Nausea and Vomiting

Overview

Nausea is the uneasy, queasy sensation that you might be sick, while vomiting is the forceful bringing up of the contents of the stomach. They frequently occur together, although each can happen on its own. Both are common and usually short-lived, often caused by a passing stomach upset.

Nausea and vomiting are controlled by a part of the brain that responds to signals from the gut, the inner ear, the bloodstream, and the senses. This is why so many different things can trigger them, from infections and motion to medications, migraine, and pregnancy. Most episodes settle with simple measures, but persistent or severe vomiting can lead to dehydration, and some causes need prompt medical care. Vomiting is the body's way of removing something it perceives as harmful, which is why it often accompanies infections and food poisoning, but it can also be triggered by signals that have nothing to do with the stomach itself.

Common Causes

Nausea and vomiting can arise from many sources:

• Gastroenteritis: Viral or bacterial stomach infections are a very common cause. See gastroenteritis.
• Motion sickness: From travel by car, boat, or plane.
• Pregnancy: Morning sickness, especially in early pregnancy.
• Migraine: Often comes with nausea and vomiting.
• Medications and treatments: Such as some painkillers, antibiotics, and chemotherapy.
• Other causes: Food poisoning, inner-ear problems, cyclic vomiting syndrome, and, in babies, pyloric stenosis. More serious causes include appendicitis, bowel blockage, and raised pressure in the brain.

Associated Symptoms

Other symptoms occurring with nausea and vomiting help reveal the cause:

• Diarrhea and fever with stomach infections
• Abdominal pain or cramping
• Headache, sometimes severe, with migraine or brain causes
• Dizziness or a spinning sensation with inner-ear problems
• Signs of dehydration such as thirst, dry mouth, and reduced urination
• Warning signs such as blood in the vomit or a stiff neck

Diagnosis & Evaluation

A doctor will ask about how long symptoms have lasted, what the vomit contains, recent food and travel, medications, and the chance of pregnancy, then examine the abdomen and hydration.

• Pregnancy test: Where relevant.
• Blood and urine tests: To check hydration, salts, infection, and other causes.
• Imaging: Ultrasound or scans if a blockage, appendicitis, or other abdominal cause is suspected.
• Further tests: Such as brain imaging if neurological causes are a concern.

Treatment & Management

Most cases settle with self-care, while staying hydrated is the priority.

• Fluids: Take small, frequent sips of water or oral rehydration solution to replace losses and prevent dehydration.
• Rest and gradual eating: Rest the stomach, then reintroduce bland foods as nausea eases.
• Anti-sickness medicines: A doctor may prescribe these for severe or ongoing vomiting, or for specific causes.
• Treating the cause: Such as managing migraine, adjusting medications, or surgery for a blockage.
• Avoiding triggers: Strong smells, fatty foods, or motion, where these provoke symptoms.

Self-Care & Prevention

Many bouts of nausea and vomiting can be eased at home and some triggers avoided:

• Sip fluids slowly: Small, frequent sips of water or oral rehydration solution are better tolerated than large drinks.
• Eat bland foods: When ready, choose plain foods such as toast, crackers, rice, or bananas, and avoid fatty or strongly spiced meals.
• Rest and get fresh air: Resting and avoiding strong smells can settle the stomach.
• Prevent stomach infections: Wash hands well, especially before eating and after using the toilet, and handle and store food safely.
• Manage motion sickness: Sit where movement is felt least, focus on the horizon, and consider remedies advised by a pharmacist before travel.
• Try ginger: Some people find ginger helpful for mild nausea.

Throughout, watch for dehydration and seek care if you cannot keep fluids down.

When to See a Doctor

Seek emergency care immediately for nausea and vomiting with:

• Vomiting blood, or material that looks like coffee grounds
• Green or yellow (bile-stained) vomit
• Severe or constant abdominal pain
• A severe headache, stiff neck, confusion, or vomiting after a head injury
• Signs of significant dehydration, or inability to keep any fluids down

Also see a doctor for vomiting lasting more than a day or two in adults, any persistent vomiting in young children or babies, or vomiting with other worrying symptoms.

Related Topics

Frequently Asked Questions

References

1. Mayo Clinic. Nausea and vomiting — When to see a doctor.
2. MedlinePlus, U.S. National Library of Medicine. Nausea and vomiting.
3. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Symptoms and Causes of Gastroenteritis.