Medical Help For Vomiting (Nausea, Upset Stomach)
“Almost everyone vomits from time to time. Brief episodes of vomiting may be due to a virus or a dietary indiscretion. For some people, vomiting occurs as part of a pattern of illness. If you are vomiting frequently or have other warning signs of a serious illness, it’s important that you seek medical care.”
What is the difference between nausea and vomiting?
Nausea is the sensation that you are about to vomit. It may occur by itself or may actually be followed by vomiting, which is the forceful ejection of the stomach contents up through the esophagus and out your mouth. Both nausea and vomiting are extremely unpleasant sensations that most people would just as soon avoid!
Causes of nausea and vomiting
There are many conditions that can make us feel nauseated or cause us to vomit. The following is only a partial list:
- stomach or intestinal infection with a virus or bacteria– we’ve all experienced “the stomach flu”, which often causes nausea, vomiting and diarrhea for a day or two and usually subsides on its own without treatment. Viral gastrointestinal illnesses are extremely contagious and can be passed from person to person very easily. Bacterial illness affecting the GI tract may result from eating contaminated food (“food poisoning”) and can make you feel very ill. Food poisoning often requires medical treatment.
- acid reflux and GERD (gastroesophageal reflux disease)- in GERD, patients sometimes vomit because the flap of tissue between the stomach and esophagus which prevents food from “refluxing” from the stomach back up into the esophagus is incompetent
- pain– patients will sometimes become nauseated when they are in pain and may actually vomit when pain is severe (think kidney stones and migraine headaches)
- food intolerance/allergies– some people become nauseated when they eat foods that they are sensitive or allergic to, or foods that they lack the proper enzyme to digest
- medications– many medications, such as antibiotics and opioids, have nausea as a side effect (which doesn’t necessarily mean that the person is allergic to the medication); nausea due to medication may pass as your body adjusts to the medication
- motion sickness– some people become nauseated and may vomit when they travel by car or boat
- morning sickness- some women experience nausea and vomiting during pregnancy, thought to be due to hormonal changes
- ulcers– some people with gastric or duodenal ulcers may experience nausea/vomiting
- bowel obstruction– nausea and vomiting are common symptoms of bowel obstruction, more typically with small bowel obstructions
- cancer or cancer treatment– certain types of cancer may cause nausea and vomiting (i.e., colon cancer resulting in bowel obstruction); chemotherapy, radiation and other cancer treatments may also cause nausea and vomiting
How do I know if I need to be seen by a doctor?
As can be seen, nausea and vomiting may be caused by a number of conditions, some fairly benign and others far more serious. It can be difficult to determine when you should come in to be assessed. The following are some guidelines:
- dehydration- if you are unable to keep any fluids down, or you are vomiting very frequently and/or experiencing diarrhea, you may become dehydrated. If you are dehydrated, you may feel weak, dizzy and very thirsty with a dry mouth. You may urinate less often, your urine may appear darker than normal and your eyes may appear sunken in your eye sockets. Even a simple virus can cause significant dehydration that can be dangerous, especially if you have an underlying health condition. If you have been vomiting for longer than a day, or have been unable to keep any fluids down for longer than 12 hours, it may be time to seek help.
- abdominal pain– if you are experiencing severe abdominal pain along with your nausea and vomiting, this may be a sign of a more serious condition such as a bowel obstruction, especially if you are not passing flatus (gas) and have not had a bowel movement in some time.
- urination– if you are urinating infrequently, your urine is very dark in color or you have not voided in longer than 8 hours, you are likely dehydrated.
- vomiting blood– if you are vomiting blood, or dark material resembling coffee grounds, you should seek emergency care
- fever– you may experience a low-grade fever with viral gastrointestinal illness; if your fever is over 101 degrees Fahrenheit you should seek medical care
- weight loss– if you have been nauseated and/or vomiting for a prolonged period of time you may lose weight, which could signify a serious problem.
These are guidelines only. If you are feeling very sick, you should seek medical care- you do not need to have any or all of these symptoms!
What can I expect when I come in with nausea or vomiting?
When you come in to see us complaining of nausea and vomiting we will first need to ask you about your past medical history, any medications you are taking and whether you have any allergies to foods or medications.
Once we have gathered this information, we’ll ask you to describe your current symptoms: when they started, how many times you have vomited and whether you are also experiencing diarrhea or other symptoms such as abdominal pain or fever. We will also ask whether you have taken any over-the-counter remedies for nausea and vomiting and whether they were helpful. We’ll ask you to estimate your fluid and food intake. Once we have gathered all of the pertinent information we will examine you, focusing on signs of dehydration and your abdomen. We will listen to your abdomen and feel for any masses or tender areas that may provide clues as to the cause of your symptoms.
If necessary, we will order lab work such as a CBC and electrolytes to help us determine your level of dehydration and whether an infection might be causing your symptoms. If you are also suffering from diarrhea, we might order a stool culture to look for bacteria in your stool. We may also order an abdominal x-ray if we feel it is needed based on your symptoms.
Once we have gathered the information we need we’ll sit down and discuss what we think is causing your symptoms of nausea and vomiting. Together we’ll decide on the best course of action.
If you have been experiencing nausea and vomiting for longer than a day or two, especially if you are unable to keep fluids down, make an appointment to come in and see me. Whether it takes one visit or more, we’ll figure out what the problem is and get you feeling better!