Nausea and Vomiting Diagnosis

  • Diagnosis

    Nausea is that queasy feeling that often occurs right before you vomit. Vomiting involves forcefully ejecting stomach contents through the mouth. Both are experiences that almost everyone goes through at one time or another.

    Nausea and vomiting can occur together or independently; however, it is rare for them to occur separately. Nausea and vomiting can be insignificant, or can indicate a serious disease. Nausea and vomiting lasting less than 48 hours rarely presents a serious problem. If your symptoms last longer, they may signal a more serious illness.

    A specialist is occasionally required to treat nausea and vomiting. While a doctor is usually not needed in short-term uncomplicated nausea and vomiting, a general physician can certainly treat these symptoms. However, a specialist may be needed if the nausea and vomiting are caused by a serious illness.

    Nausea and vomiting can be caused by medication, infections, or an obstruction in the digestive tract.

    Certain dangerous bacteria in food—particularly in undercooked meat or eggs—may cause a specific type of nausea and vomiting called food poisoning.

    Nausea and vomiting may also stem from reactions in the central nervous system (CNS). If your illness does not seem to be caused by digestive problems, see your doctor to determine if it is caused by your central nervous system (CNS), which consists of the brain and spinal cord. Some of these causes include motion sickness, emotional responses to unpleasant smells or stress, a build-up of urine in the blood (uremia), or elevated levels of thyroid hormone (hyperthyroidism).

    Pregnancy is a common cause of nausea and vomiting. In the first trimester, 70% of pregnant women experience morning sickness.

    Surgery often causes nausea and vomiting. Up to 40% of surgical operations are followed by postoperative nausea and vomiting, more commonly in women and children than in men. Newer anaesthetic agents such as propofol are less nausea-inducing than older agents.

    Severe nausea and vomiting may be a symptom of an illness associated with high fever (such as a viral illness). It can also be associated with pain, such as that resulting from a heart attack.

    Self-induced vomiting after binge eating is a symptom of bulimia, which is an eating disorder. Bulimia is an eating disorder in which a person eats large amounts of food and then forces himself or herself to vomit, takes laxatives or diuretics, fasts, or exercises vigorously to keep from gaining weight. The patient's dentist may diagnose this condition because the tooth enamel may be damaged from contact with stomach acid.

    Nausea is a feeling of being queasy and unwell, or being likely to vomit.

    Weakness or dizziness may accompany nausea. You may feel the need to sit or lie down, and you may break into a sweat.

    Nausea and salivation usually precede vomiting. Vomiting involves expelling the stomach contents through the mouth. The actual act of vomiting involves contractions of the lower stomach, a downward thrust of the diaphragm, and muscular relaxation of the lower esophagus, allowing vomit to be expelled.

    Risk factors vary widely and may be unavoidable, as in the case of pregnancy or chemotherapy treatment. Because nausea and vomiting are often secondary to other conditions, they may be difficult to prevent. In the case of causes such as surgery or pregnancy, nausea and vomiting may be unavoidable and unpleasant secondary effects. Patients should be aware of medications that cause nausea and vomiting, and avoid those medications. In cases of infection or obstruction, nausea and vomiting may be considered an important signal that something serious is occurring in your body.

    Eating meat or fish that is undercooked or raw—particularly pork or shellfish—puts you at risk for nausea and vomiting associated with food poisoning.

    Short bouts of nausea or vomiting do not require a professional diagnosis.

    Consult a physician if symptoms become severe. Don't try to treat yourself if symptoms last more than two days, as this may be a warning signal for a very serious condition. Call your doctor if you have continuous vomiting or diarrhea, severe digestive pain or discomfort, black stool (unless you took a bismuth subsalicylate drug like Pepto Bismol), blood in the stool, or vomiting of blood or digested blood (which looks like coffee grounds).

    If nausea and vomiting are chronic, your physician will want to determine whether the condition originates in your central nervous system or your digestive system. Symptoms such as headache, confusion, difficulty moving about, dizziness, or a history of drug ingestion or stress indicate that your symptoms may originate in your CNS, not your digestive tract. If you have symptoms such as diarrhea, abdominal pain, constipation, and weight loss, however, the condition probably originates in your digestive tract.

    Nausea and vomiting rooted in digestive disease may call for various tests, such as a pregnancy test or tests used to find obstructions. If you are a woman of childbearing age, your doctor will probably start with a pregnancy test. Other tests—called radiography and endoscopy—will help your doctor to see abnormalities in your digestive system that could be causing problems.

    Other tests can be done if you are not pregnant and do not have an obstruction. For example, your doctor will test to see how effectively you are emptying out the contents of your stomach. Sometimes stomach acid splashes up into the esophagus, causing serious irritation. This condition, gastroesophageal reflux disease (GERD) is a result of a weakness in the muscle between your lower esophagus and the top of your stomach. Your doctor may perform additional tests to determine the level of stomach acidity.

    Avoid foods such as fats or sweets that give you nausea.

    Don't read during travel, avoid excess food and drink, keep your sight-line straight ahead, and avoid strong odors. Stay in the part of the vehicle that is moving the least (the front seat of a car, near an airplane's wings, or at the back of a ship).

  • Prevention and Screening

    Avoid foods such as fats or sweets that give you nausea.

    Don't read during travel, avoid excess food and drink, keep your sight-line straight ahead, and avoid strong odors. Stay in the part of the vehicle that is moving the least (the front seat of a car, near an airplane's wings, or at the back of a ship).

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