Nauseas and vomiting are usually manifestation of some underlying disease that are usually non life threatening. Occasionally, it might be an indicator of underlying serious conditions like brain disease, intestinal obstruction and heart disease. Nausea is the feeling of uneasiness in the stomach whereas vomiting is the forceful emptying of the stomach content. Vomiting occurs when the muscles of stomach and esophagus contract vigorously forcing the food content up and out of mouth. Occasionally, during these contraction no food particles are ejected. It is called “retching”. Vigorous retching can lead to tear in the inner lining of the esophagus called “Mallory Weiss tear” or sometimes lead to rupture of the esophagus. Nausea and vomiting usually occur together but can occur separately. You can have nausea that does not lead to vomiting and you may have vomiting without nausea. Nausea and vomiting is triggered by stimulation of stomach and  intestine, inner ear and brain.

Common Causes

• Gastrointestinal system:
  • Gastroenteritis (usually viral)
  • Food poisoning, food allergies
  • Peptic ulcer disease, gastroesophageal reflux disease (GERD)
  • Gallstones
  • Liver disease: hepatitis
  • Intestinal obstruction

• Side effects of medicines and therapy:

• Chemotherapy: anticancer drugs  and radiation therapy can cause nausea and vomiting
• Effects of anesthesia: sometime nausea and vomiting is caused by general anesthesia in post operative period
• Morphine can induce nausea and vomiting

• Endocrine/ hormonal causes:

• Delayed emptying of gastric contents due to complication of diabetes
• Inadequate hormone production from adrenal gland
• Morning sickness during first three months of pregnancy

• Neurological cause:

• Migraine headache
• Increased intracranial pressure from meningitis, brain tumor, hematoma, enlarged brain ventricles

• Others:  

• Motion sickness
• Intense pain from internal organ, example heart attack, kidney stone
• Alcohol abuse

When to seek Care

Nausea and vomiting are usually non life threatening and resolve in a day or two with home remedies. Seek immediate medical care if nausea and vomiting is accompanied by:

• Dehydration
• Vomiting of blood
• Constant severe abdominal pain
• Chest or back pain
• Fever above 102°F
• Stiffness of neck
• Lethargy/confusion
• Rapid respiration and pulse
• Reduced or absent urine output

Treatment Options

Treatment of nausea and vomiting depends on its cause. In addition to treating the underlying cause, fluid and electrolyte imbalance should be corrected by oral rehydration solution/ intravenous infusion along with antiemetic medicine. Stay hydrated, avoid too much activity, avoid exposure to strong smell or odor, eat bland and digestible food.

Nausea and vomiting associated with pregnancy usually resolves on its own after several months of pregnancy. No medicine should be taken  by pregnant women without medical advice in order to avoid harmful effect to the fetus.

Nausea vomiting can be life threatening in children. Every measures should be taken to avoid dehydration.