What nausea and vomiting are and where they come from
Nausea is an unpleasant feeling in the upper belly or throat, the sense that you are about to throw up. Vomiting is the involuntary emptying of the stomach. Neither is a disease: they are signals from the stomach and intestines, the inner ear or the brain, and from medicines, alcohol, pregnancy and stress. Most often the cause is harmless and passes in a day or two, as with a gut infection. The main danger of vomiting is losing fluid, so it helps to know when it is no longer just a stomach bug.
Nausea in the morning
Morning nausea is often an early sign of pregnancy, but not always. An empty stomach, poor sleep, heartburn, gastritis and some medicines can cause it too. If pregnancy is possible, take a test. If morning nausea keeps returning for weeks and you are not pregnant, see a general practitioner or a gastroenterologist.
Nausea and vomiting in pregnancy
In the first months nausea is very common and usually eases gradually. Small, frequent meals and small sips of fluid help. But if you vomit many times a day, cannot keep even water down, lose weight quickly or feel dizzy and weak, do not wait: see a gynecologist.
Nausea and vomiting with diarrhea and fever
Vomiting together with loose stools and a fever most often points to a gut infection or food poisoning. In children it is often rotavirus infection. Vomiting usually settles within one or two days, while stools take longer to return to normal. If nausea comes with yellow skin, dark urine and weakness, it may be hepatitis A, which is a reason to see a doctor. For related symptoms, see Diarrhea and Fever.
Nausea after eating and with abdominal pain
Nausea after meals, heaviness and burning in the upper belly are typical of gastritis, reflux and indigestion. If the pain is sharp and building, especially in the lower right, it belongs on the page Abdominal pain: severe pain with vomiting needs urgent assessment.
Nausea with headache and dizziness
Nausea with a headache is typical of migraine, and with dizziness of inner-ear problems or blood pressure swings. See Headache and Dizziness. But a sudden headache that is the worst of your life, a stiff neck, confusion, or vomiting after a blow to the head is a reason to call 112.
Nausea and vomiting in a child
In children vomiting is mostly infectious, but they get dehydrated faster than adults. Warning signs are refusing to drink, passing urine much less often, a dry mouth, crying without tears, and drowsiness. Show the child to a pediatrician the same day, and a baby with repeated vomiting urgently. If the baby is breastfed, keep feeding, more often and in smaller amounts.
What you can do before the visit
- Drink often and in small sips: water, weak tea, or oral rehydration solutions from a pharmacy. A large amount at once can bring on more vomiting.
- Do not eat for the first hours after vomiting, then return to light food in small portions, avoiding fatty, spicy and fried dishes.
- Rest, air the room, and do not lie down right after a meal.
- Do not take anti-nausea or anti-diarrhea medicines just in case while the cause is unclear, and do not give them to children without a doctor.
- Wash your hands after the toilet and before eating: gut infections are contagious.
- Note when it began, how many times you vomited, what you ate, whether you have a fever and how often you pass urine. The doctor will ask.
How a doctor finds the cause
The doctor asks about the onset, food, medicines, pregnancy and other symptoms, examines the belly and looks for signs of dehydration. Blood, urine and stool tests may follow, an abdominal ultrasound, a gastroscopy, and for head symptoms a neurologist's examination. Treatment depends on the cause; with dehydration a drip may be needed.