- Antiemetics for Nausea and Vomiting Center
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What can cause nausea and vomiting?
Nausea and vomiting occur for many reasons. Common causes include motion sickness, self-limited illnesses (viruses or food poisoning) that last a few hours to a few days, and toxins (such as certain medications).
People should consult a doctor if nausea and/or vomiting are persistent or are accompanied by other severe symptoms such as abdominal pain, fever, yellow discoloration of the skin (jaundice), or bleeding. Individuals with severe or ongoing vomiting who have other serious medical problems, are elderly, are very young, or are pregnant or nursing infants should also seek medical attention.
Motion sickness may occur in many settings including travel by car, air, or boat. This may be the best indication for the use of over-the-counter medications for nausea and vomiting associated with riding in a vehicle. Other inner-ear problems that are related to motion sickness can create a feeling of nausea as well.
Viral infections can cause nausea and vomiting, which is often associated with diarrhea. Often, an "outbreak" can be identified with several cases occurring in the same household or community. Food poisoning from either bacteria or viruses can cause similar symptoms. In both situations, the illnesses generally run their course over a period of one to two days and resolve without treatment. The very young and very old are at risk for dehydration from these usually minor illnesses.
Medications can cause nausea or vomiting and should be suspected when the symptoms appear within a short time after starting a new medication. Notify your prescribing physician if this happens.
Nausea and vomiting are not diseases but symptoms that can be caused by many conditions. Several other less common reasons for nausea and vomiting are
- early stages of pregnancy (nausea occurs in approximately 50%-90% of all pregnancies, vomiting in 25%-55%),
- painful injury,
- postoperative (the period following surgery),
- an emotional or fearful situation,
- gallbladder disease, gallstones or infection (cholecystitis),
- overeating (especially after gastric bypass surgery),
- a reaction to certain smells or odors,
- heart attack (may be the only symptom in some people),
- concussion or head injury,
- brain tumor,
- ulcers or gastritis,
- bulimia or other psychological illnesses, and
- gastroparesis (slow stomach emptying often seen in people with diabetes).
What types of medications are available to treat nausea and vomiting?
Drugs used to treat nausea and vomiting are called antiemetics. Many types of antiemetics can decrease the severity of nausea, although most require a medical evaluation and prescription. Medicines available over-the-counter are mainly recommended for use in motion sickness and for cases of mild nausea.
- Meclizine hydrochloride (Bonine) is an antihistamine that is effective in the treatment of nausea, vomiting, and dizziness associated with motion sickness. Unless recommended by a physician, it should not be taken by people with lung diseases, glaucoma, or those who have difficulty urinating due to an enlarged prostate. Meclizine may cause drowsiness and should not be taken with other sedatives such as alcohol, tranquilizers, or sleeping pills. Due to drowsiness, people using meclizine should not drive or operate dangerous machinery. Meclizine is not recommended in children under 12 or in pregnant or nursing women unless recommended by a doctor.
- Dimenhydrinate (Dramamine) also is an antihistamine. Its use should be limited to motion sickness. It can cause drowsiness and should be avoided in the same situations as Meclizine. Several different formulations of dimenhydrinate are available, including a children's liquid, which should be used according to the directions under the direction of a physician. Dramamine Less Drowsy Formula contains meclizine, like Bonine, and may have fewer sedative side effects. Both meclizine and dimenhydrinate are recommended to be taken about an hour before travel to prevent motion sickness.
- Emetrol is an oral solution designed to soothe the stomach when nausea and vomiting are caused by a viral or bacterial infection or overeating. Emetrol contains sugar and phosphoric acid. Diabetics should not use Emetrol without medical supervision because of the concentrated sugar. According to its manufacturer, Emetrol should not be taken for more than five doses in one hour without consulting a physician. Consult a doctor before using this medicine for pregnant or nursing women and young children.
