Stomach/GI: Nausea and Vomiting
Overview
Nausea and vomiting are very common symptoms associated with numerous medical conditions and can cause unpleasant feelings of unease, queasiness, and dizziness. Nausea and vomiting are most often the result of gastroenteritis but can be attributed to several other factors. Nausea and vomiting can occur simultaneously or alone. Most episodes are self-limiting and can be managed easily with proper treatment. Sometimes nausea and vomiting can be an early warning sign of a more serious medical condition; they can also be a side effect associated with the use of a medication. It is important to identify and treat the cause early because excessive vomiting can lead to dehydration.

Causes/Common Triggers
Nausea and vomiting can result from a number of situations and conditions:
  • Motion sickness
  • Gastrointestinal infection
  • Chemotherapy
  • Overeating
  • Bowel obstruction
  • Early pregnancy
  • Concussion/brain injury
  • Appendicitis
  • Migraine headache
  • Gastroparesis
  • Emotional stress
  • Medication induced
Nausea and vomiting can also be a sign of a serious medical condition, such as a heart attack, kidney or liver disorder, or gallbladder disease.

Tests and Diagnosis
Your doctor will conduct a physical examination, check for signs of dehydration, and review your symptoms and medical history. He or she will then determine a treatment plan to suit your individual needs.

Prevention
Not all cases of nausea and vomiting can be prevented. If you are prone to motion sickness, for example, it is imperative that you take medications at least 30 minutes before traveling. Patients undergoing chemotherapy typically receive anti-emetics to prevent nausea and vomiting.

Management
If you are experiencing nausea and vomiting, it is important to drink plenty of clear liquids to prevent dehydration and to rest when possible. Other management strategies include the following:
  • Eat light, bland foods such as crackers or toast.
  • Eat only small amounts of food.
  • Avoid fried or greasy foods or foods with strong odors.
Treatment and Care
Nausea and vomiting typically involve the use of medications called antiemetics to control symptoms. Routine fluid replacement is also a mainstay of treatment to decrease the likelihood of dehydration. Other treatments may also be needed depending on the cause of the nausea and vomiting. If nausea is not relieved by lifestyle modifications or use of OTC anti-emetic medications, or if nausea and vomiting worsen, you should consult your primary health care provider. This is especially true if nausea is accompanied by excessive vomiting or if you are exhibiting these signs of dehydration:
  • Increased thirst
  • Decreased urine output
  • Dark-colored urine
  • Dry lips, mouth, and skin
  • Fatigue
  • Sunken eyes
  • Dizziness or lightheadedness
  • Few or no tears when crying
Patients showing signs of dehydration, especially children and the elderly, should be evaluated and treated immediately by their doctor to prevent further complications.

Homeopathic and Alternative Remedies
Some health care professionals may recommend the use of ginger tea to ease nausea, especially for nausea attributed to morning sickness. Some studies have shown that aromatherapy with peppermint oil and acupressure may also relieve nausea.

Self-Care
OTC anti-emetic medications are available to relieve nausea symptoms. To avoid potential drug–drug interactions or contraindications, a pharmacist can provide advice or recommendations based on your preferences and symptoms.

Educational Resources
PHARMACIST INFORMATION
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