was higher in folks who had been diagnosed with HCV. Lastly, researchers suggest that nausea among individuals with HCV is correlated with increased ALT levels, liver biopsy scores, amount of fibrosis, alcohol use, and NSAID use – all elements that impact the ability of the liver to function.

Why does HCV cause nausea?

To further understand why nausea persists in patients who have been diagnosed with HCV, one must first consider the functioning of a healthy liver. The liver performs a myriad of functions that help regulate digestion and one’s overall health. First, the liver produces bile, which helps break down fats in the foods someone eats. The bile produced by the liver is stored in the gallbladder, and from the gallbladder, it is sent to the beginning section of the small intestine, called the duodendum. Once bile reaches the duodendum, it is combined with digestive fluids from the pancreas and stomach acids. Bile, digestive fluids, and stomach acids all help nutrients enter the bloodstream through the intestines.

An HCV infection can severely hinder the liver’s ability to produce bile, and when the liver’s ability to produce bile has been compromised, the body struggles to digest fatty foods. When the body has a hard time digesting fatty foods, the gallbladder can become inflamed, and that inflammation may elicit symptoms of pain in the upper right portion of the abdomen. An infected liver may also have trouble producing enough albumin, a substance that regulates the amount of fluid in cells. When there is too much fluid built up in the stomach (ascites), additional inflammation and pain can be felt in the abdomen from that inflammation.

While nausea can be caused by the effects of the hepatitis C virus directly, it can also be caused by HCV treatment regimens. In fact, nausea is one of the most common gastrointestinal symptoms from interferon and ribavirin medications.

Ways to reduce nausea

No matter the cause of nausea, it can greatly impact someone’s quality of life and overall well-being, and as a result, that often influences whether or not a patient wants to continue treatment. So, it’s important to first consider the underlying cause of the nausea and then to take as many steps as possible to reduce or eliminate those symptoms altogether.

Reducing the impact nausea has on your day-to-day activities may be as simple as altering normal habits and the things you eat and drink to help eliminate triggers. Some suggested tips for controlling general symptoms of nausea and gastrointestinal symptoms are included below:

• If you experience strong nausea symptoms in the morning, get out of bed slowly, and eat plain, dry crackers when you get up
• Try avoiding foods and smells that trigger your symptoms
• Avoid foods that are hard to digest, such as greasy, deep-fried, and spicy foods
• Eat small meals every couple of hours – five to six small meals instead of two to three large meals
• When feeling nauseous, avoid acidic fruit juices, and replace them with ginger ale, chicken broth, herbal tea, or sports drinks
• Eat all meals slowly, and sip on beverages slowly
• Avoid foods that are very hot or very cold, and eat room-temperature foods
• Try some peppermint, chamomile or ginger tea to help calm the stomach
• Try ginger root cooked or raw, ginger ale, ginger candy, or ginger snap cookies
• Try relaxation, yoga, or meditation techniques
• Avoid strenuous exercise – instead, try light activities
• Try acupuncture or acupressure

When nausea persists or becomes worse, always contact you healthcare provider. Both over-the-counter and prescription medicines for nausea should be used under the supervision of a licensed practitioner and with your individual issues considered. While some of the simple steps listed above have been known to reduce nausea symptoms, it’s important you consult a physician before discontinuing any therapy and/or supplementing your prescribed regimen.