What causes pregnancy symptoms but negative test?

Dear Doctor,
Is it normal to get pregnancy-like symptoms even when not?  For instance, for the past two weeks I’ve been feeling nauseous, dizzy and I can’t stand the smell of certain things that I didn’t have a problem with before. I took a pregnancy test and I’m not. What could be the cause of this? Irene

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Dear Irene,

Nausea and or vomiting is the first sign of pregnancy in many women all over the world. Exact cause for it is not known. But it is presumed to be due to rise in the “pregnancy hormone”, that is, human chorionic gonadotropin (HCG). It peaks during early pregnancy and women when pregnant often suffer from nausea and vomiting at the same time. In some, it subsides after the first trimester, whereas in some, it continues throughout the pregnancy. Many women also feel nauseous with the smell, or sometimes even with the sight, of certain foods.

However, these symptoms are not restricted to pregnancy. One may get them any time and even children, men or the elderly can have them.

Nausea and vomiting can be due to functional dyspepsia or simple indigestion. This can occur due to taking a heavy meal or eating late in the evening, or binge drinking alcohol, and etcetera. One can have it due to regular consumption of alcohol, as it causes irritation of the inner lining of the stomach.

Nausea can occur due to chronic constipation, where the bowels are not evacuated regularly. Taking very spicy food can cause dyspepsia and nausea and vomiting in people. It can be a side effect of drugs like some pain killers.

Among medical conditions, peptic ulcer disease is manifested by burning pain in the stomach, associated with nausea and sometimes, bilious vomiting. One can have nausea with or without vomiting due to chronic kidney or liver disease, infections of the bowels, worm infestation, and cancer of the stomach or bowel, and other diseases. Uncontrolled diabetes may manifest as acute abdominal pain with vomiting.

Nausea due to smell of certain foods can occur in very sensitive people. Due to their very sensitive mind, the digestive system also becomes sensitive to smell or even sight of any food that is disliked can make them feel nauseous. It can also be a manifestation of stress. The digestive system of many people becomes sensitive due to stress and one tends to feel nauseous and may even vomit due to smell of certain foods or after consumption of certain foods. Allergy to certain types of foods can make one feel nauseated, just by looking at them. It can be due to staying up till late in the night and not getting adequate sleep.

If the problem is temporary and mild, it can be solved by making small dietary changes and anti-emetic drugs. Alcohol, heavy meals, late evening meals, should be avoided. A high fibre diet aids in digestion and prevents constipation and dyspepsia.

If the nausea/vomiting is severe and persistent, it is better to seek medical advice to exclude an underlying medical problem. Majority of the problems are treatable.
                        
Dr. Rachna   Pande is a specialist in internal medicine. 

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