Digestive Diseases: Nausea and Vomiting

Nausea is an uneasiness of the stomach that often precedes vomiting. Vomiting is the forcible voluntary or involuntary emptying ("throwing up") of stomach contents through the mouth.

Nausea and vomiting are not diseases, but they are symptoms of many conditions such as:

• Motion sickness or seasickness
• Early stages of pregnancy (nausea occurs in 50%-90% of all pregnancies; vomiting in 25%-55%)
• Medication induced vomiting
• Intense pain
• Emotional stress (fear)
• Gallbladder disease
• Food poisoning
• Infections (such as the "stomach flu")
• Overeating
• A reaction to certain smells or odors
• Heart attack
• Concussion or brain injury
• Brain tumor
• Ulcers
• Some forms of cancer
• Bulimia or other psychological illnesses
• Gastroparesis (a condition seen in people with diabetes)

The causes of vomiting differ according to age. For children, it is common for vomiting to occur from a viral infection, food poisoning, milk allergy, motion sickness, overeating or feeding, coughing, or blocked intestines and illnesses in which the child has a high fever.

The timing of the nausea or vomiting can indicate the cause. When appearing shortly after a meal, nausea or vomiting may be caused by food poisoning, gastritis (inflammation of the stomach lining), an ulcer or bulimia. Nausea or vomiting one to eight hours after a meal may also indicate food poisoning. However, certain food borne bacteria, such as salmonella, can take longer to produce symptoms.

Call a doctor:

• If the nausea lasts for more than a few days or or if there is a possibility of being pregnant.
• If home treatment is not working, dehydration is present, or a known injury has occurred (such as head injury or infection) that may be causing the vomiting.
• Adults should consult a doctor if vomiting occurs for more than one day, diarrhea and vomiting last more than 24 hours, or there are signs of moderate dehydration.
• Take your infant or child under six years to the doctor if vomiting lasts more than a few hours, diarrhea is present, signs of dehydration occur, there is a fever higher than 100 degrees Fahrenheit, or if the child hasn't urinated for six hours.
• Take your child over age six years 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.

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). But, do not discontinue any medication before checking with your doctor first.
• If vomiting and diarrhea last more than 24 hours, an oral rehydrating solution such as Pedialyte should be used to prevent and treat dehydration.
• Pregnant women experiencing morning sickness can eat some crackers before getting out of bed or eat a high protein snack before going to bed (lean meat or cheese).
• Vomiting associated with cancer treatments 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 some forms of dizziness. However, consult with your doctor before using these treatments.

• Eat small meals throughout the day instead of three large meals
• Eat slowly
• Avoid hard-to-digest foods
• Consume foods that are cold or room temperature to avoid nausea from the smell of hot or warm foods
• Rest after eating with your head elevated about 12 inches above your feet
• Drink liquids between meals instead of during meals and drink at least six to eight 8-ounce glasses of water a day to prevent dehydration (unless fluid restricted for another medical condition).
• Try to eat when you feel less nauseated

QUESTION

Pancreatitis is inflammation of an organ in the abdomen called the pancreas. See Answer

• Drink small amounts of clear, sweetened liquids such as soda or fruit juices (except orange and grapefruit juices because these are too acidic).
• Rest either in a sitting position or in a propped lying position. Activity may worsen nausea and may lead to vomiting.

• To treat motion sickness in a car, seat your child so he or she faces the front windshield (watching fast movement out the side windows can make the nausea worse).
• Don't let your kids eat and play at the same time.

Reviewed by the doctors at The Cleveland Department of Gastroenterology.
Reviewed on March 01, 2006 and Edited by Cynthia Dennison Haines, MD, on March 01, 2006.

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