Nausea and Vomiting
What is Nausea?
Nausea is the feeling that you’re going to vomit. This urge to vomit does not always result in vomiting. Nausea is often described as feeling queasy or sick to your stomach.
What is Vomiting?
Vomiting is the forceful emptying of stomach contents through the mouth. Muscles along the abdominal wall contract and create the necessary pressure to vomit (retching). Retching may also occur without vomiting or before vomiting.
What Causes Nausea and Vomiting?
Nausea and vomiting may occur together or separately. Common causes include:
- Gastroenteritis (Stomach Flu)
- Food poisoning
- Motion sickness / seasickness
- Morning sickness / early pregnancy
- Migraine headaches
- Chemotherapy / radiation therapy
Other possible nausea and vomiting causes include:
- Emotional stress (anxiety/fear)
- General anesthesia
- Drinking too much alcohol
- Intestinal obstruction
- Liver failure
- Certain cancers/tumors
- Crohn’s disease
- Diabetic ketoacidosis
- Ear infection
- Gastroesophageal reflux disease (GERD)
- Irritable bowel syndrome
- Kidney failure
- Medications – including NSAIDs, aspirin, narcotics, antibiotics
- Peptic ulcer
- Ingesting toxins
Determining the likely cause of nausea and vomiting
Knowing what preceded nausea and vomiting may help identify the cause.
- Sudden onset of nausea and vomiting accompanied by diarrhea, fevers, and body aches may indicate a possible infection.
- Medication may be the cause if symptoms begin after anesthesia, chemotherapy, or use of recreational drugs like alcohol, marijuana, or cocaine.
- Vomiting in the morning is common during pregnancy, but could also indicate kidney failure.
- Vomiting a couple of hours after a meal could indicate food poisoning, but could also suggest a blockage in the intestines or stomach
- Vomiting preceded by abdominal pain could indicate abdominal inflammation such as pancreatitis.
- Chronic vomiting or nausea could be due to a hormonal disorder (pregnancy, diabetes) or functional disorders.
- Vomiting immediately after a meal may suggest a digestive blockage but is also associated with psychiatric disorders such as anorexia or bulimia.
Tests to determine the cause of nausea and vomiting may include:
- Blood tests (to measure the blood count, chemical levels, liver and pancreatic enzymes)
- X rays of the GI tract, abdomen, or brain. This may include traditional x rays or more advanced imaging such as CT or MRI.
- Endoscopy – This test uses a long flexible tube with a camera that allows the doctor to visually inspect the esophagus, stomach, and part of the small intestine. An endoscopy can look for abnormalities that could be causing nausea and vomiting.
- Gastrointestinal motility testing – these tests can assess digestive movement through in the stomach and intestines.
Psychological tests or a psychiatric consultation may be helpful if no cause is found and symptoms aren’t controlled with standard therapy. This may help identify psychogenic vomiting and eating disorders such as anorexia nervosa or bulimia.
Risk of Dehydration
Another concern with vomiting is the risk of dehydration. Adults are less likely to experience dehydration because they can recognize the signs – including increased thirst, dry mouth, lips, etc.
Young children may not be able to tell someone about these symptoms and are therefore at a greater risk for dehydration. Those caring for young children should watch for signs of dehydration in children like dry lips and mouth, rapid breathing/pulse, sunken eyes, or decreased urination.
Nausea and Vomiting Diagnosis
There is little cause for concern if vomiting and nausea are short-term or from a minor illness. Doctors will usually examine your medical history and complete a physical exam. These steps will help your doctor determine the appropriate course of action. This may include prescribing medication, additional testing, or being admitted to a hospital.
Hospitalization is more common for patients who are elderly or very young due to the risk of dehydration.
When to see a doctor
Adults should see a doctor if vomiting and/or diarrhea last more than 48 hours or if there are signs of dehydration. 24 hours for children, and 2 to 12 hours for infants.
You should seek immediate care if you have nausea and vomiting together with:
- Chest pain
- Severe abdominal pain/cramping
- Blurry vision
- Fecal material or odor in vomit
- Rectal bleeding
- High fever (over 101) and stiffness in the neck
- Blood in vomit (looks like coffee grounds)
- Severe headache – especially if you haven’t experienced it before
Nausea and Vomiting Treatment
Treatment for nausea and vomiting will often depend on the cause, but some measures are appropriate for anyone experiencing nausea and vomiting. If these remedies do not work for you, consult your doctor.
Remedies for nausea include:
- Drinking clear or ice-cold drinks
- Eating bland foods such as plain bread or saltine crackers
- Avoiding greasy or fried foods
- Eating smaller, more frequent meals
- Eating more slowly
- Drinking slowly
- Avoiding exercise or activity after eating
- Selecting foods you can tolerate to avoid malnutrition
Remedies for vomiting include:
- Gradually drinking more clear liquids
- Avoiding solid food until symptoms pass
- Discontinuing oral medications (be sure to talk to your doctor before stopping any prescribed medications)
Vomiting that occurs after anesthesia, radiation therapy, or cancer drugs may be treated with another type of drug therapy. Prescription and over-the-counter medications exist to ease symptoms associated with motion sickness, pregnancy, and vertigo. Talk to your doctor before taking these medications.
FAQ – Nausea and Vomiting
Who is more likely to have nausea and vomiting?
Children and adults can experience nausea and vomiting. People who are undergoing treatment for cancer, including chemotherapy or radiation therapy, are more likely to experience nausea and vomiting. Women who are pregnant and in their first trimester are also more likely to experience nausea and vomiting. The common name for this is morning sickness and usually resolves as the pregnancy progresses.