Nausea is the sensation of having an urge to vomit. Vomiting is forcing the contents of the stomach up through the esophagus and out of the mouth.
Emesis; Vomiting; Stomach upset; Upset stomach
Your body has a few main ways to respond to an ever-changing, wide variety of invaders and irritants. Sneezing ejects the intruders from the nose, coughing from the lungs and throat, diarrhea from the intestines, and vomiting from the stomach.
Vomiting is a forceful action accomplished by a fierce, downward contraction of the diaphragm muscle. At the same time, the abdominal muscles tighten against a relaxed stomach with an open gastroesophageal sphincter. The contents of the stomach are propelled up and out.
As part of a bodily reflex, you may produce more saliva just before vomiting.
Vomiting is a complex, coordinated reflex orchestrated by the vomiting center of the brain. It responds to signals coming from:
An amazing variety of stimuli can trigger vomiting, from migraines to kidney stones. Sometimes, just seeing someone else vomit will start you vomiting, in your body's effort to protect you from possible exposure to the same danger.
Vomiting is common. Almost all children will vomit several times during their childhood. In most cases, it is due to a viral gastrointestinal infection.
Spitting up, the gentle sloshing of stomach contents up and out of the mouth, sometimes with a burp, is an entirely different process. Some spitting up is normal for babies, and usually gets gradually better over time. If spitting up worsens or is more frequent, it might be reflux disease. Discuss this with your child's doctor.
Most of the time, nausea and vomiting do not require urgent medical attention. However, if the symptoms continue for days, they are severe, or you cannot keep down any food or fluids, you may have a more serious condition.
The following are possible causes of vomiting:
These are possible causes of vomiting in infants (0 - 6 months):
Call the doctor immediately or take the child to an emergency care facility if you suspect poisoning or drug ingestion.
It is important to stay hydrated. Try frequent, small amounts of clear liquids, such as electrolyte solutions. Other clear liquids -- such as water, ginger ale, or fruit juices -- also work unless the vomiting is severe or it is a baby who is vomiting.
For breast-fed babies, breast milk is usually best. Formula-fed babies usually need clear liquids.
Don't drink too much at one time. Stretching the stomach can make nausea and vomiting worse. Avoid solid foods until there has been no vomiting for six hours, and then work slowly back to a normal diet.
An over-the-counter bismuth stomach remedy like Pepto-Bismol is effective for upset stomach, nausea, indigestion, and diarrhea. Because it contains aspirin-like salicylates, it should NOT be used in children or teenagers who might have (or recently had) chickenpox or the flu.
Most vomiting comes from mild viral or food-related illnesses. Nevertheless, if you suspect the vomiting is from something serious, the person may need to be seen immediately by a medical professional.
If you have morning sickness during pregnancy, ask your doctor about the many possible treatments.
The following may help treat motion sickness:
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:
Signs of dehydration include:
You should also call if:
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:
The following diagnostic tests may be performed:
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.
A number of medicines are effective at preventing vomiting. In some situations, preventing the vomiting makes life much better.
Proctor DD. Approach to the patient with gastrointestinal disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 134.
This article uses information by permission from Alan Greene, M.D., © Greene Ink, Inc.