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Nausea and vomiting

DEFINITION

Nausea and vomiting are common symptoms that can be caused by numerous conditions. Nausea and vomiting most often are due to viral gastroenteritis — often mistakenly termed “stomach flu” — or the morning sickness of early pregnancy.

Many medications can cause nausea and vomiting, as can general anesthesia for surgery. Rarely, nausea and vomiting may indicate a serious or even life-threatening problem.

CAUSES

Nausea and vomiting may occur separately or together. Common causes include:

  • Chemotherapy

  • Gastroparesis (a condition in which the muscles of the stomach wall don’t function properly, interfering with digestion)

  • General anesthesia

  • Intestinal obstruction

  • Migraine

  • Morning sickness

  • Rotavirus

  • Viral gastroenteritis (stomach flu)

  • Vestibular neuritis


Other possible causes of nausea and vomiting include:

  • Alcoholism

  • Anaphylaxis (in children)

  • Anorexia nervosa

  • Appendicitis

  • Benign paroxysmal positional vertigo (BPPV)

  • (both cancerous and noncancerous)

  • Bulimia nervosa

  • Concussion

  • Cholecystitis

  • Crohn’s disease

  • Cyclic vomiting syndrome

  • Depression

  • Dizziness

  • Diabetic ketoacidosis

  • Ear infection (middle ear)

  • Food poisoning

  • Generalized anxiety disorder

  • GERD — Gastroesophageal reflux disease

  • Heart attack

  • Heart failure

  • Hepatitis

  • High fever (in children)

  • Hydrocephalus (a congenital brain abnormality)

  • Hyperparathyroidism (overactive parathyroid)

  • Hyperthyroidism (overactive thyroid)

  • Hypoparathyroidism (underactive parathyroid)

  • Intestinal ischemia

  • Intestinal obstruction

  • Intracranial hematoma

  • Intussusception (in children)

  • Irritable bowel syndrome

  • Liver cancer

  • Liver failure

  • Medications (including aspirin, nonsteroidal anti-inflammatories, oral contraceptives, digitalis, narcotics and antibiotics)

  • Meniere’s disease

  • Meningitis

  • Milk allergy (in infants and children)

  • Pancreatic cancer

  • Pancreatitis

  • Peptic ulcer

  • Pseudotumor cerebri

  • Pyloric stenosis (in infants)

  • Radiation therapy

  • Severe pain

  • Traumatic brain injury

WHEN TO SEE A DOCTOR

Call 911 or emergency medical assistance

Seek prompt medical attention if nausea and vomiting are accompanied by other warning signs, such as:

  • Chest pain

  • Severe abdominal pain or cramping

  • Blurred vision

  • Fainting

  • Confusion

  • Cold, clammy, pale skin

  • High fever and stiff neck

  • Fecal material or fecal odor in the vomit


Seek immediate medical attention
Ask someone to drive you to urgent care or an emergency room if:

  • Nausea and vomiting are accompanied by pain or a severe headache, especially if you haven’t had this type of headache before

  • You’re unable to eat or drink for 12 hours or your child hasn’t been able to keep liquids down for eight hours

  • You have signs or symptoms of dehydration — excessive thirst, dry mouth, infrequent urination, dark-colored urine and weakness, dizziness or lightheadedness upon standing

  • Your vomit contains blood, resembles coffee grounds or is green


Schedule a doctor’s visit
Make an appointment with your doctor if:

  • Vomiting lasts more than two days for adults, 24 hours for children under age 2 or 12 hours for infants

  • You’ve had bouts of nausea and vomiting for longer than one month

  • You’ve experienced unexplained weight loss along with nausea and vomiting


Take self-care measures while you wait for your appointment with your doctor:

  • Take it easy. Too much activity and not getting enough rest might make nausea worse.

  • Stay hydrated. Take small sips of cold, clear, carbonated or sour drinks, such as ginger ale, lemonade and water. Mint tea also may help.

  • Avoid strong odors and other triggers. Food and cooking smells, perfume, smoke, stuffy rooms, heat, humidity, flickering lights, and driving are among the possible triggers of nausea and vomiting.

  • Eat bland foods. Start with easily digested foods such as gelatin, crackers and toast. When you can keep these down, try cereal, rice, fruit, and salty or high-protein, high-carbohydrate foods. Avoid fatty or spicy foods. Wait to eat solid foods until about six hours after the last time you vomited.

  • Use over-the-counter (OTC) motion sickness medicines. If you’re planning a trip, OTC motion sickness drugs, such as Dramamine or Rugby Travel Sickness, may help calm your queasy stomach. For longer journeys, such as a cruise, ask your doctor about prescription motion sickness adhesive patches, such as scopolamine (Transderm Scop).



If your queasiness stems from pregnancy, try nibbling on some crackers before you get out of bed in the morning.