Have you ever experienced nausea? Who hasn’t? It’s a terrible feeling. It can be brought on by vertigo or medications. Cancer chemotherapy drugs are notorious for triggering unrelenting nausea and vomiting. Some other contributors include motion sickness, morning sickness, migraine headaches, gastroenteritis, appendicitis, anesthesia, food poisoning and intestinal obstruction. Anti-nausea drugs don’t always work. There is a surprising home remedy as close as your medicine cabinet: a sniff of alcohol.
Alcohol Aromatherapy vs. Drugs for Nausea:
Home remedies usually get short shrift from health professionals. That’s because they are rarely studied in a scientific manner. Without a plausible explanation, many physicians may attribute these old wives’ tales to the power of suggestion.
Medications are usually perceived as real medicine. An FDA green light is tantamount to a medical seal of approval. But sometimes a home remedy may work as well or better than a prescribed medication.
OK, we admit that such a statement seems heretical. Let’s look at the both experience and science.
A Sniff of Alcohol For Nausea After Anesthesia:
This health professional believes a sniff of alcohol can be helpful:
Q. Today I noticed the comment about smelling alcohol as a treatment for nausea. I practiced anesthesia for 42 years and was Clinical Director of Adult Post Anesthesia Units (PACU) for 8 years at my last hospital.
Very early in my career I noticed that nurses in the PACU would often open alcohol pad packets for patients who suffered from nausea. The patients sniffed the “fumes.” I was totally unfamiliar with this practice at the time. It never hurt and sometimes helped.
One can learn a great deal from nurses, so I shared this information with my medical colleagues. We saw it as essentially no risk with potential benefit.
Over the years, aromatherapy became more recognized as a treatment for nausea and some commercial products were developed. One (whose name always tickled me) is “QueaseEASE.” I believe that there are others. Please note that I have no financial or other conflicts of interest in this product.
There are other non-pharmacologic therapies as well as medications for post-operative nausea and vomiting (PONV). This is a very troubling event for patients, their families and caregivers, but there is no treatment that always works. A number of treatments can reduce the frequency or intensity of PONV, especially when used together. However, as with motion sickness, nothing is always effective or without side effects. Research goes on.
A. Thank you for sharing your professional experience. The research does indeed go on.
We found a Dutch study confirming the use of: “nasal inhalation of isopropyl alcohol (IPA)” in the International Journal of Emergency Medicine (Feb. 24, 2021).
The authors conclude:
“Implementation of IPA as the first-line nausea treatment in the ED [emergency department] can increase the quality of care and improve care efficiency.”
Thank you for alerting us to QueaseEASE. This inhaler contains four essential oils: peppermint, lavender, ginger and spearmint.
Disappointing Drug Effects:
Each year roughly five million people go to emergency departments (EDs) because of severe nausea and vomiting. Doctors often prescribe powerful antiemetic drugs such as ondansetron (Zofran), promethazine (Phenergan) or metoclopramide (Reglan).
Unfortunately, these medications have side effects and are not always more effective than placebo. Such a statement will be hard for most health professionals to stomach. Nevertheless, we live in an age of evidence-based medicine.
A study published in the American Journal of Emergency Medicine, March, 2006, likely shocked many emergency physicians:
“We sought to compare the efficacy of 3 intravenous antiemetic medications in ED [emergency department] patients complaining of moderate to severe nausea…Metoclopramide and prochlorperazine were not more effective than saline placebo.”
A randomized, placebo-controlled trial compared ondansetron, metoclopramide, promethazine or saline (American Journal of Emergency Medicine, Nov. 2014). The patients who participated in this study were so nauseated that they felt their only recourse was to go to the emergency department. They received intravenous medication to ease their suffering. The authors reported:
“This study found no clinically important difference in the reduction of nausea between ondansetron, metoclopramide, promethazine, and saline placebo.”
Another double-blind, placebo-controlled trial compared ondansetron, metoclopramide and placebo (Annals of Emergency Medicine, Nov. 2014).
The researchers reported:
“Reductions in nausea severity for this adult ED [emergency department] nausea and vomiting population were similar for 4 mg intravenous ondansetron, 20 mg intravenous metoclopramide, and placebo.”
A word of caution re: ondesetron (Zofran). This anti-nausea medication does seem quite effective for easing nausea and vomiting associated with chemotherapy. The trials reported above were designed to study a general patient population that showed up in emergency departments complaining of moderate to severe nausea and vomiting. Most were probably not cancer patients.
The Science Behind a Sniff of Alcohol:
Every so often we stumble across actual research to support an improbable remedy. Such is the case with aromatherapy for nausea.
A study published in the Annals of Emergency Medicine (online, Feb. 17, 2018) compared three different treatments.