- Bismuth subsalicylate (Pepto-Bismol) is a product containing bismuth subsalicylate, a chemical shown to be effective in relieving nausea and upset stomach. This remedy has a direct effect on the stomach lining and has no known serious side effects. It may cause darkening of the stool color and of the tongue. Pregnant or nursing women should consult their doctors before using bismuth subsalicylate since part of the active ingredient (salicylate) is chemically similar to aspirin, which may harm infants and the fetus. Patients allergic to aspirin or related drugs also should not use bismuth subsalicylate. Use under the direction of a physician if you take anticoagulants (blood thinners) or have diabetes or gout because the salicylate may further promote the anticoagulant effect.
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Brain TumorA brain tumor can be either non-cancerous (benign) or cancerous (malignant), primary, or secondary. Common symptoms of a primary brain tumor are headaches, seizures, memory problems, personality changes, and nausea and vomiting. Causes and risk factors include age, gender, family history, and exposure to chemicals. Treatment is depends upon the tumor type, grade, and location.
People with bulimia nervosa, an eating disorder that involves episodes of bingeing and purging, experience symptoms and signs such as deteriorating teeth, sore throat, constipation, thinning hair, and dehydration. Treatment of bulimia may involve cognitive behavior therapy, family therapy, nutritional counseling, and medication.
Food PoisoningFood poisoning is common, but can also be life threatening. The symptoms for food poisoning are fever, abdominal pain, headache, diarrhea, nausea and vomiting. Food poisoning has many causes, for example, chemicals (from toxic fish or plants) and bacteria (Staphylococcus aureus or Salmonella). Treatment of food poisoning depends upon the cause.
GallstonesGallstones are stones that form when substances in the bile harden. Gallstones (formed in the gallbladder) can be as small as a grain of sand or as large as a golf ball. There can be just one large stone, hundreds of tiny stones, or any combination. The majority of gallstones do not cause signs or symptoms; however, when they do occur the primary sign is biliary colic. Symptoms of biliary colic are constant pain for 15 minutes to 4-5 hours, and it may vary in intensity; nausea, severe pain that does not worsen with movement; and pain beneath the sternum. Treatment of gallstones depends upon the patient and the clinical situation.
GastritisGastritis (acute and chronic) is an inflammation of the lining of the stomach Some people have no gastritis symptoms, but when they do occur they may include bloating, belching, loss of appetite, nausea, and vomiting. H. pylori infection and nonsteroidal anti-inflammatory drugs (NSAIDs) are the two main causes of gastritis. Alcohol, caffeine, and high-fat foods also can cause gastritis. Fried, fatty, and spicy foods, and alcohol aggravate gastritis symptoms. Other stomach lining irritants that aggravate symptoms include cigarette smoking, acidic juices, caffeine, tomato products, peppers, and chili powder. Foods that sooth gastritis symptoms, and that help reduce and stop H. pylori infection growth in the stomach include apples, onions, garlic, teas, green leafy vegetables, coconut water, and wheat bran. Gastritis is diagnosed with endoscopy, blood tests, or stool tests. Some people get relief from gastritis symptoms with prescription and non-prescription antacids, histamine blockers like famotidine (Pepcid AC) or ranitidine (Zantac 75), or proton pump inhibitors (PPIs) like omeprazole (Prilosec) and esomeprazole (Nexium). These drugs will not cure gastritis. Complications of gastritis include gastric cancers, MALT lymphoma, renal problems, and death.
GastroparesisGastroparesis is a medical condition in which the muscle of the stomach is paralyzed by a disease of either the stomach muscle itself or the nerves controlling the muscle. As a consequence, food and secretions do not empty normally from the stomach. Gastroparesis symptoms are nausea and vomiting; abdominal bloating, and pain can result.
A heart attack happens when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical instability of the heart.
IBS vs IBD Differences and Similarities
IBS (irritable bowel syndrome) and IBD (inflammatory bowel disease) are both problems with the digestive tract (gastrointestinal or GI tract), but they are not the same disease. IBS is a functional disorder (a problem with the way the GI tract functions), and IBD is a disease that causes chronic prolonged inflammation of the GI tract, that can lead to ulcers and other problems that may require surgery. The most common forms of IBD are Crohn's disease and ulcerative colitis, or UC.
