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Nausea and vomiting - adults


Definition:

Nausea is feeling an 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.

Alternative Names:

Emesis; Vomiting; Stomach upset; Upset stomach

Causes:

Many common problems may cause nausea and vomiting, including:

Nausea and vomiting may also be early warning signs of more serious medical problems, such as:

Home Care:

Once you and your doctor find the cause, you will want to know how to treat your nausea or vomiting. You may need to take medicine, change your diet, or try other things to make you feel better.

It is very important to keep enough fluids in your body. Try drinking frequent, small amounts of clear liquids.

If you have morning sickness during pregnancy, ask your doctor about possible treatments.

The following may help treat motion sickness:

  • Lying down.
  • Over-the-counter antihistamines, such as dimenhydrinate (Dramamine).
  • Using scopolamine prescription skin patches (such as Transderm Scop). These are helpful for extended trips, such as an ocean voyage. Use the patch as your doctor instructs. Scopolamine is for adults only. It should NOT be given to children.
When to Contact a Medical Professional:

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
What to Expect at Your Office Visit:

Your health care provider will perform a physical exam, and will 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?

The diagnostic tests may be performed:

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 fluids given through your veins (intravenous or IV).

References:

Malagelada J-R, Malagelada C. Nausea and vomiting. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Saunders Elsevier; 2010:chap 14.

Mcquaid K. Approach to the patient with gastrointestinal disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 134.


Review Date: 10/13/2013
Reviewed By: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, CA. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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