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'''For patient information, click [[Nausea and vomiting (patient information)|here]]'''
{{Nausea and Vomiting}}
{{CMG}}; {{AE}} [[User:Tayebah Chaudhry|Tayebah Chaudhry]][mailto:dr.thch@yahoo.com]; '''Associate Editor-In-Chief:''' {{MUT}}


{{Editor Join}}
'''''Synonyms and Keywords:''''' Emesis


'''''Synonyms and Keywords:''''' emesis
==[[Nausea and vomiting overview|Overview]]==


==Overview==
==[[Nausea and vomiting historical perspective|Historical Perspective]]==
'''Nausea''' ([[Latin]]: ''Nausea'', [[Greek language|Greek]]: ''{{Polytonic|Ναυτεία}}'', "[[sea-sickness]]") is the sensation of unease and discomfort in the [[stomach]] with an urge to [[vomit]].
<br />
==[[Nausea and vomiting classification|Classification]]==


Nausea is not a sickness, but rather a symptom of several conditions, many of which are not related to the stomach. Nausea is often indicative of an underlying condition elsewhere in the body. Travel sickness, which is due to confusion between perceived movement and actual movement, is an example. The sense of equilibrium lies in the ear and works together with eyesight. When these two don't "agree" to what extent the body is actually moving the symptom is presented as nausea even though the stomach itself has nothing to do with the situation. Nausea is also an [[Adverse effect (medicine)|adverse effect]] of many drugs. Nausea may also be an effect of a large intake of sugary foods.
==[[Nausea and vomiting pathophysiology|Pathophysiology]]==


In medicine, nausea can be a problem during some [[chemotherapy]] regimens and following [[general anaesthesia]]. Nausea is also a common symptom of [[pregnancy]]. Mild nausea experienced during pregnancy can be normal, and should not be considered an immediate cause for alarm.
==[[Nausea and vomiting causes|Causes]]==
* '''Vomiting ''' (also '''throwing up''' or '''emesis''') is the forceful expulsion of the contents of one's [[stomach]] through the [[mouth]] and sometimes the [[nose]]. '''Vomiting''' may result from many causes, ranging from [[gastritis]] or [[poison]]ing to [[brain tumor]]s, or elevated [[intracranial pressure]] (ICP). The feeling that one is about to vomit is called [[nausea]]. It usually precedes, but does not always lead to vomiting. [[Antiemetic]]s are sometimes necessary to suppress nausea and vomiting, and in severe cases where [[dehydration]] develops, [[intravenous]] fluid may need to be administered to replace fluid volume.


The medical branch investigating vomiting, emetics and antiemetics is called '''emetology'''.
==[[Nausea and vomiting differential diagnosis|Differentiating Nausea and Vomiting from other Conditions]]==
==Causes==
===Complete Differential Diagnosis of the Causes of Nausea and Vomiting (alphabetical)===


