Nausea is an unpleasant feeling of need to vomit. The person may also feel dizzy, vague discomfort in the abdomen and little willingness to eat.
Vomiting is a forced contraction of the stomach that pushes its contents through the esophagus to exit through the mouth. Vomiting empties the stomach of its contents and often makes a person with nausea feel considerably better, at least for a while. Vomiting is quite uncomfortable, and it can be violent. An intense vomit can throw the stomach content several meters away (shotgun vomit).
Vomiting, that is, vomited material, usually reflects what has been eaten recently. Sometimes it contains fragments of food. When vomiting blood, the vomit is usually red (hematemesis), but if the blood has been partially digested it looks like coffee beans. If the vomit contains bile, it has a bitter taste and a yellow-green color.
Nausea and vomiting occur when the center of the vomit is activated in the brain. Usually, the causes are associated with disorders of the digestive tract or the brain, or substances ingested.
- The most frequent causes of nausea and vomiting are:
- Gastroenteritis (infection of the digestive tract)
- Drugs or substances
Nausea and vomiting usually occur when there is some digestive tract dysfunction, but they are especially frequent in gastroenteritis (see Gastroenteritis). Intestinal obstruction is a less frequent disorder that causes vomiting because food and fluids recede into the stomach because of the obstruction. Many other abdominal disorders that cause vomiting can also cause significant abdominal pain. In these disorders (for example, appendicitis and pancreatitis) is usually pain, rather than vomiting, which makes the person go to the doctor.
Nausea and vomiting can also be caused by many drugs and substances, such as alcohol, opioid analgesics (such as morphine), and antineoplastic (chemotherapeutic) drugs. Toxic substances, such as lead and some found in food and plants, can cause severe nausea and vomiting.
Less Frequent Causes
The less frequent causes of nausea and vomiting are:
- Disorders of the brain or central nervous system
- Dizziness of the traveler (motion sickness)
- Metabolic changes or disease that affects the entire organism (systemic disease)
- Psychological disorders
Nausea and vomiting can also occur with metabolic changes in the body, such as early in pregnancy, or with severely out-of-control diabetes or severe liver or kidney failure.
Nausea and vomiting are also associated with certain psychological problems (so-called functional or psychogenic vomiting). This type of vomiting can be intentional; For example, people who have bulimia cause vomiting to lose weight. Or it may be unintentional; For example, children who are afraid to go to school vomit as an answer to their psychological distress.
The specific disorders must be treated. If there is no serious underlying disease and the patient is not dehydrated, it is recommended to ingest small amounts of clear liquids about half an hour after the last episode of vomiting. Normally you start with about 30 ml. Water is a suitable liquid, but you can also give broth or a little loaded and sweetened tea. Isotonic drinks have no particular advantage, but they are not harmful. Avoid carbonated drinks and alcohol. If the person tolerates liquids, the amount will gradually increase. When you also tolerate these increases, you can start taking solid foods.
Even when the person is just a little dehydrated, doctors usually recommend oral rehydration solutions, as long as they can tolerate some fluids by mouth. In case of major dehydration or electrolyte abnormalities, active vomiting or intolerance to liquids by mouth, it is usually necessary to administer fluids and/or drugs intravenously.
In some adults and adolescents, medications are administered to relieve nausea (antiemetics), depending on the cause and severity of vomiting:
For vomiting caused by dizziness: antihistamines (such as dimenhydrinate), scopolamine patches, or both.
For mild to moderate symptoms: prochlorperazine or metoclopramide.