Hangover Nausea: Why the Stomach Takes the Hit

Nausea after drinking is a stomach problem before it is a brain one. NIAAA identifies gastrointestinal irritation as one of the mechanisms behind a hangover: alcohol directly irritates the lining of the stomach and increases acid release, which leads to nausea and stomach discomfort. Nausea and stomach pain both appear on its list of typical symptoms.

Why it can outlast the drinking by hours

Two effects overlap. The irritation and extra acid are still there in the morning, and the symptom peak arrives when blood alcohol comes back to about zero — which is usually well after the last drink. So the queasiest hour tends to be the one in which you feel most entitled to be over it.

What tends to settle it

• Sips, not glasses. Large volumes of water on an irritated stomach often come straight back. Small amounts, often, do the same job without the trigger.
• Plain food in small portions. Toast, crackers, plain rice, banana. The goal is something in the stomach, not a meal.
• Electrolyte drinks or broth, if they go down. MedlinePlus mentions sports drinks and bouillon for replacing salt and potassium lost. Note that NIAAA found no link between electrolyte disruption and hangover severity, so treat these as tolerable fluid rather than as treatment.
• Cool air and no strong smells. Cheap, and it works for the sensory half of the problem.
• Sitting or lying propped up rather than flat.

What makes it worse

Aspirin and ibuprofen are the trap. NIAAA notes that, like alcohol, they increase acid release and irritate the stomach lining, so the pill taken for the headache aggravates the queasiness. Coffee on an empty stomach, fatty or heavily spiced food, and another drink all push in the same direction. Acetaminophen avoids the acid problem but carries its own: combined with alcohol it can be toxic to the liver. That trade-off is set out in hangover headache.

Vomiting that is not part of a hangover

This is the section worth reading before you need it. NIAAA lists the critical signs of an alcohol overdose: mental confusion or stupor, difficulty remaining conscious or inability to wake up, vomiting, seizures, slow breathing at fewer than 8 breaths per minute, irregular breathing with 10 seconds or more between breaths, slow heart rate, clammy skin, no gag reflex, and extremely low body temperature, bluish skin or paleness.

If you suspect an overdose, call 911. Do not wait for every symptom to appear, and do not assume someone can sleep it off — blood alcohol keeps rising after the last drink, and alcohol at high levels blunts the gag reflex, which is how someone chokes on their own vomit. While waiting: stay with the person, keep them sitting or partially upright rather than in a chair, and if they are unconscious roll them onto one side with an ear toward the ground.

Even short of that, get medical help for repeated vomiting that keeps nothing down for hours, blood in the vomit, severe abdominal pain, or clear signs of dehydration such as dizziness on standing and very dark or scant urine.

This content is informational and does not replace medical consultation, diagnosis, or treatment. See also hangover symptoms and how to cure a hangover.