Nausea and Vomiting (cont.)
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.
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.
In this Article
- Nausea and vomiting definition and facts
- What is nausea? What is vomiting?
- What causes nausea or vomiting?
- Throat and stomach irritants that cause nausea and vomiting
- Nausea and vomiting caused by neurological conditions
- Other diseases and conditions that cause nausea and vomiting
- Nausea and vomiting caused by medications and medical treatments
- Morning sickness nausea and vomiting during pregnancy
- Vomiting in infants
- How do doctors diagnose the cause of nausea and vomiting?
- What natural home remedies help relieve for nausea or vomiting?
- What is the medical treatment for nausea or vomiting?
- When should I call the doctor if I have nausea and vomiting?
Nausea and vomiting caused by medications and medical treatments
- Side effects from medications: The side effect of many medications include stomach irritation and/or nausea and vomiting. Anti-cancer drugs used for chemotherapy commonly cause nausea and vomiting that is not easily relieved. Narcotic pain medications, anti-inflammatory medications, steroids, and antibiotics all have nausea and vomiting listed as common side effects.
- Radiation therapy: Nausea and vomiting can be associated with radiation therapy.
- Chemotherapy for cancer
Morning sickness nausea and vomiting during pregnancy
Vomiting in pregnancy is especially common in the first trimester due to hormone level changes in the bloodstream.
Vomiting in infants
It may be hard to decide if an infant is vomiting or spitting up. If the episodes occur shortly after feeding and only a small amount comes up, this may be spitting up.
- Forceful vomiting: In the first two or three months, if the vomiting is forceful after eating (imagine it flying across the room), this may be a sign of pyloric stenosis, or an abnormal narrowing of the pylorus, the location where the stomach empties into the duodenum (the first part of the small intestine). The vomiting is impressive and is described as projectile. The diagnosis is often made by history and physical examination, confirmed by ultrasound. The treatment is surgery.
- Vomiting associated with pain: if the infant cries uncontrollably, and if the stool is bloody or red, the diagnosis may be an intussusception (the pushing of one segment of the bowel into an adjacent segment). The stool is classically described as currant jelly, but any blood in the stool is not normal and should always be a cause for concern. It is reasonable to seek medical care for any inconsolable infant.
- Viral infection: If there is vomiting with associated diarrhea that is not bloody, then a viral infection is a possibility. Alternatively, there may be an issue with intolerance to the type of baby formula. Infants and children are at greater risk of dehydration if the vomiting episodes last for more than 24 hours. If dehydration is suspected, seek medical care. Signs and symptoms of dehydration in an infant include dry mouth, lack of sweat in the armpits and groin, sunken eyes, weakness with a poor cry, and decreased muscle tone.
How do doctors diagnose the cause of nausea and vomiting?
Diagnosis often can be made when the health care professional takes a careful history and performs a physical examination. Any tests that need to be ordered will be based on the information from the history and physical exam, and sometimes no further testing is required to make the diagnosis.
Laboratory tests and X-rays may be ordered to assess the stability of the patient and not necessarily to make the diagnosis. For example, a patient with food poisoning may need blood tests ordered to measure the electrolytes(minerals) and other chemicals, since the patient may lose significant amounts of sodium, potassium, and chloride from the body from persistent vomiting and diarrhea.
Urinalysis may be helpful in assessing hydration status. Concentrated, dark urine is associated with dehydration because the kidneys try to preserve as much water as possible in the body. Ketones in the urine are also a sign of dehydration.
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