Nausea and Vomiting
What is Nausea?
Nausea is usually described as queasy, unpleasant sensations in the stomach leading to the urge to vomit. Nausea is often a symptom of various disorders that may be relatively minor or quite severe. Nausea is usually felt when nerve endings in the stomach or other parts of the body (such as the inner ear) are irritated. The irritated nerves send messages to the center in the brain that controls the vomiting reflex. When the nerve irritation becomes intense, vomiting results.
How is it diagnosed?
History: Individuals may complain of fever, dizziness, cramps, diarrhea, and vomiting along with the feeling of nausea. Individuals should be screened for medication use and side effects and the correlation of symptoms with events or emotions that might bring on symptoms. Ingestion of food and beverages that may also precipitate episodes should be considered. In female individuals of childbearing age, pregnancy is a possibility. History of foreign travel and possible related disease should be considered. Chemical and industrial fumes and unpleasant odors can also cause nausea. Individuals should also be screened for possible exposure to hepatitis. Nausea is also a symptom of head injury.
Physical exam Common physical symptoms include abdominal tenderness, abnormal bowel sounds, fever, and distended abdomen. Individuals with hepatitis may have jaundice and liver enlargement. Dark stools may signal ulcer or tumor. Visual disturbances and difficulty with balance and coordination are common with head injury.
Tests: Laboratory testing includes blood or urine test to rule out pregnancy, gastrointestinal x-ray studies (barium enema, upper gastrointestinal, esophagogastroduodenoscopy), stool testing, and diagnostic testing for inner ear function and balance, and head injury (CT scan, MRI).
How is Nausea treated?
Medications often provide short-term relief from symptoms caused by pregnancy, chemotherapy, pain, stress, or migraine headaches. Surgery may be necessary for gallbladder disease. Inner ear disease and diseases of equilibrium require long-term treatment, as do eating disorders, gastrointestinal conditions (ulcer, heartburn, colitis), and cancer.
What might complicate it?
Complications include stress, intense pain, fever, infection, cardiovascular disease, or diabetes.
With treatment, outcome is good.
Other conditions include allergic reaction, food intolerance, pregnancy, concussion, migraine headache, hepatitis, side effect of cancer therapy (chemotherapy), infection, stress, gallbladder disease, ulcer, heartburn, motion sickness, food poisoning, disturbances of equilibrium, and eating disorders (bulimia, anorexia nervosa).
Gastroenterologist and internist.
Last updated 24 November 2011