Nausea & Vomiting
What is 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
- Various viruses
- 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:
- Intestinal blockage
- Migraine headaches
- 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
In infants, parents should look for decreased urination, and a sunken fontanelle (soft spot on top of the baby's head).
Care and Treatment
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, talk to 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
- 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 healthcare provider before using these treatments.
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
- 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.
When to Call the Doctor
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 lessens within six 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 6 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
- The child hasn't urinated for six hours
Take your child over 6 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
- 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
- Decreased alertness
- Severe abdominal pain
- Vomiting with fever over 101 degrees Fahrenheit
- Vomiting and diarrhea are both present
- Rapid breathing or pulse
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.