Researchers do not know the exact cause of either disease, but they believe that IBS may be caused and triggered by a variety of factors (foods, stress, and the nervous system of the GI tract), while IBD may be genetic or due a problem with the immune system.
Common symptoms of both diseases are an urgent need to have a bowel movement, diarrhea, nausea, vomiting, and abdominal pain and cramping.
There are differences between the signs and symptoms of irritable bowel syndrome and inflammatory bowel disease, for example, symptoms unique to IBD are:
- Joint pain or soreness
- Skin changes
- Rectal bleeding
- Eye redness or pain
- Unintentional weight loss
- Feeling tired
Symptoms unique to irritable bowel syndrome include:
- Sexual problems
- Abdominal bloating
- Whitish mucous in the stool
- Changes in bowel movements and in the way stools look
- An urgent need to urinate
- Urinating frequently
Treatment for IBS is with diet recommendations from a doctor or nutritionist, medication, and lifestyle changes like stress management and avoiding foods that trigger the condition. Treatments for IBD depend upon the type of disease, its symptoms, and health of the patient. Surgery may be necessary for some individuals.
Brown, AC, et al. "Existing Dietary Guidelines for Crohn's Disease and Ulcerative Colitis." Medscape.
Lehrer, J. "Irritable Bowel Syndrome." Medscape. Updated: Apr 04, 2017.
Rowe, W. "Inflammatory Bowel Disease." Medscape. Updated: Jun 17, 2016.
Romanowski, A, MS, RD. "Matching the Right Diet to the Right Patient." Medscape. Jan 27, 2017.
meclizineMeclizine (Antivert, Bonine, Meni-D, Antrizine) is an OTC antinausea medication used to treat nausea and vomiting, and dizziness associated with motion sickness. Side effects, drug interactions, dosage, storage, and pregnancy safety information should be reviewed prior to taking any medication.
Motion Sickness (Sea Sickness, Car Sickness)
Motion sickness is a feeling of unwellness caused by the inner ear and balance systems. Motion sickness can include sea sickness, car sickness, and train or plane sickness. Symptoms include, headache, nausea, vomiting, fatigue, dizziness, cold sweats, and pale skin.
Treatment for motion sickness include home remedies such as ginger, not eating large or fatty meals prior to traveling, and OTC and prescription medications.
Nausea and Vomiting
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. There are numerous cases of nausea and vomiting. Some causes may not require medical treatment, for example, motion sickness, and other causes may require medical treatment by a doctor, for example, heart attack, lung infections, bronchitis, and pneumonia.
Some causes of nausea and vomiting may be life threatening, for example, heart attack, abdominal obstruction, and cancers.
Treatment of nausea and vomiting depends upon the cause.
Peptic or stomach ulcers are ulcers are an ulcer in the lining of the stomach, duodenum, or esophagus. Ulcer formation is related to H. pylori bacteria in the stomach, use of anti-inflammatory medications, and cigarette smoking. Symptoms of peptic or stomach ulcers include abdominal burning or hunger pain, indigestion, and abdominal discomfort after meals.
Treatment for stomach ulcers depends upon the cause.
promethazinePromethazine (Phenergan [Discontinued brand], Phenadoz, Promethegan) is a drug prescribed to treat nausea, vomiting, motion sickness, allergic reactions, and for sedation prior to surgery. Side effects and numerous drug interactions should be reviewed prior to taking this medication.
Stomach PictureThe stomach is a muscular sac located on the left side of the upper abdomen. See a picture of the Stomach and learn more about the health topic.
TonsillectomyTonsillectomy is the surgical removal of both tonsils. A tonsillectomy may be performed in cases of recurrent tonsillitis, or treat sleep apnea and some speech disorders.