Nausea and Vomiting Health Article

Definition

Nausea is the sensation of being about to vomit. Vomiting, or emesis, is the expelling from the stomach of undigested food through the mouth.

Description

Nausea is a reaction to a number of causes that include overeating, infection, or irritation of the throat or stomach lining. Persistent or recurrent nausea and vomiting should be checked by a doctor.

A doctor should be called if nausea and vomiting occur in the following instances:

• after eating rich or spoiled food or taking a new medication
• repeatedly or for 48 hours or longer
• following intense dizziness

It is important to see a doctor if nausea and vomiting are accompanied by the following:

• yellowing of the skin and whites of the eyes
• pain in the chest or lower abdomen
• trouble with swallowing or urination
• dehydration or extreme thirst
• drowsiness or confusion
• constant, severe abdominal pain
• a fruity breath odor

Demographics

Nausea and vomiting are commonly experienced. There are no distinctive patterns of age, gender, or race.

Causes and symptoms

Persistent, unexplained, or recurring nausea and vomiting can be symptoms of a variety of serious illnesses. They can be caused by overeating or drinking too much alcohol. These symptoms can be due to stress, certain medications, or illness. For example, people who are given morphine or other opioid medications for pain relief after surgery sometimes feel nauseated by the drug. Such poisonous substances as arsenic and other heavy metals cause nausea and vomiting. Morning sickness is a consequence of pregnancy-related hormone changes. Motion sickness can be induced by traveling in a vehicle, plane, or on a boat. Many people experience nausea after eating spoiled food or foods to which they are allergic. Individuals who suffer migraine headache often experience nausea. Cancer patients receiving chemotherapy are often nauseated. Gallstones, gastroenteritis, and stomach ulcer may cause nausea and vomiting. These symptoms should be evaluated by a physician.

Nausea and vomiting may also be psychological in origin. Some people vomit under such conditions of emotional stress as family arguments, academic tests, airplane travel, losing a job, and similar high-stress situations. In addition, some eating disorders are characterized by self-induced vomiting.

When to call the doctor

A doctor should be notified if vomiting is heavy and/or bloody, if the vomitus looks like feces, or if the affected person has been unable to keep food down for 24 hours. Most vomiting episodes should stop in eight to 12 hours of onset. The pediatrician should be consulted if vomiting continues beyond that time, if the child shows signs of dehydration, seems extremely lethargic, or if the child is a very young infant.

An ambulance or emergency response number should be called immediately if the following occurs:

• The child's mouth and tongue are very dry.
• The child has very rapid heartbeat and breathing.
• The child cries but has no tears.
• The child has sunken eyes.
• Diabetic shock is suspected.
• Nausea and vomiting continue after other symptoms of viral infection have subsided.
• The person has a severe headache.
• The person is sweating and having chest pain and trouble breathing.
• The person is known or suspected to have swallowed a drug overdose or poisonous substance.
• The person has a high body temperature, muscle cramps, and other signs of heat exhaustion or heat stroke.
• Nausea, vomiting, and breathing problems occur after exposure to a known allergen.

Diagnosis

Diagnosis is based on the severity, frequency, and duration of symptoms, and other factors that could indicate the presence of a serious illness.

Diagnosis is based on a careful medical history that includes foods recently eaten, travel, and occupation. In some cases, the doctor may order laboratory tests or imaging studies to determine the presence of drugs or poisonous substances in the person's blood or urine, or evidence of head injuries or abnormalities in the digestive tract. If the nausea and vomiting appear to be related to anxiety, stress, or an eating disorder, the doctor may refer the person to a psychiatrist for further evaluation.