Nausea is an abdominal discomfort or queasiness that may be accompanied by vomiting (the forceful expulsion of stomach contents through the mouth).

Bouts of nausea and vomiting are common, especially in children. They usually subside quickly but can lead to dehydration, malnutrition and other complications if they continue over a prolonged period. Also, nausea and vomiting are symptoms of many conditions, some of which are serious in nature.

Nausea and vomiting may be accompanied by other symptoms, such as abdominal pain, fever and diarrhea. The symptoms experienced often provide clues about the cause of the nausea or vomiting.

There are many potential causes of nausea and vomiting, including certain medications (e.g., cancer drugs), gastrointestinal problems (e.g., foodborne illnesses) or other infections (e.g., pancreatitis), pregnancy, motion sickness and excessive consumption of alcohol. In addition, people with eating disorders such as bulimia nervosa may regularly induce vomiting after binge eating.

Nausea and vomiting may be treated in a variety of ways. Many cases require no treatment, or simply avoiding the food or medication causing the problem. Nausea can be controlled by drinking clear fluids and eating bland foods. Treatment for vomiting may include drinking fluids to avoid dehydration and taking antiemetics (medications to prevent or treat nausea and vomiting).

Some cases of nausea and vomiting can be prevented if the cause is known. For example, medication can be taken to prevent motion sickness.

Nausea is a feeling of queasiness or discomfort in the abdomen, which may be accompanied by the urge to vomit. Vomiting is the forceful expulsion of stomach contents through the mouth.

Retching occurs when a person attempts to vomit, but no stomach contents are expelled. It is also called dry heaves. Retching and nausea can occur without vomiting or before vomiting.

Nausea includes uneasiness in the abdomen, but may not lead to vomiting. It may be related to a decrease of the normal motion (motility) in the stomach. Vomiting occurs when a part of the brain receives signals and stimulates action in the stomach and esophagus. Food does not move from the stomach to the intestines as it normally does, but flows back (refluxes) into the stomach. The surrounding muscles contract and the stomach contents are expelled through the mouth. Dry heaves occur when the stomach and its surrounding muscles contract, but the opening at the back of the throat (glottis) remains closed. 

People experience occasional bouts of nausea or vomiting for many reasons. Nausea and vomiting are particularly common in infants and children. In most people, nausea and vomiting are symptoms that pass within a day or two. However, in patients with chronic medical or psychiatric conditions, nausea and vomiting may last for a week or longer.

Nausea and vomiting that occur repeatedly over time can cause a variety of complications, including:

• Dehydration. Prolonged vomiting can lead to loss of fluids in the body, especially when it occurs with diarrhea. Children become dehydrated more quickly than adults and are particularly prone to dehydration from vomiting.
  
  
• Electrolyte imbalance. Electrolytes are substances that are necessary for normal body chemistry and functioning. Severe vomiting can result in loss of electrolytes.
  
  
• Weight loss and/or malnutrition. Severe vomiting can result in weight loss and malnutrition, particularly if it prevents eating.
  
  
• Bruises or tears. Violent retching can occasionally cause bruises or tears in the abdominal wall muscles or in the gastroesophageal junction, where the esophagus and stomach meet. Tears at this junction are called Mallory-Weiss tears.
  
  
• Dental disease. Stomach acid in vomit can damage teeth and gums and lead to dental disease. This complication commonly occurs in eating disorders where patients induce vomiting frequently (e.g., bulimia nervosa).

Nausea and vomiting may be accompanied by a variety of other symptoms. The type of symptom experienced often provides clues about the cause of the nausea and vomiting. Symptoms may include:

• Diarrhea. Many cases of nausea and vomiting are accompanied by diarrhea. This may indicate an infection in the gastrointestinal (GI) tract.
  
  
• Abdominal pain. This may be a symptom of an intestinal obstruction or inflammation in the abdomen due to pancreatitis (inflammation or irritation of the pancreas, often caused by gallstones or alcohol abuse).
  
  
• Sudden onset of nausea and vomiting accompanied by fevers, body aches, runny nose and cough. This may also indicate an infection in the GI tract.

The timing of nausea and vomiting may also provide clues about its cause. If it occurs shortly after a meal, it may indicate a peptic ulcer or may be related to a mental disorder. If it occurs between one and eight hours after a meal, it may indicate food poisoning.

Vomiting is caused by a signal in the brain. It can be triggered by nausea, which may result from a variety of stimuli such as motions, smells, tastes, infections and emotions. In addition, overindulgence in a particular food or alcohol may induce nausea or vomiting.

There are many possible causes of nausea and vomiting. They include:

• Gastrointestinal (GI) disorders. Many disorders of the stomach and intestines cause nausea and vomiting. Some of the most common disorders include:
  
  
  • Infectious disease. Viral gastroenteritis is an infection of the stomach or intestines by a particular virus. Foodborne illnesses are acute GI infections caused by eating food that contains harmful bacteria, toxins, viruses or parasites.
    
    
  • Gastroparesis. A condition in which food or liquid passes too slowly from the stomach into the small intestine. This is common in people who have had diabetes for many years.
    
    
    
    
    
  • Pancreatitis. Inflammation or irritation of the pancreas, often due to gallstones or alcohol abuse.
    
    
    
    
    
  • Intestinal blockage. This can be due to peptic ulcers (an open sore, or ulcer, in the lining of the esophagus, stomach or duodenum) or inflammatory diseases, such as Crohn's disease (a type of inflammatory bowel disease in which the large intestine or small intestine is inflamed over a long period of time).
    
