Nausea and Vomiting
Nausea and vomiting are not diseases, but rather are symptoms of many different
conditions, such as infection ("stomach flu"), food poisoning, motion
sickness, overeating, blocked intestine, illness, concussion or brain injury,
appendicitis, and migraines. Nausea and vomiting can sometimes be symptoms of
more serious diseases such as heart attacks, kidney or liver disorders, central
nervous system disorders, brain tumors, and some forms of cancer.
What is the difference between nausea and vomiting?
Nausea
is an uneasiness of the stomach that often accompanies the urge to vomit, but
doesn't always lead to vomiting. Vomiting is the forcible voluntary or
involuntary emptying ("throwing up") of stomach contents through the
mouth. Some triggers that may result in vomiting can come from the stomach and
intestines (infection, injury, and food irritation), the inner ear (dizziness and
motion sickness), and the brain (head injury, brain infections, tumors, and
migraine headaches).
Who is more likely to experience nausea and vomiting?
Nausea and vomiting can occur in both children and adults. People who
are undergoing cancer treatments, such as radiation therapy or
chemotherapy, have an increased risk of nausea and vomiting. Pregnant women in
their first trimester may also experience nausea and vomiting, commonly referred
to as "morning sickness." It is estimated that 50 to 90 percent of
pregnant women experience nausea, while 25 to 55 percent experience vomiting.
What causes nausea or vomiting?
The
causes of nausea and vomiting are quite similar. Many things can bring on
nausea. Some common causes are seasickness and other motion sicknesses, early
pregnancy, intense pain, exposure to chemical toxins, emotional stress (fear),
gallbladder disease, food poisoning, indigestion, various viruses, and certain
smells or odors.
The causes of vomiting differ according to age. For adults,
vomiting is commonly a result of a viral infection and food poisoning, and
occasionally a result of motion sickness and illnesses in which the person has a
high fever. For children, it is common for vomiting to occur because of a viral
infection, food poisoning, motion sickness, overeating or feeding, coughing, and
illnesses in which the child has a high fever. Although rare, blocked intestines
can cause vomiting, most typically in early infancy.
Usually vomiting is harmless, but it can be a sign of a more serious illness.
Some examples of serious conditions that may bring on nausea or vomiting
include concussions, encephalitis, meningitis, intestinal blockage,
appendicitis, migraine headaches, and brain tumors.
Another concern with vomiting
is dehydration. Adults have a lower risk of becoming dehydrated because they can
usually detect the symptoms of dehydration (such as increased thirst and dry
lips or mouth). Children have a greater risk of becoming dehydrated, especially if the
vomiting occurs with diarrhea, because young children may often be unable to
tell an adult about symptoms of dehydration. Adults caring for sick children
need to be aware of these visible signs of dehydration: dry lips and mouth,
sunken eyes, rapid breathing or pulse; or in infants, decreased urination, and a
sunken fontanelle (soft spot on top of the baby's head).
When should a doctor be consulted?
The
timing of the nausea or vomiting can indicate the cause. When it appears shortly
after a meal, nausea or vomiting may indicate a mental disorder or a peptic
ulcer. Nausea or vomiting one to eight hours after a meal may indicate food
poisoning. Foodborne diseases, such as Salmonella, may take longer to produce
symptoms because of the incubation time.
A person who is experiencing nausea should consult a physician if it lasts more than
one week, and if there is a possibility of pregnancy. Vomiting usually subsides
within 6 to 24 hours, and may be treated at home.
You should see your doctor if home treatment is not working, dehydration is
present, or a known injury (such as head injury or infection) is causing the
vomiting.
Take your infant or a child under six years old to the doctor
if:
- vomiting lasts more than a few hours;
- diarrhea is also present;
- signs of
dehydration occur;
- there is a fever higher than 100 degrees Fahrenheit; or
- the
child hasn't urinated for six hours.
Take your child over six years old to the
doctor if:
- vomiting lasts one day;
- diarrhea combined with vomiting lasts for
more than 24 hours;
- there are signs of dehydration;
- there is a fever higher
than 102 degrees Fahrenheit; or
- the child hasn't urinated for six hours.
Adults should consult a doctor if vomiting occurs for more than one day, if
diarrhea and vomiting last more than 24 hours, and if there are signs of
moderate dehydration.
You should see a doctor immediately if the following signs or symptoms occur:
- blood in the vomit ("coffee grounds" appearance)
- severe headache or stiff neck
- lethargy
- confusion
- decreased alertness
- severe abdominal pain
- vomiting with fever over 101 degrees Fahrenheit
- vomiting and diarrhea are both present
- rapid breathing or pulse
What can be done to control or relieve nausea and vomiting?
There
are several ways to control or relieve nausea; however, if these techniques do
not seem to ease the queasiness, consult your doctor.
When trying to control
nausea:
- Drink clear or ice-cold drinks.
- Eat light, bland foods (such as saltine crackers or plain bread).
- Avoid fried, greasy, or sweet foods.
- Eat slowly and eat smaller, more frequent meals.
- Do not mix hot and cold foods.
- Drink beverages slowly.
- Avoid activity after eating.
- Avoid brushing your teeth after eating.
- Choose foods from all the food groups as you can tolerate them to
get adequate nutrition.
Treatment for vomiting (regardless of age or cause) includes: drinking
gradually larger amounts of clear liquids; avoiding solid food until the
vomiting episode has passed; resting; and temporarily discontinuing all oral
medications, which can irritate the stomach and make vomiting worse. If vomiting
and diarrhea last more than 24 hours, an oral rehydrating solution should be
used to prevent and treat dehydration.
Vomiting associated with surgery, radiation therapy, anticancer drugs,
alcohol, and morphine can often be treated with another type of drug therapy.
There are also prescription and nonprescription drugs that can be used to
control vomiting associated with pregnancy, motion sickness, and vertigo.
However, you should consult with your health care provider before using these treatments.
Are there complications from prolonged nausea or vomiting?
Persistent
vomiting combined with diarrhea can result in dehydration. More aggressive
treatment may be necessary for younger children or anyone with severe
dehydration.
How can you prevent nausea?
Nausea can
be prevented by: eating small meals throughout the day instead of three large
meals; eating slowly; avoiding hard-to-digest foods; and consuming foods that are
cold or at room temperature to avoid becoming nauseated from the smell of hot or
warm foods. Resting after eating and keeping your head elevated about 12 inches
above your feet helps reduce nausea.
If you feel nauseated when you wake up in
the morning, eat some crackers before getting out of bed or eat a high protein
snack (lean meat or cheese) before going to bed. Drink liquids between (instead
of during) meals, and drink at least six to eight 8-ounce glasses of water
a day to prevent dehydration. Try to eat when you feel less nauseated.
Once you feel nauseated, how do you prevent vomiting?
Vomiting
can be prevented by consuming small amounts of clear, sweetened liquids such as
soda pop, fruit juices (except orange and grapefruit because these are too
acidic) and popsicles. Drinks containing sugar calm the stomach better than
other liquids. Rest either in a sitting position or in a propped lying position.
Activity may worsen nausea and may lead to vomiting.
For children, control persistent coughs and fever with over-the-counter
medicines. To treat motion sickness in a car, seat your child so that he or she faces
the front windshield (watching fast movement out the side windows can make the
nausea worse). Limit snacks, and do not serve sweet snacks with regular soda
pop. Don't let your kids eat and play at the same time. Encourage them to take a
break during their snack time.
© Copyright 1995-2005 The Cleveland Clinic
Foundation. All rights reserved.
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