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Nausea and vomiting Health Article

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Call your health care provider if

Call 911 or go to an emergency room if you think vomiting is from poisoning or a child has taken aspirin.

Call if the person has:

Vomiting longer than 24 hours
Blood or bile in the vomit
Severe abdominal pain
Headache and stiff neck
Signs of dehydration

Signs of dehydration include:

Increased thirst
Infrequent urination or dark yellow urine
Dry mouth
Eyes that appear sunken
Crying without tears
Loss of normal skin elasticity (if you touch or squeeze the skin, it doesn't bounce back the way it usually does)

You should also call if:

A young child is lethargic or has marked irritability.
An infant vomits repeatedly.
A child is unable to retain any fluids for 8 hours or more.
Vomiting is recurrent.
An adult is unable to retain any fluids for 12 hours or more.
There is a decrease in urination (including a baby who is not wetting the normal amount of diapers).
Nausea persists for a prolonged period of time (in a person who is not pregnant).

What to expect at your health care provider's office

Your health care provider will perform a physical examination, particularly to look for signs of dehydration.

To help diagnose the cause of the nausea or vomiting, your doctor will ask medical history questions, such as:

Are you vomiting fresh blood? Do you have repeated episodes of vomiting blood?
Are you vomiting material that looks like coffee grounds?
Are you vomiting undigested food?
Are you vomiting greenish material?
Is the nausea or vomiting severe enough to cause unintentional weight loss?
Is the vomiting self-induced?
Have you been traveling? Where?
What medications do you take?
Did other people that ate at the same location as you have the same symptoms?
Are you pregnant or could you be pregnant?
When did the vomiting begin? How long has it lasted?
Does it occur several hours after meals?
What other symptoms are also present -- abdominal pain, fever, diarrhea, poor skin turgor, other signs of dehydration, abdominal swelling, headaches?

The following diagnostic tests may be performed:

Blood tests (such as CBC with differential and basic electrolytes)
Urinalysis
X-rays of the abdomen

If dehydration is severe, you may need intravenous fluids. This may require hospitalization, although it can often be done in the doctor's office. The use of antivomiting drugs (anti-emetics) is controversial, and they should be used only in severe cases.

Prevention

A number of medicines are effective at preventing vomiting. In some situations, preventing the vomiting makes life much better.

References

Koch KL. Nausea and vomiting during pregnancy. Gastroenterol Clin North Am. 2003; 32(1): 201-234, vi.

Quigley EM. AGA technical review on nausea and vomiting. Gastroenterology. 2001; 120(1): 263-286.

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Reviewer Info: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Jefferson Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network.; ADAM Health Illustrated Encyclopedia, 07/25/2007