Nausea and vomiting (patient information)
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]
Overview
Nausea is the feeling of having the urge to vomit. It is often called being sick to your stomach. Vomiting or throwing up is forcing the contents of the stomach up through the esophagus and out of the mouth.
What causes nausea and vomiting?
Many common problems may cause nausea and vomiting:
- Food allergies
- Infections of the stomach or bowels, such as the "stomach flu" or food poisoning
- Leaking of stomach contents (food or liquid) upwards (also called gastroesophageal reflux or GERD)
- Medications or medical treatments, such as cancer chemotherapy or radiation treatment
- Migraine headaches
- Morning sickness during pregnancy
- Seasickness or motion sickness
- Severe pain, such as with kidney stones
Nausea and vomiting may also be early warning signs of more serious medical problems, such as:
- Appendicitis
- Blockage in the intestines
- Cancer or a tumor
- Ingesting a drug or poison, especially by children
- Ulcers in the lining of the stomach or small intestine
Diagnosis
Your health care provider will perform a physical examination and look for signs of dehydration.
Your health care provider will ask questions about your symptoms, such as:
- When did the vomiting begin? How long has it lasted? How often does it occur?
- Does it occur after you eat, or on an empty stomach?
- What other symptoms are present -- abdominal pain, fever, diarrhea, or headaches?
- Are you vomiting blood?
- Are you vomiting anything that looks like coffee grounds?
- Are you vomiting undigested food?
- When was the last time you urinated?
Other questions you may be asked include:
- Have you been losing weight?
- Have you been traveling? Where?
- What medications do you take?
- Did other people who ate at the same place as you have the same symptoms?
- Are you pregnant or could you be pregnant?
Diagnostic tests may be performed, including:
- Blood tests (such as CBC with differential, blood electrolyte levels, and liver function tests)
- Urinalysis
- X-rays of the abdomen
- Depending on the cause and how much extra fluids you need, you may have to stay in the hospital or clinic for a period of time. You may need intravenous fluids.
When to seek urgent medical care?
Call 911 or go to an emergency room if:
- You think vomiting is from poisoning.
- You notice blood or dark, coffee-colored material in the vomit.
Call a health care provider right away or seek medical care if you or another person has:
- Been vomiting for longer than 24 hours.
- Been unable to keep any fluids down for 12 hours or more.
- Headache or stiff neck.
- Not urinated for 8 or more hours.
- Severe stomach or belly pain.
- Vomited three or more times in 1 day.
Signs of dehydration include:
- Crying without tears.
- Dry mouth.
- Increased thirst.
- Eyes that appear sunken.
- Skin changes -- for example, if you touch or squeeze the skin, it doesn't bounce back the way it usually does.
- Urinating less often or having dark yellow urine.
Treatment options
Throughout the period of nausea and vomiting, it is essential that you remain hydrated. Try drinking frequent, small amounts of clear liquids. Once you and your doctor establish the cause of your nausea and vomiting, you may be asked to take medicine or change your diet as treatment.
If the nausea and vomiting is due to morning sickness, ask your doctor about possible treatments.
If motion sickness is the cause, the following treatments may help:
- Lying down
- Over-the-counter antihistamines (such as Dramamine)
- Scopolamine (prescription skin patches such as Transderm Scop) are useful for extended trips, such as an ocean voyage. Place the patch on your skin 4 - 12 hours before setting sail. Scopolamine is effective but may produce dry mouth, blurred vision, and some drowsiness. Scopolamine is for adults only. It should NOT be given to children.
Where to find medical care for nausea and vomiting?
Directions to Hospitals Treating Nausea and vomiting