Nausea and Vomiting, Age 12 and Older
Nausea is a sick feeling in the pit of your stomach. When you are nauseated, you may feel weak and sweaty and have too much saliva in your mouth. You may even vomit. This forces your stomach contents up your esophagus and out of your mouth. Most of the time, nausea and vomiting are not serious. Home treatment will often help you feel better.
Nausea and vomiting can be a symptom of another illness. Nausea and vomiting may be caused by:
- Illness caused by a virus, such as viral stomach illness (gastroenteritis).
- Food poisoning.
- Medicines, such as antibiotics, birth control pills, or heart medicines.
- Pregnancy. "Morning sickness" may be one of your first symptoms.
- Problems with abdominal (belly) organs.
- Migraine headache.
- Heart attack.
- Head injury.
- Alcohol or drug abuse or withdrawal.
- Eating disorders, such as anorexia or bulimia.
- Disorders of the inner ear, such as labyrinthitis, Ménière's disease, or motion sickness.
- Radiation therapy.
Nausea or vomiting also may be a symptom of a problem or a disease, such as:
- Liver disease (hepatitis or cirrhosis).
- Inflammation of the pancreas (pancreatitis).
- Inflammation or irritation of the lining of the stomach (gastritis).
- Ulcer disease of the stomach or small intestine (peptic ulcers).
- Gallbladder problems (cholecystitis).
- Inflammation of the appendix (appendicitis).
- Kidney stones.
- Kidney disease (pyelonephritis or chronic kidney disease).
- Urinary problems, such as a urinary tract infection (UTI).
- Bowel problems, such as a bowel obstruction.
- Infection in or around the brain, such as meningitis, encephalitis, or a brain tumor.
Nausea and vomiting can quickly cause dehydration. Older adults have an increased chance of becoming dehydrated.
Check your symptoms to decide if and when you should see a doctor.
Check Your Symptoms
Severe dehydration means:
- Your mouth and eyes may be extremely dry.
- You may pass little or no urine for 12 or more hours.
- You may not feel alert or be able to think clearly.
- You may be too weak or dizzy to stand.
- You may pass out.
Moderate dehydration means:
- You may be a lot more thirsty than usual.
- Your mouth and eyes may be drier than usual.
- You may pass little or no urine for 8 or more hours.
- You may feel dizzy when you stand or sit up.
Mild dehydration means:
- You may be more thirsty than usual.
- You may pass less urine than usual.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
It is easy for your diabetes to become out of control when you are sick. Because of an illness:
- Your blood sugar may be too high or too low.
- You may not be able take your diabetes medicine (if you are vomiting or having trouble keeping food or fluids down).
- You may not know how to adjust the timing or dose of your diabetes medicine.
- You may not be eating enough or drinking enough fluids.
Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.
Symptoms of shock in a child may include:
- Passing out.
- Being very sleepy or hard to wake up.
- Not responding when being touched or talked to.
- Breathing much faster than usual.
- Acting confused. The child may not know where he or she is.
You can get dehydrated when you lose a lot of fluids because of problems like vomiting or fever.
Symptoms of dehydration can range from mild to severe. For example:
- You may feel tired and edgy (mild dehydration), or you may feel weak, not alert, and not able to think clearly (severe dehydration).
- You may pass less urine than usual (mild dehydration), or you may not be passing urine at all (severe dehydration).
Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:
- Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
- Long-term alcohol and drug problems.
- Steroid medicines, which may be used to treat a variety of conditions.
- Chemotherapy and radiation therapy for cancer.
- Other medicines used to treat autoimmune disease.
- Medicines taken after organ transplant.
- Not having a spleen.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
If you're not sure if a fever is high, moderate, or mild, think about these issues:
With a high fever:
- You feel very hot.
- It is likely one of the highest fevers you've ever had. High fevers are not that common, especially in adults.
With a moderate fever:
- You feel warm or hot.
- You know you have a fever.
With a mild fever:
- You may feel a little warm.
- You think you might have a fever, but you're not sure.
Symptoms of serious illness may include:
- A severe headache.
- A stiff neck.
- Mental changes, such as feeling confused or much less alert.
- Extreme fatigue (to the point where it's hard for you to function).
- Shaking chills.
Severe vomiting can mean that:
- You vomit more than 10 times in 24 hours.
- For at least 24 hours, you vomit every time you try to drink something.
- The vomit shoots out in large amounts and with great force.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
- Make an appointment to see your doctor in the next 1 to 2 weeks.
