Patient education: Nausea and vomiting in adults (The Basics)

What are nausea and vomiting? — Nausea is the feeling you get when you think you might throw up. Vomiting is when you actually throw up. These 2 symptoms can happen together. But sometimes people feel nauseous without throwing up, and some people throw up without feeling nauseous first.

What causes nausea and vomiting? — The most common causes include:

●Food poisoning – This can happen if you eat food that has gone bad. It is basically an infection in your stomach. Food poisoning often also causes diarrhea.

●Other infections – Other kinds of infections that affect the stomach or intestines can also cause nausea and vomiting. These include infections caused by different viruses and bacteria.

●Dizziness or motion sickness – This can happen if you're on a boat or in a car, or something else that moves. It can also happen if there's something wrong inside your ears that affects your balance.

●Medicines – Lots of different medicines can cause nausea or vomiting. Some examples are antidepressants, antibiotics, vitamins, birth control pills, and pain medicines. People who are on chemotherapy for cancer treatment or who have been under anesthesia also often have nausea or vomiting. Sometimes, people who use cannabis (marijuana) over a long time have repeated episodes of vomiting.

●Pregnancy – Many people who are pregnant have nausea or vomiting. People sometimes call this "morning sickness," but it can happen at any time of day.

●Gastroesophageal reflux disease (GERD) – GERD is condition that causes the juices that are in the stomach to leak back up into the esophagus, the tube that connects the throat to the stomach. It can sometimes cause nausea.

●Problems with the stomach or intestines – In some people, the stomach or intestines do not move food along the way that they are supposed to. In others, the intestines can get blocked. Both of these problems can cause nausea or vomiting.

●Migraine headaches – Some people who get migraine headaches have nausea during their headaches.

●Alcohol – Drinking too much alcohol can cause nausea and vomiting.

Should I see a doctor or nurse? — Call your doctor or nurse if your symptoms last longer than a day or 2, or you have severe symptoms. You should also call if you:

●Have chest or belly pain

●Throw up blood or something that looks like coffee grounds

●Have a bowel movement with blood, or a bowel movement that is black and looks like tar

●Have a fever higher than 101°F

●Have a severe headache or stiff neck

●Feel very tired or have trouble getting up

●Show signs of dehydration (meaning that your body has lost too much water). Signs of dehydration include:

•Feeling very tired

•Being very thirsty or having a dry mouth or tongue

•Muscle cramps

•Dizziness

•Confusion

•Urine that is dark yellow, or not needing to urinate for more than 5 hours

What can I do on my own to feel better? — You can:

●Drink fluids when you are able. It might help to take small sips every 15 to 30 minutes. Try to drink more as you start to feel better.

When you are vomiting a lot, your body loses both water and salt. Drinking fluids that contain salt can help replace what your body has lost. Examples include "oral rehydration solutions," sports drinks, and broth.

●Try eating, but start with foods that have a lot of fluid in them. Good examples are soup, gelatin, and ice pops. If this goes well, you can try soft, bland foods. Foods that are high in carbohydrates ("carbs"), like bread or saltine crackers, can help settle your stomach. Some people also find that ginger helps with nausea.

You should avoid foods that have a lot of fat in them. They can make nausea worse. Call your doctor if your symptoms come back when you try to eat.

●Avoid strong smells, such as the smell of perfume

●If you need to take medicines, take them with meals if possible. But check the bottle first, because some medicines must be taken on an empty stomach.

How are nausea and vomiting treated? — If you have been vomiting a lot for more than a day, your doctor or nurse will ask you questions to try to find out what might be causing your symptoms. They might also:

●Give you fluids through a thin tube that goes in a vein, called an "IV"

●Give you medicines that control nausea and vomiting. Some examples include:

•Prochlorperazine (brand name: Compro)

•Promethazine (brand name: Phenergan)

•Metoclopramide (brand name: Reglan)

•Ondansetron (brand name: Zofran)

●Schedule tests for you to help find out why you have nausea or vomiting, such as:

•A stomach X-ray

•An upper endoscopy – For this test, a doctor puts a thin tube down your throat and into your stomach. The tube has a light and a tiny camera on the end, so the doctor can see inside your stomach.

Can nausea and vomiting be prevented? — It depends on the cause. You can do these things to lower the risk of getting an infection that causes nausea and vomiting:

●Wash your hands often with soap and water (figure 1). This is especially important if you have been around someone who is sick. It's also important to wash your hands after using the bathroom or changing diapers.

●Pay attention to food safety. This includes avoiding unpasteurized milk, washing fruits and vegetables before eating them, not eating undercooked food, and washing all cooking utensils. Wash your hands thoroughly after touching raw food.

If you often get nausea and vomiting for another reason, like from motion sickness or with migraines, talk to your doctor or nurse. They might suggest things that can help.

More on this topic

Patient education: Food poisoning (The Basics)
Patient education: Diarrhea in teens and adults (The Basics)
Patient education: Diarrhea in children (The Basics)
Patient education: Motion sickness (The Basics)
Patient education: Viral gastroenteritis in adults (The Basics)
Patient education: Hypovolemia in adults (The Basics)
Patient education: Bland diet (The Basics)
Patient education: Hypomagnesemia (The Basics)

Patient education: Foodborne illness (food poisoning) (Beyond the Basics)
Patient education: Nausea and vomiting in infants and children (Beyond the Basics)