* [[1,2-Dichloroethene]]
==[[Nausea and vomiting epidemiology and demographics|Epidemiology and Demographics]]==
* [[1,3-Dichloropropene]]
* [[2C-E]]
* [[2C-I]]
* [[2C-T-7]]
* [[2-Ethylhexanol]]
* [[5-Hydroxytryptophan]]
* [[5-MeO-AMT]]
* [[Abrin]]
* [[ABVD]]
* [[Accessory pancreas]]
* [[Acetaminophen (patient information)]]
* [[Acetoxyketobemidone]]
* [[Acetylcysteine]]
* [[Acetylsalicylic acid]]
* [[Achalasia]]
* [[Aciclovir]]
* [[Aconitine]]
* [[Acoustic neuroma]]
* [[Acromegaly]]
* [[Acute abdomen]] and/or [[peritonitis]]
* [[Acute Coronary Syndromes]]
* [[Acute fatty liver of pregnancy]]
*Acute [[high altitude sickness]]
*Acute [[infections]]
* [[Acute pancreatitis]]
* [[Acute prostatitis]]
* [[Acute viral nasopharyngitis (common cold)]]
* [[Adamsite]]
* [[Addison's Disease]]
* [[Adjustable gastric band]]
* [[Adrenal failure]]
* [[Adrenal insufficiency]]
* [[Afferent Loop Syndrome]]
* [[AIDS]]
* [[Airsickness]]
* [[Alatrofloxacin Injection (patient information)]]
* [[Albuterol Inhalation (patient information)]]
* [[Alcohol Withdrawal]]
* [[Alcoholic Hepatitis]]
* [[Alcoholism]]
* [[Aldesleukin (patient information)]]
* [[Allylprodine]]
* [[Alpha-Methyltryptamine]]
* [[Alprazolam]]
* [[Altitude sickness]]
* [[Altretamine]]
* [[Alvarado score]]
* [[Amifostine]]
* [[Amineptine]]
* [[Aminocaproic acid]]
* [[Aminopterin]]
* [[Aminosalicylic acid]]
* [[Amitriptyline (patient information)]]
* [[Ammonium chloride]]
* [[Amnesic shellfish poisoning]]
* [[Amoxicillin]]
* [[Amphotericin B]]
* [[Amrinone]]
* [[Amyl nitrite]]
* [[Amyloidosis]]
* [[Anadenanthera peregrina]]
* [[Analgesic]]
* [[Anastomosis]] [[stenosis]]
* [[Anastrozole (patient information)]]
* [[Anesthesia]]
* [[Angina pectoris]]
* [[Anorexia nervosa]]
* [[Antihistamine]]
* [[Antiretroviral drug]]
* [[Anxiety]]
* [[Aortic Arch Anomalies]]
* [[Appendicitis]]
* [[Arachnoid cyst]]
* [[Aripiprazole (patient information)]]
* [[Arsenic Poisoning]]
* [[Asceptic Meningitis]]
* [[Asparaginase (patient information)]]
* [[Aspirin]]
* [[Astrovirus]]
* [[Atomoxetine]]
* [[Auranofin]]
* [[Autonomic neuropathy]]
* [[Azithromycin]]
* [[Aztreonam]]
* [[Bacillus cereus]]
* [[Bacterial gastroenteritis]]
* [[Balance disorder]]
* [[Barbiturate]]
* [[Barcoo Fever]]
* [[Barium oxalate]]
* [[Barium Sulfate (patient information)]]
* [[Beef tapeworm]]
* [[Beleric]]
* [[Belladonna Alkaloid Combinations and Phenobarbital (patient information)]]
* [[Benign intracranial hypertension]] and [[hydrocephalus]]
* [[Benzodiazepine]]
* [[Benzylpiperazine]]
* [[Beta-lactam antibiotic]]
* [[Bevacizumab Injection (patient information)]]
* [[Bezafibrate (patient information)]]
* [[Bicalutamide (patient information)]]
* [[Biliary colic]]
* [[Blastocystosis]]
* [[Bleomycin (patient information)]]
* [[Bortezomib (patient information)]]
* [[Bothrops|Bothrops bite]]
* [[Bowel obstruction]]
* [[Brain]] [[radiation]]
* [[Brain Stem Gliomas]]
* [[Brain tumor]]
* [[Breastfeeding complications]]
* [[Bromelain]]
* [[Bromomethane]]
* [[Bronchodilator]]
* [[Brucella]]
* [[Bulimia nervosa]]
* [[Buprenorphine]]
* [[Bupropion]]
* [[Busulfan (patient information)]]
* [[Butanethiol]]
* [[Butorphanol]]
* [[Cabergoline]]
* [[Caecitis]]
* [[Calcitonin]]
* [[Calcitriol]]
* [[Calcium carbamide]]
* [[Cancer]]
* [[Capecitabine (patient information)]]
* [[Capsaicin]]
* [[Carbon monoxide poisoning]]
* [[Carboplatin (patient information)]]
* [[Cardiac arrhythmia]]
* [[Carmustine (patient information)]]
* [[Carprofen]]
* [[Carvedilol (patient information)]]
* [[Caspofungin]]
* [[Cefaclor]]
* [[Cefoperazone Sodium Injection (patient information)]]
* [[Cefuroxime]]
* [[Cephalosporin]]
* [[Cerebral aneurysm]]
* [[Cerebral arteriovenous malformation]]
* [[Cerebral hemorrhage]]
* [[Cerebral shunt|Cerebral shunt (blocked)]]
* [[Cerebrovascular disease]]
* [[Cetuximab Injection (patient information)]]
* [[Cevimeline]]
* [[Chelation therapy]]
* [[Chemotherapy]]
* [[Childbirth]]
* [[Chloral hydrate]]
* [[Chlordiazepoxide]]
* [[Chloromethane]]
* [[Chlorothiazide]]
* [[Chlorpropamide]]
* [[Cholecystitis]]
* [[Cholecystolithiasis]]
* [[CHOP]]
* [[Chronic fatigue syndrome]]
* [[Cicuta]]
* [[Ciguatera]]
* [[Cimicifuga racemosa]]
* [[Cinchonism]]
* [[Cisplatin]]
* [[Citalopram]]
* [[Cladribine (patient information)]]
* [[Clarithromycin]]
* [[Clindamycin]]
* [[Clofarabine]]
* [[Clofibrate]]
* [[Clomifene]]
* [[Clorazepate]]
* [[Co-codamol]]
* [[Codeine]]
* [[Colorado tick fever]]
* [[Combat stress reaction]]
* [[Combined oral contraceptive pill]]
* [[Community-acquired pneumonia]]
* [[Concussion]]
* [[Contraceptive patch]]
* [[Controlled Substances Act]]
* [[Coprinopsis atramentaria]]
* [[Craniopharyngioma]]
* [[Crohn's disease]]
* [[Croup]]
* [[Cryptosporidium parvum]]
* [[Cyanogen]]
* [[Cyclic vomiting syndrome]]
* [[Cyclizine]]
* [[Cyclophosphamide]]
* [[Cyclospora cayetanensis]]
* [[Cytarabine (patient information)]]
* [[Cytisine]]
* [[Dacarbazine (patient information)]]
* [[Dactinomycin (patient information)]]
* [[Dantrolene]]
* [[Daptomycin]]
* [[Darbepoetin Alfa Injection (patient information)]]
* [[Darunavir (patient information)]]
* [[Daunorubicin (patient information)]]
* [[Decompression sickness]]
* [[Deferasirox (patient information)]]
* [[Defibrotide]]
* [[Dehydration]]
* [[Dengue fever]]
