Nausea and vomiting

Definition

Nausea and vomiting are common signs and symptoms that can be caused by numerous conditions. Nausea and vomiting most often are due to viral gastroenteritis — often called stomach flu — or the morning sickness of early pregnancy.

Many medications or substances can also cause nausea and vomiting, including marijuana (cannabis). Rarely, nausea and vomiting may indicate a serious or even life-threatening problem.

Causes

Nausea and vomiting may occur separately or together. Common causes include:

• Chemotherapy
• Gastroparesis (a condition in which the muscles of the stomach wall don't function properly, interfering with digestion)
• General anesthesia
• Intestinal obstruction
• Migraine
• Morning sickness
• Motion sickness: First aid
• Rotavirus
• Viral gastroenteritis (stomach flu)
• Vestibular neuritis

Other possible causes of nausea and vomiting include:

• Acute liver failure
• Alcohol use disorder
• Anaphylaxis
• Anorexia nervosa
• Appendicitis
• Benign paroxysmal positional vertigo (BPPV)
• Brain tumor
• Bulimia nervosa
• Cannabis (marijuana) use
• Cholecystitis
• Coronavirus disease 2019 (COVID-19)
• Crohn's disease
• Cyclic vomiting syndrome
• Depression (major depressive disorder) or other mood disorders
• Diabetic ketoacidosis (in which the body has high levels of blood acids called ketones)
• Dizziness
• Ear infection (middle ear)
• Enlarged spleen (splenomegaly)
• Fever
• Food allergy (for example, cow's milk, soy or eggs)
• Food poisoning
• Gallstones
• Gastroesophageal reflux disease (GERD)
• Generalized anxiety disorder
• Heart attack
• Heart failure
• Hepatitis
• Hiatal hernia
• Hydrocephalus
• Hyperparathyroidism (overactive parathyroid)
• Hyperthyroidism (overactive thyroid)
• Hypoparathyroidism (underactive parathyroid)
• Intestinal ischemia
• Intestinal obstruction
• Intracranial hematoma
• Intussusception (in children)
• Irritable bowel syndrome
• Medications (including aspirin, nonsteroidal anti-inflammatories, oral contraceptives, digitalis, narcotics and antibiotics)
• Meniere's disease
• Meningitis
• Pancreatic cancer
• Pancreatitis
• Peptic ulcer
• Pseudotumor cerebri (idiopathic intracranial hypertension)
• Pyloric stenosis (in infants)
• Radiation therapy
• Severe pain
• Toxic hepatitis

When to see a doctor

Call 911 or emergency medical assistance

Seek prompt medical attention if nausea and vomiting are accompanied by other warning signs, such as:

• Chest pain
• Severe abdominal pain or cramping
• Blurred vision
• Confusion
• High fever and stiff neck
• Fecal material or fecal odor in the vomit
• Rectal bleeding

Seek immediate medical attention

Ask someone to drive you to urgent care or an emergency room if:

• Nausea and vomiting are accompanied by pain or a severe headache, especially if you haven't had this type of headache before
• You have signs or symptoms of dehydration — excessive thirst, dry mouth, infrequent urination, dark-colored urine and weakness, or dizziness or lightheadedness upon standing
• Your vomit contains blood, resembles coffee grounds or is green

Schedule a doctor's visit

Make an appointment with your doctor if:

• Vomiting lasts more than two days for adults, 24 hours for children under age 2 or 12 hours for infants
• You've had bouts of nausea and vomiting for longer than one month
• You've experienced unexplained weight loss along with nausea and vomiting

Take self-care measures while you wait for your appointment with your doctor:

• Take it easy. Too much activity and not getting enough rest might make nausea worse.
• Stay hydrated. Take small sips of cold, clear, carbonated or sour drinks, such as ginger ale, lemonade and water. Mint tea also may help. Oral rehydration solutions, such as Pedialyte, can aid in preventing dehydration.
• Avoid strong odors and other triggers. Food and cooking smells, perfume, smoke, stuffy rooms, heat, humidity, flickering lights, and driving are among the possible triggers of nausea and vomiting.
• Eat bland foods. Start with easily digested foods such as gelatin, crackers and toast. When you can keep these down, try cereal, rice, fruit, and salty or high-protein, high-carbohydrate foods. Avoid fatty or spicy foods. Wait to eat solid foods until about six hours after the last time you vomited.
• Use nonprescription motion sickness medicines. If you're planning a trip, nonprescription motion sickness drugs, such as dimenhydrinate (Dramamine) or meclizine (Bonine) may help calm your queasy stomach. For longer journeys, such as a cruise, ask your health care provider about prescription motion sickness adhesive patches, such as scopolamine (Transderm Scop).

If your queasiness stems from pregnancy, try nibbling on some crackers before you get out of bed in the morning.