Sunday, February, 12, 2012

Nausea and vomiting

Table of Contents

Call 911 or go to an emergency room if you think vomiting is from poisoning or a child has taken aspirin.

Call a health care provider if the person has:

  • Been vomiting for longer than 24 hours
  • Blood or bile in the vomit
  • Severe abdominal pain
  • Headache and stiff neck
  • Signs of dehydration

Signs of dehydration include:

  • Increased thirst
  • Infrequent urination or dark yellow urine
  • Dry mouth
  • Eyes that appear sunken
  • Crying without tears
  • Loss of normal skin elasticity (if you touch or squeeze the skin, it doesn't bounce back the way it usually does)

You should also call if:

  • A young child is lethargic or has marked irritability.
  • An infant vomits repeatedly.
  • A child is unable to retain any fluids for 8 hours or more.
  • Vomiting is recurrent.
  • An adult is unable to retain any fluids for 12 hours or more.
  • There is a decrease in urination (including a baby who is not wetting the normal amount of diapers).
  • Nausea persists for a prolonged period of time (in a person who is not pregnant).

What to expect at your health care provider's office

Your health care provider will perform a physical examination, particularly to look for signs of dehydration.

To help diagnose the cause of the nausea or vomiting, your health care provider will ask medical history questions, such as:

  • When did the vomiting begin? How long has it lasted?
  • Does it occur several hours after meals?
  • What other symptoms are present -- abdominal pain, fever, diarrhea, poor skin turgor, other signs of dehydration, abdominal swelling, headaches?
  • Are you vomiting fresh blood? Do you have repeated episodes of vomiting blood?
  • Are you vomiting material that looks like coffee grounds?
  • Are you vomiting undigested food?
  • Are you vomiting greenish material?
  • Is the nausea or vomiting severe enough to cause unintentional weight loss?
  • Is the vomiting self-induced?
  • Have you been traveling? Where?
  • What medications do you take?
  • Did other people that ate at the same location as you have the same symptoms?
  • Are you pregnant or could you be pregnant?

The following diagnostic tests may be performed:

  • Blood tests (such as CBC with differential, blood electrolyte levels, and liver function tests)
  • Urinalysis
  • X-rays of the abdomen

If dehydration is severe, you may need intravenous fluids. This may require hospitalization, although it can often be done in a doctor's office. Antivomiting drugs (anti-emetics) may be helpful but they should be used only when the potential benefits outweigh the risks.


Images
  • < Page
    • 1 2
  • >

Review Date: 10/20/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)