Best Practice Guidelines 1
Nausea and Vomiting
Nausea and Vomiting, the Basics
Almost everyone has had episodes of nausea or dealt with someone else with this problem.
Following you will find some basic information about possible causes as well as when to
become concerned and seek medical help for yourself or the person showing these symptoms.
Definitions:
• Nausea is the sensation of being about to vomit. It can occur alone or
accompany vomiting, indigestion, or other gastrointestinal symptoms.
• Vomiting is the forceful expulsion of gastric (stomach) contents.
• Regurgitation is the return of contents from the esophagus to the back of the
throat with little effort.
Causes of nausea and vomiting:
There are a several different causes of nausea and vomiting. Below is a list of some of
the most common causes:
I. Medications and other agents:
Chemotherapy (intravenous therapy used for cancer, etc)
Pain medications
Some heart medications
Hormones such as oral contraceptives
Antibiotics (especially sulfonamides, erythromycin, tetracycline)
Anticonvulsants, theophylline, antiparkinsonian drugs
Food poisoning
II. Infectious causes
Viral infections
Bacterial infections
o Especially ear infections
III. Disorders of the gut
Bowel obstruction
Irritable bowel syndrome
Ulcers and dyspepsia (indigestion)
Pancreatitis (inflammation of the pancreas)
Hepatitis
Gall bladder disease
Cancer
IV. Central nervous system causes
Migraine headaches
Seizure disorders
Infections such as meningitis
Brain tumor, stroke or other brain trauma
Anxiety disorders, depression
Pain, especially acute pain
2012, 8-22 JJustad, MD, DDP
Best Practice Guidelines 2
Nausea and Vomiting
V. Inner Ear Disorders
Motion sickness
Labyrinthitis (which is a form of vertigo) or Meniere disease
Tumors
VI. Miscellaneous
Pregnancy
Metabolic disorders such as hyperthyroidism (excess thyroid hormones)
Postoperative nausea and vomiting
Cyclic vomiting syndrome
Some cardiac diseases
Starvation
Getting help:
If symptoms of nausea and/or vomiting last 2 days or if the person is not able to take in
any fluids; medical attention should be sought immediately. Medical help should be obtained
even sooner if the following signs or symptoms are present:
• Abdominal or chest pain
• Throwing up blood or something that looks like tar
• Bowel movements that are bloody or black
• Temperature over 101 degrees F
• Severe headache or stiff neck
• Very fatigued or difficulty getting up or staying awake
• Signs of dehydration are present
o Being very thirsty, having dry mouth or tongue
o Muscle cramps
o Excessive fatigue, dizziness or confusion
o Urine is very dark yellow or there is no urination in over 5 hours
Treatment:
Dehydration happens when the body loses more water than it takes in from eating and drinking.
It can occur quickly with vomiting, especially if diarrhea is also present. Dehydration can be
mild and not cause problems; but if not treated, it will progress. Severe dehydration is a medical
emergency and can be life-threatening.
To prevent dehydration; encourage drinking a lot of liquids. If there has been a lot of vomiting
and especially if accompanied by diarrhea, the body’s potassium stores can be depleted. To
help treat this, drinks such as Gatorade or other sports drinks can help. Drinks such as coffee
or those with caffeine should be avoided as the caffeine acts as a diuretic causing increased
urination.
If able to eat, start with foods with a lot of fluid such as jello, popsicles, or soup. Then progress
to soft, bland foods such as plain yogurt, bread, and saltine crackers.
Strong smells such as perfume should be avoided.
Medications can help control the symptoms of nausea. These medications include: Compazine,
Phenergan, metoclopramide, scopolamine, Benadryl, and Zofran (ondansetron) to name just a
few.
2012, 8-22 JJustad, MD, DDP