* [[Depression]]
* [[Dextroamphetamine and Amphetamine (patient information)]]
* [[Dextromethorphan]]
* [[Dextropropoxyphene]]
* [[Diabetes mellitus]]
* [[Diabetic gastroparesis]]
* [[Diabetic Ketoacidosis]]
* [[Diabetic nephropathy]]
* [[Diarrhea]]
* [[Diarrheal shellfish poisoning]]
* [[Diazepam]]
* [[Diazinon]]
* [[Dicofol]]
* [[Dientamoebiasis]]
* [[Diethyl ether]]
* [[Diethylcathinone]]
* [[Diflunisal]]
* [[Digitalis purpurea]]
* [[Digitoxin]]
* [[Digoxin]]
* [[Dioxathion]]
* [[Dioxin]]
* [[Diphtheria]]
* Disagreeable sights, smells or thoughts (such as decayed matter, others' vomit, thinking of vomiting), etc.
* [[Disulfiram]]
* [[Disulfiram (patient information)]]
* [[Diuretic]]
* [[Diverticulitis]]
* [[Docetaxel (patient information)]]
* [[Dofetilide (patient information)]]
* [[Dolasetron (patient information)]]
* [[Domperidone]]
* [[Donepezil (patient information)]]
* [[Dopaminergic]]
* [[Dosulepin hydrochloride]]
* [[Doxorubicin]]
* [[Droperidol]]
* [[DTPA]]
* [[Duke's disease]]
* [[Duloxetine]]
* [[Dumping syndrome]]
* [[Dysmenorrhea]]
* [[Dysmenorrhea]]
* [[Ear infection]]
* [[Ebola]]
* [[Edema]]
* [[Emergency contraception]]
* [[Emetine]]
* [[Emetrol]]
* [[Encephalitis]]
* [[Endometriosis]]
* [[Endoscopic retrograde cholangiopancreatography]]
* [[Endosulfan]]
* [[Enema]]
* [[Enfuvirtide]]
* [[Entecavir (patient information)]]
* [[Enteric Neuropathy]]
* [[Entheogens]]
* [[Eosinophilic gastroenteritis]]
* [[Ependymoma]]
* [[Epiploic appendagitis]]
* [[Epirubicin Injection (patient information)]]
* [[Episodic ataxia]]
* [[Epistaxis]]
* [[Epoetin Alfa Injection (patient information)]]
* [[Ergotism]]
* [[Erlotinib (patient information)]]
* Erotic vomiting
* [[Erythromycin]]
* [[Esophageal cancer]]
* [[Esophageal diverticulum]]
* [[Esophageal stenosis]]
* [[Esophagitis]]
* [[Essure]]
* [[Estradiol]]
* [[Estrogen and Progestin (Oral Contraceptives) (patient information)]]
* [[Ethcathinone]]
* [[Ethchlorvynol]]
* [[Ethosuximide]]
* [[Ethyl carbamate]]
* [[Ethylmorphine]]
* [[Etidronate (patient information)]]
* [[Etoposide]]
* [[Exenatide]]
* [[Exercise induced nausea]]
* [[Exercise urticaria]]
* Extreme pain
* [[Familial hemiplegic migraine]]
* [[Felbamate (patient information)]]
* [[Fentanyl Oral Transmucosal (patient information)]]
* [[Fexofenadine]]
* [[Fexofenadine and Pseudoephedrine (patient information)]]
* [[Filgrastim (patient information)]]
* [[Fioricet]]
* [[Floxuridine (patient information)]]
* [[Flu]]
* [[Fluconazole]]
* [[Flucytosine]]
* [[Fludarabine Phosphate (patient information)]]
* [[Fluorescein]]
* [[Fluoride poisoning]]
* [[Fluorouracil (patient information)]]
* [[Flurazepam]]
* [[Flutamide (patient information)]]
* [[Food allergies]]
* [[Food poisoning]]
* [[Foodborne illness]]
* [[Foreign bodies]]
* [[Fructose intolerance]] [[hypoglycemia]]
* [[Fulvestrant Injection (patient information)]]
* [[Fundic gland polyposis]]
* [[Gabapentin (patient information)]]
* [[Gall bladder]] disorders
* [[Gallstone]]
* [[Gamma-Hydroxybutyric acid]]
* [[Gastric carcinoma]]
* [[Gastric dumping syndrome]]
* [[Gastric outlet obstruction]]
* [[Gastritis]]
* [[Gastritis]] (inflammation of the gastric wall, usually by viruses)
* [[Gastrocolic fistula]]
* [[Gastroenteritis]]
* [[Gastroesophageal reflux disease]]
* [[Gastrointestinal perforation]]
* [[Gastroparesis]]
* [[Gatifloxacin (patient information)]]
* [[Gatifloxacin Injection (patient information)]]
* [[Gefitinib (patient information)]]
* [[Gemcitabine Hydrochloride (patient information)]]
* [[Gemeprost]]
* [[General anaesthesia]]
* [[Gestational diabetes]]
* [[Giardia lamblia]]
* [[Ginger]]
* [[Gingerol]]
* [[Ginkgo]]
* [[Glaucoma]]
* [[Glioblastoma multiforme]]
* [[Glioma]]
* [[Glycylcycline]]
* [[Goserelin (patient information)]]
* [[Graft-versus-host disease]]
* [[Granisetron (patient information)]]
* [[Granisetron Hydrochloride Injection (patient information)]]
* [[Green Tobacco Sickness]]
* [[Grifulvin V]]
* [[Guaifenesin]]
* [[H1 antihistamine]]
* [[Haloperidol Oral (patient information)]]
* [[Hangover]]
* [[Hantavirus pulmonary syndrome]]
* [[Head and neck cancer]]
* [[Head injury]]
* [[Head trauma]]
* [[Heart attack]]
* [[Heart failure]]
* [[Heat stroke]]
* [[Heavy metal ingestion]]
* [[Helicobacter pylori infection]]
* [[HELLP syndrome]]
* [[Hematemesis]]
* [[Hemicrania continua]]
* [[Hemorrhage]]
* [[Henipavirus]]
* [[Hepatic coma]]
* [[Hepatic porphyria]]
* [[Hepatitis]]
* [[Hepatitis B]]
* [[Hepatitis E]]
* [[Herkinorin]]
* [[Hernia]]
* [[Heroin]]
* High doses of [[ionizing radiation]]
* [[HIV]]
* [[Hookworm]]
* [[Hormone replacement therapy (trans)]]
* [[Human ehrlichiosis]]
* [[Hydralazine]]
* [[Hydrocephalus]]
* [[Hydrochloride]]
* [[Hydrochlorothiazide]]
* [[Hydrocodone]]
* [[Hydromorphone]]
* [[Hydroxychloroquine]]
* [[Hydroxyurea (patient information)]]
* [[Hydroxyzine (patient information)]]
* [[Hypercalcemia]]
* [[Hyperemesis gravidarum]]
* [[Hypermagnesemia]]
* [[Hyperparathyroidism]]
* [[Hypertension]]
* [[Hyperthermia]]
* [[Hyperthyroidism]]
* [[Hypervitaminosis A]]
* [[Hypocalcemia]]
* [[Hypocholermia]]
* [[Hypoglycemia]]
* [[Hypokalemia]]
* [[Hyponatremia]]
* [[Hysterical contagion]]
* [[Iatrogenesis]]
* [[Ibogaine]]
* [[Ibuprofen]]
* [[Idarubicin (patient information)]]
* [[Idiopathic]]
