Nausea and vomiting
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/nausea/MY00572
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Definition
Nausea and vomiting are very common symptoms that can be caused by a wide variety of 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 (poor functioning of stomach muscles)
- General anesthesia
- Migraine
- Motion sickness: First aid
- Overdose of alcohol, illicit substances or toxic substances
- Rotavirus
- Vertigo (false sense of motion or spinning)
- Viral gastroenteritis (stomach flu)
Other possible causes of nausea and vomiting include:
- Addison's disease
- Alcoholic hepatitis
- Anaphylaxis
- Anorexia nervosa
- Appendicitis
- Benign paroxysmal positional vertigo (BPPV)
- Brain AVM (arteriovenous malformation)
- Brain hemorrhage
- Brain infarction
- Brain tumor
- Bulimia nervosa
- Chronic kidney failure
- Congenital adrenal hyperplasia (condition that limits adrenal function)
- Crohn's disease
- Cyclic vomiting syndrome
- Depression (major depression)
- Diabetic ketoacidosis
- Dizziness
- Ear infection (middle ear)
- Food poisoning
- Frontal lobe seizures
- Gallstones
- Generalized anxiety disorder
- GERD
- Head injury
- Heart attack
- Heart failure
- Hirschsprung's disease
- Hydrocephalus
- 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
- Meniere's disease
- Meningitis
- Milk allergy (in infants and children)
- Nonulcer stomach pain
- Pancreatic cancer
- Pancreatitis
- Peptic ulcer
- Porphyria
- Pseudotumor cerebri
- Pyloric stenosis (in infants)
- Radiation therapy
- Retroperitoneal fibrosis
- Social anxiety disorder (social phobia)
- Stomach obstruction
- Strep throat (in children)
- Temporal lobe seizure
- 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:
- 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 the 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 anything 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.
- Longstreth GF. Approach to the adult with nausea and vomiting. http://www.uptodate.com/home/index.html. Accessed May 4, 2011.
- Scorza K, et al. Evaluation of nausea and vomiting. American Family Physician. 2007;76:76.
- Di Lorenzo C. Approach to the infant or child with nausea and vomiting. http://www.uptodate.com/home/index.html. Accessed May 4, 2011.
- Shakil A, et al. Gastrointestinal complications of diabetes. American Family Physician. 2008;77:1697.
- Smith JA, et al. Treatment of nausea and vomiting of pregnancy (hyperemesis gravidarum and morning sickness). http://www.uptodate.com/home/index.html. Accessed May 4, 2011.
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