Nausea and vomiting

Definition

Nausea is feeling an urge to vomit. It is often called "being sick to your stomach."

Vomiting or throwing-up forces the contents of the stomach up through the food pipe (esophagus) and out of the mouth.

Alternative Names

Emesis; Vomiting; Stomach upset; Upset stomach; Queasiness

Causes

Common problems that may cause nausea and vomiting include:

Food allergies
Infections of the stomach or bowels, such as the "stomach flu" or food poisoning
Leaking of stomach contents (food or liquid) upward (also called gastroesophageal reflux or GERD)
Medicines or medical treatments, such as cancer chemotherapy or radiation treatment
Migraine headaches
Morning sickness during pregnancy
Seasickness or motion sickness
Severe pain, such as with kidney stones
Excessive use of marijuana

Nausea and vomiting may also be early warning signs of more serious medical problems, such as:

Appendicitis
Blockage in the intestines
Cancer or a tumor
Ingesting a drug or poison, especially by children
Ulcers in the lining of the stomach or small intestine

Home Care

Once your health care provider finds the cause, you will want to know how to treat your nausea or vomiting.

You may need to:

Take medicine.
Change your diet, or try other things to make you feel better.
Drink small amounts of clear liquids often.

If you have morning sickness during pregnancy, ask your provider about possible treatments.

The following may help treat motion sickness:

Remaining still.
Taking over-the-counter antihistamines, such as dimenhydrinate (Dramamine).
Using prescription scopolamine skin patches (such as Transderm Scop). These are helpful for extended trips, such as an ocean voyage. Use the patch as your provider instructs. Scopolamine is for adults only. It should NOT be given to children.

When to Contact a Medical Professional

Call 911 or the local emergency number or go to an emergency room if you:

Think the vomiting is from poisoning
Notice blood or dark, coffee-colored material in the vomit

Call a provider right away or seek medical care if you or another person has:

Been vomiting for longer than 24 hours
Been unable to keep any fluids down for 12 hours or more
Headache or stiff neck
Not urinated for 8 or more hours
Severe stomach or belly pain
Vomited 3 or more times in 1 day

Signs of dehydration include:

Crying without tears
Dry mouth
Increased thirst
Eyes that appear sunken
Skin changes: For example, if you touch or squeeze the skin, it doesn't bounce back the way it usually does
Urinating less often or having dark yellow urine

What to Expect at Your Office Visit

Your provider will perform a physical exam and will look for signs of dehydration.

Your provider will ask questions about your symptoms, such as:

When did the vomiting begin? How long has it lasted? How often does it occur?
Does it occur after you eat, or on an empty stomach?
Are other symptoms present such as abdominal pain, fever, diarrhea, or headaches?
Are you vomiting blood?
Are you vomiting anything that looks like coffee grounds?
Are you vomiting undigested food?
When was the last time you urinated?

Other questions you may be asked include:

Have you been losing weight?
Have you been traveling? Where?
What medicines do you take?
Did other people who ate at the same place as you have the same symptoms?
Are you pregnant or could you be pregnant?
Do you use marijuana? If yes, how often do you use it?

Diagnostic tests that may be performed include:

Blood tests (such as CBC with differential, blood electrolyte levels, and kidney and liver function tests)
Urinalysis
Imaging studies (ultrasound or CT) of the abdomen

Depending on the cause and how much extra fluids you need, you may have to stay in the hospital or clinic for a period of time. You may need fluids given through your veins (intravenous or IV).

References

Crane BT, Kaylie DM. Central vestibular disorders. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 168.

Guttman J. Nausea and vomiting. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 25.

McQuaid KR. Approach to the patient with gastrointestinal disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 118.