* [[Ifosfamide (patient information)]]
* [[Ileus]]
* [[Imatinib (patient information)]]
* [[Imipenem]]
* [[Inappetence]]
* [[Indometacin]]
* [[Inflammation]] in the area of the vestibular organ
* [[Influenza]]
* [[Instillation abortion]]
* [[Insulin]]
* [[Interstitial nephritis]]
* [[Intestinal parasite]]
* [[Intussusception (medical disorder)]]
* [[Iodomethane]]
* [[Iron poisoning]]
* [[Iron(II) sulfate]]
* [[Irritable bowel syndrome]]
* [[Irukandji syndrome]]
* [[Ischemic bowel]]
* [[Isoniazid]]
* [[Isopropyl alcohol]]
* [[Isosorbide mononitrate]]
* [[Itraconazole]]
* [[Japanese Encephalitis]]
* [[Japanese Encephalitis Vaccine (patient information)]]
* [[Kaopectate]]
* [[Kaposi's sarcoma]]
* [[Kayser-Fleischer ring]]
* [[Ketogenic diet]]
* [[Ketorolac]]
* [[Ketotic hypoglycemia]]
* [[Kidney failure]]
* [[Kidney stone]]
* [[Kinetosis]]
* [[La Crosse encephalitis]]
* [[Labyrinthitis]]
* [[Lactose intolerance]]
* [[Lanreotide]]
* [[Lassa fever]]
* [[Lead poisoning]]
* [[Letrozole (patient information)]]
* [[Leuprolide (patient information)]]
* [[Levodopa and Carbidopa (patient information)]]
* [[Levonantradol]]
* [[Lewisite]]
* [[Lightheadedness and Vertigo]]
* [[Lindane]]
* [[Lingzhi]]
* [[Listeria monocytogenes]]
* [[Lithium nitrate]]
* [[Lobelia]]
* [[Lomotil]]
* [[Lopinavir]]
* [[Loprazolam]]
* [[Lorazepam]]
* [[Lower respiratory tract infection]]
* [[Magnesium citrate]]
* [[Malaria]]
* [[Malaria prophylaxis]]
* [[Malignant hypertension]]
* [[Malingering]]
* [[Marine toxins]]
* [[Mastocytosis]]
* [[Mazindol]]
* [[Mechlorethamine (patient information)]]
* [[Meclizine]]
* [[Medazepam]]
* [[Medical cannabis]]
* [[Medications]]
* [[Megestrol (patient information)]]
* [[Melarsoprol]]
* [[Melphalan (patient information)]]
* [[Ménière's disease]]
* [[Meningitis]]
* [[Meningococcal Infections]]
* [[Meningococcemia]]
* [[Meningoencephalitis]]
* [[Mercaptopurine]]
* [[Meropenem]]
* [[Mesalamine (patient information)]]
* [[Mescaline]]
* [[Mesenteric infarction]]
* [[Mesenteric ischemia]]
* [[Mesna (patient information)]]
* [[Metabolic acidosis]]
* [[Metal fume fever]]
* [[Metformin]]
* [[Methadone]]
* [[Methotrexate]]
* [[Methylergonovine]]
* [[Methylketobemidone]]
* [[Methylphenidate]]
* [[Methyprylon]]
* [[Metoclopramide]]
* [[Metronidazole]]
* [[Mifepristone]]
* [[Migraine]]
* [[Migraleve]]
* [[Milk of Magnesia]]
* [[Miltefosine]]
* [[Minimally Invasive Thorasic Spinal Fusion]]
* [[Mirtazapine]]
* [[Misoprostol]]
* [[Mitomycin (patient information)]]
* [[Mitotane]]
* [[Mitoxantrone]]
* [[Moclobemide]]
* [[Monocrotophos]]
* [[Montezuma's Revenge (illness)]]
* [[Mood stabilizer]]
* [[MOPP (medicine)]]
* [[Morning sickness]]
* [[Morphine]]
* [[Motion sickness]]
* [[Motofen]]
* [[Moxifloxacin]]
* [[Multiple chemical sensitivity]]
* [[Murray Valley encephalitis virus]]
* [[Mushroom poisoning]]
* [[Mycophenolic acid]]
* [[Myocardial infarction]]
* [[Nabilone]]
* [[Naegleria fowleri]]
* [[Nafcillin]]
* [[Nalbuphine]]
* [[Nalmefene]]
* [[Naloxone]]
* [[Naphthalene]]
* [[Natamycin]]
* [[Nerve agent]]
* [[Nervousness]]
* [[N-Ethyl-3-piperidyl benzilate]]
* [[Nicorandil]]
* [[Nicotine]]
* [[Nicotine poisoning]]
* [[Nilutamide (patient information)]]
* [[Nitrazepam]]
* [[N-Methyl-3-piperidyl benzilate]]
* [[N-Nitroso-N-Methylurea]]
* [[Non-Hodgkin lymphoma]]
* [[Non-steroidal anti-inflammatory drug]]
* [[Nootropic]]
* [[Norelgestromin and ethinyl estradiol transdermal system (patient information)]]
* [[Normal pressure hydrocephalus]]
* [[Norovirus]]
* [[Norplant]]
* [[Nortriptyline (patient information)]]
* [[Norwalk Virus]]
* [[Nutcracker syndrome]]
* [[Obidoxime]]
* [[Olanzapine (patient information)]]
* [[Omeprazole (patient information)]]
* [[Ondansetron]]
* [[Opioid]]
* [[Oral rehydration therapy]]
* [[Orellanine]]
* [[Orthostatic]] reaction
* [[Oseltamivir (patient information)]]
* [[Osteosarcoma]]
* [[Otitis interna]]
* [[Ovarian cyst]]
* [[Ovarian hyperstimulation syndrome]]
* [[Ovarian torsion]]
* [[Oxaliplatin]]
* [[Oxamniquine]]
* [[Oxazepam]]
* [[Oxcarbazepine]]
* [[Oxybutynin (patient information)]]
* [[Oxycodone and aspirin (patient information)]]
* [[Paclitaxel]]
* [[Paliperidone (patient information)]]
* [[Palonosetron]]
* [[Pancreatitis]]
* [[Panic attack]]
* [[Paracetamol]]
* [[Pegaspargase (patient information)]]
* [[Pemetrexed injection (patient information)]]
* [[Penicillin]]
* [[Pentamidine]]
* [[Pentavalent antimonial]]
* [[Pentetic acid]]
* [[Pentostatin (patient information)]]
* [[Peptic ulcer]]
* [[Pergolide (patient information)]]
* [[Perhexiline]]
* [[Peritonitis]]
* [[Pesticide]]
* [[Pfiesteria piscicida]]
* [[PFPP]]
* [[Phenelzine (patient information)]]
* [[Phentermine]]
* [[Pholcodine]]
* [[Phytohaemagglutinin]]
* [[Pioglitazone (patient information)]]
* [[Piribedil]]
* [[Plicamycin (patient information)]]
* [[PMA]]
* [[Pneumonia]]
* [[Polio]]
* [[Poliomyelitis]]
* [[Porphyria]]
* [[Posaconazole (patient information)]]
* [[Post-concussion syndrome]]
* [[Post-exposure prophylaxis]]
* [[Postoperative nausea and vomiting]]
* Postoperative pain
* Post-[[radiation therapy]]
* Post-tussive [[emesis]]
* Post-[[virus]]
* [[Potassium bromide]]
* [[Potassium chloride]]
* [[Praziquantel]]
* [[Pregabalin (patient information)]]
* [[Pregnancy]]
* [[Primaquine (patient information)]]
