Nausea

The Secret of Great Health Care

Your Subtitle text

Nausea

Free ebook chapter on nausea

Nausea is an unpleasant sensation in the gastrointestinal tract that often comes before vomiting. Vomiting is a forceful abdominal contraction that expels the contents of the stomach. Nausea is not a disease – but a symptom.

Regurgitation is spitting up of gastric content without nausea and without a forceful abdominal contraction.

What causes nausea

There are multiple causes of nausea and vomiting.

Infections – stomach virus
Food poisoning
Milk allergy
Motion sickness
Some medications
Psychological stress
Pain
Early pregnancy
Overeating
Cancer
Gastroparesis (a disease when the nerves in the stomach do not work well – seen most often in diabetics)
Diseases of the stomach such as small bowel obstruction
Liver diseases such as hepatitis
Toxic ingestion
Anything that affects the vomiting center in the brain such as increased pressure in the brain from a tumor, bruise or bleed
Migraine headache
Ulcers
Heart attack

A few key points that need to be considered when there is nausea and/or vomiting. When did it start? Nausea shortly after eating may suggest food poisoning or an inflammation of the stomach.

How long did it last?

Was there a recent head injury? This needs medical evaluation.

Was there any recent motion such as a plane ride, boat ride or amusement park trip? This may indicate motion sickness.

What is the content of the vomit? Is it bile (yellow-green), blood (red or coffee ground), or a recently consumed meal?

What are the associated symptoms? Abdominal pain, abdominal distention, diarrhea (gastroenteritis), headache (bleeding in the brain)?

When was the last time you passed a stool or passed gas? If it has been a long time consider a bowel obstruction and seek medical attention.

Is there any chance of pregnancy? When was the last menstrual period? Is there any breast swelling or tenderness?

Is there any blood in the urine or flank pain? This may indicate kidney stones. Kidney stones usually present with severe pain.

What is the risk of nausea

Complications of nausea and vomiting itself are not common unless it is prolonged or forceful. Complications include dehydration and electrolyte disturbances (such as low potassium level). Less commonly there are tears in the esophagus. Chronic nausea and vomiting may result in malnutrition and weight loss.

The major risk may be the underlying cause. Most cases of nausea are self-limiting and benign. Every once in a while a more serious underlying cause is present that is risky. See the "Who needs to go to the doctor" section.

Who needs to see a doctor

Dehydration – dry mouth, cracked lips, increased pulse rate, dizzy when standing, dark urine or reduced urine output

Dizziness

History of heart problems

Stomach or chest pain

Pregnant or may be pregnant

Diabetics – especially if taking insulin

Blood in the vomit

Fever over 101 degrees Fahrenheit

Headache, stiff neck or confusion

Severe abdominal pain

Not passing stool

Just started taking a new medication

Prolonged nausea or vomiting

Recurrent vomiting in pregnancy

Home treatment is not working

Those under six should see a doctor if there is vomiting/diarrhea that has lasted more than a few hours, if there is a fever or if there is a reduction in urine production

Those over six should go to a doctor if there is fever (above 101 degrees Fahrenheit), diarrhea or vomiting that has persisted over 24 hours

Treatment

Most cases of nausea are self-limiting. Management options include treating the cause, preventing dehydration, providing comfort and monitoring for complications.

To prevent dehydration drink clear fluid as the body can tolerate. Do not consume irritating foods/drinks or medications. Do not discontinue any medication given to you by a health care provider or recommended without first consulting the health care provider.

The use of a hydrating solution – such as Pedialyte – may be helpful if there is vomiting and diarrhea that has persisted.

The use of dry crackers or ginger products may be helpful – to settle the stomach.

The use of over-the-counter medications (see table below) may provide some relief to the person with nausea. While none are magic treatments, they may provide some comfort. No product has proven to be most efficacious. Given he fact that there is limited negative side effects, a trial of one of the products is worth it to minimize the discomfort that nausea can bring.

To purchase products discussed in this chapter visit The Drug Store.

Prescription medications

When time and over-the-counter medications do not provide relief the use of prescription medications can be used.

When there is motion sickness, the use of antihistamines or a scoplamine patch may help (see section on motion sickness for more details).

General medications for nausea are associated with many side effects including sedation. Common prescriptions include: promethazine (Phenergan) and prochlorperazine (Compazine).

Those affected with diabetic gastroparesis may be treated with metoclopramide (Reglan).

For those with severe nausea and vomiting – particularly cancer patients - can be tried on ondansetron (Zofran). This medication can cost over 20 dollars per dose.

Over-the-counter products for nausea

Product	Active ingredient	Directions
Emetrol	Dextrose, levulose and phosphoric acid	Adults take 1-2 tablespoons every 15 minutes, children 2-12-years-old take 1-2 teaspoons every 15 minutes until nausea is gone, do not take more than 4 doses without consulting a doctor
Nauzene	Dextrose, levulose and sodium citrate dihydrate	Adults take 2-4 tablets every 15 minutes (max 6 doses); less than 18 consult a doctor
Pepto-bismol	Bismuth Subsalicylate	For those over 12-years-old take 2 tablet every 30-60 minutes; use with doctor's advice if under 12-years-old. Max 8 doses in 24 hours; children and teenagers who have or are recovering from a viral illness should not use this product.
Children's Pepto Bismol	Calcium Carbonate	6-11-years-old take 2 tablets and those 2-5-years-old take 1 tablet; the dose may be repeated as need but no more than 3 doses in 24-hours.

Bonus: How to Treat Nausea