    
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  • Gallstones. Hard, stonelike masses formed from substances in bile such as cholesterol or bilirubin that develop in the gallbladder or bile ducts.
    
    
• Medications. Many medications can cause nausea and vomiting as side effects. The best known are those used to treat cancer. Narcotics, antibiotics and the pain relievers known as nonsteroidal anti-inflammatory drugs (NSAIDs) may also cause nausea or vomiting. Some people experience nausea or vomiting during recovery from surgery, as a side effect of general anesthesia. In addition, research suggests that nausea and vomiting may result from the use of illegal drugs (e.g., cocaine) as well.
  
  
• Disorders of the central nervous system (CNS). Nausea and vomiting are sometimes related to serious CNS conditions, such as brain tumors and increased cranial pressure. However, they are more commonly associated with the following:
  
• • Motion sickness. Illness caused by sudden direction changes or disorientation.
    
    
  • Migraine headaches. A severe form of headache that involves the blood vessels, nerves and chemicals in the brain.
    
    
  • Meningitis. An infection in the lining in the brain.
    
    
• Systemic conditions. Problems or changes in other body systems may cause nausea or vomiting. Some of the most common include pregnancy, kidney failure or a heart attack.
  
  
• Psychiatric conditions. Eating disorders such as bulimia nervosa commonly involve vomiting. People with this disorder binge eat and then induce vomiting to purge the excess food from their body. Anxiety and depressive disorders may sometimes include nausea or vomiting., among other symptoms. Nausea may also be a symptom of a concussion (temporary brain injury caused by a blow to the head).
  
  
• Cyclic vomiting syndrome. Severe, repeated attacks of vomiting, nausea and physical exhaustion that begin and end suddenly with no apparent cause.

Many bouts of nausea and vomiting usually subside within six to 24 hours and may be treated at home. In some cases, stopping or avoiding the food or medication that caused the problem is the only treatment necessary.

There are several ways to control nausea, including:

• Drink clear fluids
• Eat light, bland foods, such as crackers or plain bread
• Do not eat fried, greasy or sweet foods
• Eat and drink slowly
• Eat small meals
• Do not mix hot and cold foods
• Avoid activity after eating
• Avoid brushing teeth shortly after eating

Treatment for vomiting may include:

• Drinking fluids to prevent dehydration and an imbalance of electrolytes (substances in the body necessary to maintain body chemistry and function). After vomiting subsides, patients should begin drinking clear fluids in small quantities or sucking on ice chips. Water, carbonated beverages with sugar and broth may help. Oral hydration solutions may be consumed. In severe cases, fluid replacement may be performed intravenously (through a vein) at a medical facility.
  
  
• Eating foods to meet nutritional requirements. Patients should avoid eating solid foods until vomiting subsides. Patients who can drink clear fluids without further vomiting can try to eat small amounts of bland foods, including dry crackers, toast, cereal or fruits. In severe cases, a feeding tube can be placed into the patient’s nose and run through the esophagus and stomach into the small intestine.
  
  
• Administration of antiemetics. These are medications used in the prevention or treatment of nausea and vomiting. Antiemetics may be prescribed for cancer patients susceptible to nausea and vomiting from chemotherapy or radiation treatment.
  
  
• Administration of prokinetics.  Patients with gastroparesis may benefit from drugs that can improve gastric emptying.
  
  
• Alternative treatments. Acupressure (a traditional Chinese procedure that uses pressure applied to specific points in the body), ginger and vitamin B6 supplements have been used to treat nausea and vomiting related to pregnancy. Electrical stimulation, usually at the wrist, has been used to treat nausea and vomiting experienced after surgery. Hypnosis (a therapeutic technique in which the patient is put in a trance) has been used to treat nausea and vomiting caused by psychological disorders.

Most bouts of nausea and vomiting may be treated at home, but a physician should be consulted if:

• Nausea is accompanied by pain or severe headache
  
  
• The patient is unable to drink liquids for 24 hours
  
  
• Vomiting lasts longer than two to three days
  
  
• The patient shows signs of dehydration, such as excessive thirst, dry mouth, little or no urination, severe weakness, dizziness or lightheadedness
  
  
• Vomit resembles coffee grounds or contains blood

If the cause of the nausea and vomiting is known, it can sometimes be prevented. For example, nausea and vomiting caused by motion sickness can be prevented by taking medication just before a cruise or other event that may cause motion sickness. Nausea and vomiting caused by certain medications or foods can be prevented by avoiding the medications or foods.

In addition, research suggests that individuals who expect to experience nausea generally fare better than those who suddenly experience the symptom.

Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions related to nausea and vomiting:

1. What is the difference between nausea and vomiting?
   
   
2. What is causing my bouts of nausea and vomiting?
   
   
3. I am experiencing pain in addition to nausea and vomiting. What does this mean?
   
   
4. What are some ways that I can prevent nausea?
   
   
5. Which over-the-counter medications do you recommend for nausea and/or vomiting?
   
   
6. Could any prescription or over-the-counter medications I am currently taking be causing or contributing to my nausea and/or vomiting? Are there alternatives available?
   
   
7. At what point should I contact you if I (or a loved one) am experiencing nausea and/or vomiting?
   
   
8. My child vomits frequently. Is this normal?
   
   
9. What should I do when my child is vomiting?