* [[Primary amoebic meningoencephalitis]]
* [[Primary hyperparathyroidism]]
* [[Pro re nata]]
* [[Procainamide (patient information)]]
* [[Procarbazine (patient information)]]
* [[Prochlorperazine]]
* [[Prochlorperazine (patient information)]]
* [[Prolactinoma]]
* [[Propiram]]
* [[Propylketobemidone]]
* [[Prosidol]]
* [[Protriptyline (patient information)]]
* Pseudo-[[obstruction]]
* [[Psychogenic]] [[vomiting]]
* [[Pulmonary embolism]]
* [[Pyelonephritis]]
* [[Pyloric stenosis]]
* [[Pyrazinamide]]
* [[Pyridoxine deficiency]]
* [[Q fever]]
* [[Quetiapine (patient information)]]
* [[Quinupristin/dalfopristin]]
* [[Radiation poisoning]]
* [[Ranolazine (patient information)]]
* [[Rasagiline (patient information)]]
* [[Refractive error]]
* [[Relapsing fever]]
* [[Renal colic]]
* [[Renal failure]]
* [[Reserpine]]
* [[Reye's syndrome]]
* [[Risedronate (patient information)]]
* [[Rituximab injection (patient information)]]
* [[Rivastigmine (patient information)]]
* [[Rizatriptan (patient information)]]
* [[Rocky Mountain spotted fever]]
* [[Ropinirole (patient information)]]
* [[Rotigotine]]
* [[Roxithromycin]]
* [[Rubbing alcohol]]
* [[Salpingitis]]
* [[Salsalate (patient information)]]
* [[Sarin]]
* [[Sativex]]
* [[Scarlet fever]]
* [[Scleroderma]]
* [[Scopolamine patch (patient information)]]
* [[Seasickness]]
* [[Secobarbital]]
* [[Selective serotonin reuptake inhibitor]]
* [[Selegiline (patient information)]]
* [[Seliciclib]]
* [[Serotonin]]
* Sexual fetish (emetophilia)
* [[Shigella]]
* [[Sibutramine (patient information)]]
* [[Ski sickness]]
* [[Sleep deprivation]]
* [[Slone's Disease]]
* [[Small bowel bacterial overgrowth syndrome]]
* [[Small intestine cancer]]
* [[Smoke inhalation]]
* [[Snakebites]]
* [[Soapwort]]
* [[Sodium polystyrene sulfonate (patient information)]]
* [[Sodium stibogluconate]]
* [[Solanine]]
* [[Sorafenib (patient information)]]
* [[Space adaptation syndrome]]
* [[Spider bite]]
* [[Spironolactone (patient information)]]
* [[Splenic infarction]]
* Spoiled foods
* [[Spontaneous bacterial peritonitis]]
* [[Sporotrichosis]]
* [[Spotted fever]]
* [[SSRI discontinuation syndrome]]
* [[Staphylococcal enteritis]]
* [[Statins (patient information)]]
* [[Stem cell transplantation]]
* [[Stiripentol]]
* [[Stomach cancer]]
* [[Strep throat]]
* [[Streptozocin (patient information)]]
* [[Subdural hematoma]]
* Sub[[ileus]]
* [[Substance P]]
* [[Sufentanil]]
* [[Sultiame]]
* [[Sumatriptan injection (patient information)]]
* [[Sumatriptan oral and nasal (patient information)]]
* [[Sunitinib (patient information)]]
* [[Suramin]]
* [[Syndrome of inappropriate antidiuretic hormone]] (SIADH)
* [[Tabes dorsalis]]
* [[Tacrine]]
* [[Tapentadol]]
* [[Telbivudine (patient information)]]
* [[Telithromycin (patient information)]]
* [[Temik]]
* [[Temozolomide]]
* [[Teniposide (patient information)]]
* [[Testicular rupture]]
* [[Testicular torsion]]
* [[Tetanus, Diphtheria, and Pertussis (Tdap) Vaccine (patient information)]]
* [[Tetrahydrocannabinol]]
* [[Tetrahydrozoline]]
* [[Tetramethylsuccinonitrile]]
* [[Tetrodotoxin]]
* [[Theobromine]]
* [[Thiabendazole]]
* [[Thiethylperazine]]
* [[Thioguanine (patient information)]]
* [[Thiotepa (patient information)]]
* [[Thrombotic thrombocytopenic purpura]]
* [[Thyroid Medication (patient information)]]
* [[Thyrotoxicosis]]
* [[Tigecycline]]
* [[Tobacco]] [[smoking]] and [[second-hand smoke]]
* [[Tocopherol]]
* [[Tolcapone (patient information)]]
* [[Tolmetin]]
* [[Topiramate]]
* [[Topotecan Hydrochloride (patient information)]]
* [[Toxin|Toxic ingestions]]
* [[Toxidrome]]
* [[Tralomethrin]]
* [[Tramadol]]
* [[Trandolapril]]
* [[Trastuzumab]]
* [[Traumatic brain injury]]
* [[Traveler's diarrhea]]
* [[Trazodone]]
* [[Triamterene]]
* [[Triazolam]]
* [[Triclofos]]
* [[Tricyclic antidepressant]]
* [[Trifluoperazine]]
* [[Trifluoromethylphenylpiperazine]]
* [[Trimeperidine]]
* [[Trimethobenzamide (patient information)]]
* [[Trimetrexate Glucuronate (patient information)]]
* [[Tropisetron]]
* [[Trovafloxacin (patient information)]]
* [[Tularemia]]
* Twisted [[ovarian cyst]]
* [[Typhoid Vaccine (patient information)]]
* [[Typhus]]
* [[Ulcers]]
* [[Uremia]]
* [[Urofollitropin]]
* [[Urolithiasis]]
* [[Vagal episode]]
* [[Vagotomy]]
* [[Valaciclovir]]
* [[Valproic Acid (patient information)]]
* [[Varenicline]]
* [[Vasovagal syncope]]
* [[Venlafaxine]]
* [[Vertebro-basilar syndrome]]
* [[Vertigo]]
* [[Vestibular balance disorder]]
* [[Vestibular neuritis]]
* [[Vestibular neuronitis]]
* [[Vibrio parahaemolyticus]]
* [[Vicodin]]
* [[Vidarabine]]
* [[Vigabatrin]]
* [[Viloxazine]]
* [[Vinblastine (patient information)]]
* [[Vinorelbine Tartrate (patient information)]]
* Violent emotions (including laughing)
* Violent fits of coughing or hiccups
* [[Viral hepatitis]]
* [[Viral Hepatitis B]]
* [[Viral Hepatitis D]]
* [[Viral Hepatitis E]]
* [[Vitamin]]
* [[Vitamin A]]
* [[Vitamin B6]]
* [[Vitamin C]]
* [[Vitamin D]]
* [[Volvulus]]
* [[Voriconazole]]
* [[Vorinostat (patient information)]]
* [[Water intoxication]]
* [[Waterborne diseases]]
* [[West Nile virus]]
* [[Yellow fever]]
* [[Yuzpe regimen]]
* [[Zanamivir Inhalation (patient information)]]
* [[Ziprasidone (patient information)]]
* [[Zollinger-Ellison Syndrome]]
* [[Zolpidem (patient information)]]
* [[Zopiclone]]


