Causes
Common problems that may cause nausea and vomiting include:
- Food allergies
- Infections of the stomach or bowels, such as the "stomach flu" or food poisoning
- Leaking of stomach contents (food or liquid) upward (also called gastroesophageal reflux or GERD)
- Medicines 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
- Excessive use of marijuana
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
Definition
Nausea is feeling an urge to vomit. It is often called "being sick to your stomach."
Vomiting or throwing-up forces the contents of the stomach up through the food pipe (esophagus) and out of the mouth.
References
Crane BT, Kaylie DM. Central vestibular disorders. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 168.
Guttman J. Nausea and vomiting. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 25.
McQuaid KR. Approach to the patient with gastrointestinal disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 118.
What to Expect at Your Office Visit
Your provider will perform a physical exam and will look for signs of dehydration.
Your 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?
- Are other symptoms present such as 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 medicines 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?
- Do you use marijuana? If yes, how often do you use it?
Diagnostic tests that may be performed include:
- Blood tests (such as CBC with differential, blood electrolyte levels, and kidney and liver function tests)
- Urinalysis
- Imaging studies (ultrasound or CT) 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 fluids given through your veins (intravenous or IV).
When to Contact a Medical Professional
Call 911 or the local emergency number or go to an emergency room if you:
- Think the vomiting is from poisoning
- Notice blood or dark, coffee-colored material in the vomit
Call a 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 3 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