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Nausea and Vomiting

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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Introduction to nausea and vomiting

Nausea and vomiting are symptoms of an underlying disease and not a specific illness. Nausea is the sensation that the stomach wants to empty itself, while vomiting (emesis) or throwing up, is the act of forcible emptying of the stomach.

Vomiting is a violent act in which the stomach has to overcome the pressures that are normally in place to keep food and secretions within the stomach. The stomach almost turns itself inside out - forcing itself into the lower portion of the esophagus (the tube that connects the mouth to the stomach) during a vomiting episode.

What causes nausea or vomiting?

There are numerous causes of nausea and vomiting. These symptoms may be due to the following:

• acute gastritis
  
  
• central causes (signals from the brain)
  
  
• association with other illnesses remote from the stomach
  
  
• medications and medical treatments
  
  
• mechanical obstruction of the bowel

Acute gastritis

Acute gastritis (gastro=stomach + it is= inflammation) is often caused by an offending agent which irritates the lining of the stomach. Examples of these include:

• Infections: Infections are often the cause, whether it is a common virus or an infection that is contracted from travel. There may be associated crampy upper abdominal pain, fever ,and chills may be present. Common viral infections include noroviruses and rotavirus. Parasitic infections often are associated with diarrhea but may also have a component of nausea and vomiting. Infection by bacteria in the Helicobacter family (like H. Pylori) can also be the infectious agent.
  
  
• Stomach flu: Stomach flu is a non-specific term used to describe vomiting and diarrhea associated with a viral infection. It should not be confused with influenza, whose symptoms include fever, chills, cough, and myalgias (muscle pain).
  
  
• Food poisoning: Food poisoning may cause significant vomiting and usually is caused by a bacterial toxin. Symptoms begin within a couple hours of eating contaminated or poorly prepared food and may last for 1-2 days. Sources of food poisoning include Salmonella, Campylobacter, Shigella, E. coli, Listeria, or Clostridium botulinum (botulism).
  
  
• Other stomach irritants: alcohol, smoking, and non steroidal anti-inflammatory medications such as aspirin and ibuprofen may irritate the stomach lining.
  
  
• Peptic ulcer disease: Peptic ulcer disease can range from mild irritation of the stomach lining to the formation of a defect in the protective lining of the stomach called an ulcer.
  
  

• Gastroesophageal reflux disease (GERD, reflux esophagitis): Nausea or vomiting is also associated with irritation of the lining of the esophagus