===Complete Differential Diagnosis of the Causes of Nausea and Vomiting (by organ system)===
==[[Nausea and vomiting risk factors|Risk Factors]]==
                           
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |[[Acute Coronary Syndromes]], [[Amyloidosis]], [[Anastomosis]] [[stenosis]], [[Angina pectoris]], [[Aortic Arch Anomalies]], [[Cardiac arrhythmia]], [[Cerebral aneurysm]], [[Cerebral arteriovenous malformation]], [[Cerebrovascular disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
|bgcolor="Beige"| [[1,2-Dichloroethene]], [[1,3-Dichloropropene]] , [[Aconitine]] , [[Adamsite]], [[Bromomethane]], [[Butanethiol]], [[Capsaicin]], [[Carbon monoxide poisoning]], [[Chloromethane]], [[Ciguatera]], [[Cinchonism]]
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[2C-E]], [[2C-I]], [[2C-T-7]], [[5-Hydroxytryptophan]], [[5-MeO-AMT]], [[ABVD]], [[Acetoxyketobemidone]], [[Acetylcysteine]], [[Acetylsalicylic acid]], [[Aciclovir]], [[Alatrofloxacin Injection (patient information)|Alatrofloxacin]], [[Albuterol Inhalation (patient information)|Albuterol]], [[Aldesleukin (patient information)|Aldesleukin]] , [[Allylprodine]], [[Alpha-Methyltryptamine]], [[Alprazolam]], [[Altretamine]], [[Amifostine]], [[Amineptine]], [[Aminocaproic acid]], [[Aminopterin]], [[Aminosalicylic acid]], [[Amitriptyline (patient information)|Amitriptyline]], [[Amoxicillin]], [[Amphotericin B]], [[Amrinone]], [[Amyl nitrite]], [[Anadenanthera peregrina]], [[Analgesic]], [[Anastrozole (patient information)|Anastrozole]], [[Anesthesia]], [[Antihistamine]], [[Antiretroviral drug]], [[Aripiprazole (patient information)|Aripiprazole]], [[Asparaginase (patient information)|Asparaginase]], [[Atomoxetine]], [[Auranofin]], [[Azithromycin]], [[Aztreonam]], [[Barbiturate]], [[Barium Sulfate (patient information)|Barium sulfate]], [[Belladonna Alkaloid Combinations and Phenobarbital (patient information)|Belladonna alkaloid combinations and phenobarbital]], [[Benzodiazepine]], [[Benzylpiperazine]], [[Beta-lactam antibiotic]], [[Bevacizumab Injection (patient information)|Bevacizumab]], [[Bezafibrate (patient information)|Bezafibrate]], [[Bicalutamide (patient information)|Bicalutamide]], [[Bleomycin (patient information)|Bleomycin]], [[Bortezomib (patient information)|Bortezomib]], [[Bromelain]], [[Bronchodilator]], [[Buprenorphine]], [[Busulfan (patient information)|Busulfan]], [[Butorphanol]], [[Cabergoline]], [[Calcitriol]], [[Calcium carbamide]], [[Capecitabine (patient information)|Capecitabine]], [[Carboplatin (patient information)|Carboplatin]], [[Carmustine (patient information)|Carmustine]], [[Carprofen]], [[Carvedilol (patient information)|Carvedilol]], [[Caspofungin]], [[Cefaclor]], [[Cefoperazone Sodium Injection (patient information)|Cefoperazone sodium]], [[Cefuroxime]], [[Cephalosporin]], [[Cetuximab Injection (patient information)|Cetuximab]], [[Cevimeline]], [[Chelation therapy]], [[Chemotherapy]], [[Chlordiazepoxide]], [[Chlorothiazide]], [[Chlorpropamide]], [[CHOP]], [[Cimicifuga racemosa]], [[Cisplatin]], [[Cladribine (patient information)]], [[Clarithromycin]], [[Clindamycin]], [[Clofarabine]], [[Clofibrate]], [[Clomifene]], [[Clorazepate]], [[Co-codamol]], [[Codeine]], [[Combined oral contraceptive pill]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| [[Acromegaly]], [[Addison's Disease]], [[Adrenal failure]],
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| [[Bothrops|Bothrops bite]], [[Bromomethane]], [[Carbon monoxide poisoning]]
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Achalasia]], Acute abdomen and/or [[peritonitis]], [[Accessory pancreas]] , [[Acute fatty liver of pregnancy]], [[Acute pancreatitis]], [[Adjustable gastric band]], [[Afferent loop syndrome]], [[Alcoholic Hepatitis]], [[Alcoholism]], [[Anastomosis]] [[stenosis]], [[Appendicitis]], [[Bacterial gastroenteritis]], [[Beef tapeworm]], [[Biliary colic]], [[Blastocystosis]], [[Bowel obstruction]], [[Brucella]], [[Bulimia nervosa]], [[Caecitis]], [[Cholecystitis]], [[Cholecystolithiasis]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Cerebral hemorrhage]], [[Cholecystitis]], [[Cholecystolithiasis]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| Acute [[infections]], [[Acute prostatitis]], [[Acute viral nasopharyngitis (common cold)]], [[AIDS]], [[Asceptic Meningitis]], [[Astrovirus]], [[Bacterial gastroenteritis]], [[Bacillus cereus|Bacillus cereus infection]], [[Barcoo Fever]], [[Blastocystosis]], [[Brucella]], [[Colorado tick fever]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Acoustic neuroma]] , [[Arachnoid cyst]], [[Asceptic Meningitis]], [[Autonomic neuropathy]], [[Balance disorder]], Benign intracranial [[hypertension]] and [[hydrocephalus]], [[Brain]] [[radiation]], [[Brain Stem Gliomas]], [[Brain tumor]], [[Cerebral aneurysm]], [[Cerebral arteriovenous malformation]], [[Cerebral hemorrhage]], [[Cerebral shunt|Cerebral shunt (blocked)]], [[Cerebrovascular disease]], [[Chronic fatigue syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| [[Amnesic shellfish poisoning]], [[Bacillus cereus|Bacillus cereus infection]], [[Beef tapeworm]], [[Cicuta]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| [[Acute fatty liver of pregnancy]], [[Breastfeeding complications]], [[Childbirth]]
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[Acoustic neuroma]], [[Brain Stem Gliomas]], [[Brain tumor]], [[Cancer]]
|-
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"| [[1,2-Dichloroethene]], [[1,3-Dichloropropene]], [[2C-E]], [[2C-I]], [[2C-T-7]], [[Abrin]], [[ABVD]], [[Acetaminophen (patient information)]], [[Acetoxyketobemidone]], [[Acetylsalicylic acid]], [[Aconitine]], [[Aminopterin]], [[Antihistamine]], [[Arsenic Poisoning]], [[Aspirin]], [[Barium oxalate]], [[Beleric]], [[Bupropion]], [[Chloral hydrate]], [[CHOP]], [[Cinchonism]]
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| [[Alcohol Withdrawal]], [[Anorexia nervosa]], [[Anxiety]], [[Bulimia nervosa]], [[Combat stress reaction]]
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"| [[Adrenal failure]], [[Adrenal insufficiency]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Amyloidosis]], [[Chronic fatigue syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| [[AIDS]]
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| [[Acute prostatitis]], [[Adrenal failure]], [[Adrenal insufficiency]]
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| Acute [[high altitude sickness]], [[Airsickness]]
|-
|}