- Group 1 received inhaled isopropyl alcohol and oral ondansetron
- Group 2 received inhaled isopropyl alcohol and oral placebo
- Group 3 received inhaled saline placebo and oral ondansetron
The authors introduce their sniff of alcohol study this way:
“Multiple trials report that isopropyl alcohol has efficacy in treating postoperative nausea and vomiting. Numerous animal models have demonstrated the safety of isopropyl alcohol. Human studies are without documented adverse events after isopropyl alcohol inhalation. This substance is widely available in most health care settings in the form of pads used in the routine course of delivering care.”
The clinicians used 2” x 2” alcohol pads. Nurses often use similar pads to wipe an arm before drawing blood. The patients were advised to keep the pad about 0.4 to 0.8 inches from the nostrils and inhale “as frequently as required to achieve nausea relief.”
The Results After a Sniff of Alcohol:
“Isopropyl alcohol is a simple and inexpensive agent with previously demonstrated efficacy in the treatment of nausea among patients in the postoperative setting.
“Our present study found that subjects who received inhaled isopropyl alcohol had greater nausea relief compared with subjects who received inhaled placebo and oral ondansetron at both 30 minutes and at the time of ED disposition decision.”
Surprising Search Results for a Sniff of Alcohol:
We were so intrigued by the results of this study that we started searching for the origins of this simple remedy. The first reference to “aromatherapy” for post-operative nausea and vomiting (PONV) was in 1997 (Anesthesia and Analgesia, 84 (Suppl.), 16). In this small pilot study, “IPA [isopropyl alcohol) inhalation (N=15) showed an 80% success rate in treating PONV” (Nursing Research, March/April 2002).
Since then there have been several other studies of alcohol vapor for nausea. Nurses have seemed particularly interested in this approach to help control the nausea and vomiting post surgery. One nurse described it this way (Plastic Surgical Nursing, Oct-Dec. 2004):
“In my practice as a recovery room nurse, I had observed anesthesiologists and nurse anesthetists wave an opened alcohol preparation pad under a patient’s nose when he or she complained of nausea. When asked, ‘Why?’ the response often was, ‘Because it works.’”
From Surgery to the Emergency Department:
Emergency room doctors tested this and found that it worked for most patients, not just those whose nausea could be attributed to anesthesia (Annals of Emergency Medicine, July 2016).
The latest placebo-controlled trial showed that a sniff of alcohol actually worked better than the antiemetic ondansetron (Annals of Emergency Medicine, online, Feb. 17, 2018).
According to the authors, inhaled isopropyl alcohol works better than either inhaled saline (placebo) or an ondansetron pill. The benefits last at least 30 minutes. They note:
“Our findings suggest that supplying patients with multiple isopropyl alcohol pads for use at their discretion during the entirety of their visit may result in sustained nausea relief throughout their ED stay. We believe the existing studies of isopropyl alcohol support an excellent safety profile and that repeated dosing for recurrent symptoms is likely to be safe, with minimal risk of adverse events related to overdose, provided the route of administration is nasal inhalation alone.”
The investigators cannot explain how breathing a little alcohol from a gauze pad would relieve nausea. They conclude, however:
“Emergency providers should consider incorporation of aromatherapy into their clinical practice in patients with nausea and vomiting who do not require urgent intravenous therapy.”
Words of Caution About a Sniff of Alcohol:
Do not inhale huge amounts of alcohol for this approach. A whiff or a sniff of alcohol is all that is necessary. Remember, the researchers used disposable gauze pads with just a little isopropyl alcohol. They held them about 3/4 of an inch away from the nostrils. Do not overdose!
Too much alcohol can be irritating to the nose and throat. Some susceptible people may develop difficulty breathing. Be very cautious about this approach and if nausea and vomiting persist, check with a physician promptly! After all, nausea is a symptom that something is not quite right. Treating a symptom without looking for the cause could be problematic.
The Science Behind Other Home Remedies:
Many other home remedies may work even though we don’t always understand quite how or why.
Take muscle cramps, for example. For decades, people have been using pickle juice or yellow mustard to ease their charley horse cramps. Football coaches would keep jars of pickle juice on hand during practice. No one knew why this odd remedy helped, but for many it did.
Why TRP Channel Stimulation Cures Muscle Cramps:
Now, scientists have an explanation. Activating transient receptor potential (TRP) channels with strong flavors like hot pepper, cinnamon and ginger can reverse muscle cramps promptly (Muscle & Nerve, Sept. 2017). Read more about this remedy here:
It’s entirely possible that TRP channels may explain certain other mysterious home remedies, including Vicks VapoRub on the soles of the feet to halt a cough. Anyone who would like to know more about the science behind alternative therapies may find our newest Guide of interest: Graedons’ Favorite Home Remedies. It is available at this link:
Share your own favorite home remedies in the comment section below.