==Pathophysiology of nausea and vomiting==
==[[Nausea and vomiting natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


=== Vomiting center ===
==Diagnosis==
Vomiting is coordinated in the vomiting center in the lateral medullary [[reticular formation]] in the [[pons]]. Receptors on the floor of the [[fourth ventricle]] of the brain represent a [[chemoreceptor trigger zone]], stimulation of which can lead to vomiting. The chemoreceptor zone lies outside the [[blood-brain barrier]], and can therefore be stimulated by blood-borne drugs that can [[Vomiting#Emetics|stimulate vomiting]], or [[Vomiting#Antiemetics|inhibit it]].
[[Nausea and vomiting history and symptoms|History and Symptoms]] | [[Nausea and vomiting physical examination|Physical Examination]] | [[Nausea and vomiting laboratory findings|Laboratory Findings]] | [[Nausea and vomiting electrocardiogram|Electrocardiogram]] | [[Nausea and vomiting x ray|X Ray]] | [[Nausea and vomiting CT|CT]] | [[Nausea and vomiting MRI|MRI]] | [[Nausea and vomiting echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Nausea and vomiting other imaging findings|Other Imaging Findings]] | [[Nausea and vomiting other diagnostic studies|Other Diagnostic Studies]]


There are various sources of input to the vomiting center:
==Treatment==
*The chemoreceptor trigger zone at the base of the fourth ventricle has numerous [[Dopamine receptor D2|dopamine D<sub>2</sub> receptors]], [[5-HT receptor|serotonin 5-HT<sub>3</sub> receptors]], [[opioid receptor]]s, [[Acetylcholine receptor]]s, and receptors for [[substance P]]. Stimulation of different receptors are involved in different pathways leading to emesis, in the final common pathway substance P appears to be involved.<ref>Hornby PJ. Central neurocircuitry associated with emesis. Am J Med 2001;111:106S-12S. PMID 11749934.</ref> 
[[Nausea and vomiting medical therapy|Medical Therapy]] | [[Nausea and vomiting surgery|Surgery]] | [[Nausea and vomiting primary prevention|Primary Prevention]] | [[Nausea and vomiting secondary prevention|Secondary Prevention]] | [[Nausea and vomiting cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Nausea and vomiting future or investigational therapies|Future or Investigational Therapies]]
*The vestibular system which sends information to the brain via [[cranial nerve VIII]] (vestibulocochlear nerve).  It plays a major role in [[motion sickness]] and is rich in [[Muscarinic acetylcholine receptor|muscarinic receptors]] and [[histamine receptor|histamine H<sub>1</sub> receptors]].
*[[Vagus nerve|Cranial nerve X]] (vagus nerve), which is activated when the pharynx is irritated, leading to a gag reflex.
*Vagal and [[enteric nervous system]] inputs that transmit information regarding the state of the [[gastrointestinal system]]. Irritation of the GI mucosa by chemotherapy, radiation, distention or acute infectious [[gastroenteritis]] activates the 5-HT<sub>3</sub> receptors of these inputs.
*The CNS mediates vomiting arising from psychiatric disorders and stress.


=== Vomiting Act ===
==Case Studies==
The vomiting act encompasses three types of outputs initiated by the medulla: Motor, [[parasympathetic nervous system]] (PNS) and [[sympathetic nervous system]] (SNS). Collectively, they are as follows:


*Increased [[saliva]]tion to protect the [[tooth enamel|enamel]] of [[teeth]] from stomach acids (excessive vomiting leads to [[dental caries|caries]]). This is part of the PNS output.
[[Nausea and vomiting case study one|Case #1]]
*[[Retroperistalsis]], starting from the middle of the [[small intestine]], sweeping up the contents of the digestive tract into the stomach, through the relaxed pyloric sphincter.
*A lowering of intrathoracic pressure (by inspiration against a closed [[glottis]]), coupled with an increase in abdominal pressure as the [[abdomen|abdominal muscles]] contract, propels stomach contents into the [[esophagus]] without involvement of retroperistalsis. The [[cardia|lower esophageal sphincter]] relaxes. This is part of the motor output, and it is also important to note that the stomach itself does not contract in the process of vomiting.
*Vomiting is ordinarily preceded by [[retching]].
*Vomiting also initiates a SNS response causing both sweating and increased heart rate.


The [[neurotransmitter]]s that regulate vomiting are poorly understood, but inhibitors of [[dopamine]], [[histamine]] and [[serotonin]] are all used to suppress vomiting, suggesting that these play a role in the initiation or maintenance of a vomiting cycle. [[Vasopressin]] and neurokinin may also participate.
===Content===
Since the stomach secretes acid, vomit contains a high concentration of [[hydronium|hydronium ion]]s and is thus strongly acidic. Recent food intake will be reflected in the gastric vomit.
The content of the '''vomitus''' (vomit) may be of medical interest. Fresh [[blood]] in the vomit is termed [[hematemesis]] ("blood vomiting"). Old blood bears resemblance to coffee grounds (as the [[iron]] in the blood is [[oxidation|oxidized]]), and when this matter is identified the term "coffee ground vomiting" is used. [[Bile]] can enter the vomit during subsequent heaves due to [[duodenum|duodenal]] contraction if the vomiting is severe. [[Fecal vomiting]] is often a consequence of [[intestinal obstruction]], and is treated as a warning sign of this potentially serious problem ("signum mali ominis"); such vomiting is sometimes called "miserere". If food has recently been consumed, then partly digested food may show up in the vomit.
If the vomiting reflex continues for an extended period of time with no appreciable vomitus, the condition is known as '''non-productive emesis''' or '''dry heaves''', which can become both extremely painful and debilitating.
== Diagnosis ==
== Physical Examination ==
* Exams should include:
*:* Neurologic
*:* Ear
*:* Ophthalmagic
*:* Abdominal
== Laboratory Findings ==
* [[Complete blood count]] (CBC)
* [[Electrolytes]]
* [[Liver function tests]] (LFTs)
* [[Amylase]]
* [[Lipase]]
* [[Calcium]]
* [[Magnesium]]
* [[Salicylate]] level
* [[Hepatitis]] serologies
* [[Cerebrospinal fluid]] (CSF) analysis
* Toxicology screen
=== Electrolyte and Biomarker Studies ===
* [[Electrolytes]]
=== Electrocardiogram ===
* [[ECG]] to rule out an inferior [[MI]] or arrhythmia
=== X Ray ===
* Plain kidney, ureter, bladder (KUB) X-rays
=== MRI and CT ===
* Abdominal [[CT scan]] (with oral and IV contrast)
* Head [[CT scan]]
=== Echocardiography or Ultrasound ===
* Abdominal/pelvic ultrasound
=== Other Diagnostic Studies ===
* [[Endoscopy]]
* [[Colonoscopy]]
== Treatment ==
* Fluid resuscitation (due to vomiting-induced dehydration)
* Treat underlying disease etiologies
===Treatment of Nausea===
While short-term nausea and vomiting are generally harmless, they may sometimes indicate a more serious condition, such as [[Coeliac disease]]. When associated with prolonged vomiting, it may lead to [[dehydration]] and/or dangerous electrolyte imbalances.
Symptomatic treatment for nausea and vomiting may include short-term avoidance of solid [[food]]. This is usually easy as nausea is nearly always associated with loss of [[appetite]]. Dehydration may require [[rehydration]] with oral or intravenous [[electrolyte]] solutions. If the cause is by [[motion sickness]], sitting down in a still environment may also help.
There are several types of [[antiemetic]]s, and  researchers continue to look for more effective treatments. The main types used post operatively for surgical patients are [[ondansetron]], [[dexamethasone]], [[promethazine]], [[diphenhydramine]], and in small doses [[droperidol]]. [[Doxylamine]] is the drug of choice in pregnancy-related nausea. Anecdotally, another remedy used by recovery room nurses is to place an [[isopropyl alcohol]] swab under the patient's nose while he or she breathes through the nose. This may abate the nausea until the antiemetic medication takes effect. When ingested or inhaled, the chemical compound [[tetrahydrocannabinol]] has been shown to reduce nausea in some users.<ref>{{cite web | url = http://www.drugpolicy.org/marijuana/medical/challenges/litigators/medical/conditions/nausea.cfm | title = Medicinal Uses of Marijuana: Nausea, Emesis and Appetite Stimulation | accessdate = 2007-08-02 | date = 2001 | author = Drug Policy Alliance}}</ref> Also available are a variety of non-invasive (often untested) mechanical devices used to suppress nausea due to motion sickness.
The spice [[ginger]] is also used for centuries as a folk remedy to treat nausea, and recent research has supported this use.<ref>{{cite web | title = Ginger | author = University of Maryland Medical Centre | url = http://www.umm.edu/altmed/ConsHerbs/Gingerch.html | accessdate = 2007-08-02 | date = 2006 }}</ref>
===Treatment of Vomiting===
=== Acute Pharmacotherapies ===
* Antiemetics: An [[antiemetic]] is a [[medication|drug]] that is effective against vomiting and [[nausea]]. Antiemetics are typically used to treat [[motion sickness]] and the [[Adverse effect (medicine)|side effects]] of some [[opioid]] [[analgesic]]s and [[chemotherapy]] directed against [[cancer]]. Antiemetics act by inhibiting the receptor sites associated with emesis. Hence, anticholinergics, antihistamines, dopamine antagonists, serotonin antagonists and cannabinoids are used as anti-emetics.
* Anticholinergics
=== Surgery and Device Based Therapy ===
* Colonoscopy/endoscopy may also be used as therapy
== Complications of vomiting ==
===Aspiration of vomit ===
Vomiting can be very dangerous if the gastric content gets into the respiratory tract. Under normal circumstances the [[gag reflex]] and [[coughing]] will prevent this from occurring, however these protective reflexes are compromised in persons under narcotic influences such as [[ethanol|alcohol]] or [[anesthesia]]. The individual may choke and [[asphyxiation|asphyxiate]] or suffer an [[aspiration pneumonia]].
=== Dehydration and electrolyte imbalance ===
Prolonged and excessive vomiting will deplete the body of water (dehydration) and may alter the electrolyte status. The loss of acids leads to [[metabolic alkalosis]] (increased blood [[pH]]), and the electrolyte imbalance shows [[hypokalemia]] ([[potassium]] depletion) and [[hypochloremia]] ([[chlorine]] depletion). The hypokalemia is an indirect result of the [[kidney]] compensating for the loss of acid. With the loss of intake of food the individual will become [[cachexia|cachectic]].
== References ==
{{reflist|2}}
==External links==
*[http://faq.emetophobia.net/emetophobia.html Emetophobia FAQ]
*[http://www.cvsa.org.uk Cyclical Vomiting Syndrome]
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[[Category:Primary care]]
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[[ar:قيء]]
[[da:Opkast]]
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[[es:Vómito]]
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[[eo:Vomado]]
[[fr:Vomissement]]
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[[it:Vomito]]
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[[hr:Povraćanje]]
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[[mk:Повраќање]]
[[nl:Braken (lichaamsfunctie)]]
[[ja:嘔吐]]
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[[pt:Emese]]
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[[pl:Wymioty]]
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[[ru:Рвота]]
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[[sk:Zvracanie]]
[[sr:Повраћање]]
[[fi:Oksennus]]
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[[uk:Блювання]]
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[[zh:呕吐]]
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Tayebah Chaudhry[2]; Associate Editor-In-Chief: M.Umer Tariq [3]

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