- If appropriate, try home treatment while you are waiting for the appointment.
- If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
After you call 911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.
Symptoms of a heart attack may include:
- Chest pain or pressure, or a strange feeling in the chest.
- Shortness of breath.
- Nausea or vomiting.
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
- Lightheadedness or sudden weakness.
- A fast or irregular heartbeat.
The more of these symptoms you have, the more likely it is that you're having a heart attack. Chest pain or pressure is the most common symptom, but some people, especially women, may not notice it as much as other symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, numbness, tingling, or a strange feeling in your chest or other areas.
Temperature varies a little depending on how you measure it. For adults and children age 12 and older, these are the ranges for high, moderate, and mild, according to how you took the temperature.
Oral (by mouth) temperature
- High: 104 °F (40 °C) and higher
- Moderate: 100.4 °F (38 °C) to 103.9 °F (39.9 °C)
- Mild: 100.3 °F (37.9 °C) and lower
Ear or rectal temperature
- High: 105 °F (40.6 °C) and higher
- Moderate: 101.4 °F (38.6 °C) to 104.9 °F (40.5 °C)
- Mild: 101.3 °F (38.5 °C) and lower
Armpit (axillary) temperature
- High: 103°F (39.5°C) and higher
- Moderate: 99.4 °F (37.4 °C) to 102.9 °F (39.4 °C)
- Mild: 99.3°F (37.3°C) and lower
Many nonprescription and prescription medicines can cause nausea or vomiting. A few examples are:
- Aspirin, ibuprofen (such as Advil or Motrin), and naproxen (such as Aleve).
- Medicines used to treat cancer (chemotherapy).
- Narcotic pain medicines.
- Vitamins and mineral supplements, such as iron.
Starting a new medicine or increasing the dose can cause nausea and vomiting. Nausea and vomiting also may mean that there is too much medicine in your body, even if you took it properly.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.
Symptoms of shock (most of which will be present) include:
- Passing out.
- Feeling very dizzy or lightheaded, like you may pass out.
- Feeling very weak or having trouble standing.
- Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care in the next hour.
- You do not need to call an
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
An illness plan for people with diabetes usually covers things like:
- How often to test blood sugar and what the target range is.
- Whether and how to adjust the dose and timing of insulin or other diabetes medicines.
- What to do if you have trouble keeping food or fluids down.
- When to call your doctor.
The plan is designed to help keep your diabetes in control even though you are sick. When you have diabetes, even a minor illness can cause problems.
Home treatment may be all that is needed to treat occasional nausea.
- Watch for dehydration, and treat it early. Signs of dehydration include being thirstier than usual and having less urine than usual. Older adults and young children can quickly become dehydrated.
- Don't use aspirin or a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, to treat belly pain.
- Take an over-the-counter antinausea medicine, such as meclizine (Antivert or Bonine) or dimenhydrinate (Dramamine), or an antihistamine, such as Benadryl. Don't give antihistamines to your child unless you've checked with the doctor first.
- Try acupressure:
- Place the tip of your right index finger on the underside of your left wrist, about 1.5 in. (4 cm) from your hand. Acupressure points are very small, so you may need to try this method more than one time.
- Apply moderate pressure for 2 to 3 minutes.
- Repeat as needed.
- Acupressure bands, which are available for motion sickness, may help reduce nausea.
- Suck on peppermint candy, or chew a stick of peppermint gum. Peppermint may relax tight muscles in your stomach and help decrease the stomach contractions that may be causing your nausea.
If you are vomiting:
- Rest in bed until you are feeling better.
- Sip a rehydration drink to restore lost fluids and nutrients.
- After vomiting has stopped for 1 hour, drink 1 fl oz (30 mL) of a clear liquid every 20 minutes for 1 hour. Clear liquids include apple or grape juice mixed to half strength with water, rehydration drinks, weak tea with sugar, clear broth, and gelatin dessert. Avoid orange juice, grapefruit juice, tomato juice, and lemonade. Avoid apple and grape juice if you also have diarrhea. Do not drink milk products, alcohol, or carbonated drinks such as sodas.
- If you do not have any more vomiting, increase the amount of fluid you drink to 8 fl oz (240 mL) during the second hour. If you are not vomiting after the second hour, make sure that you continue to drink enough to prevent dehydration.
- When you are feeling better, begin eating clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Gelatin dessert, dry toast, crackers, and cooked cereal are good choices. Try to stay away from strong food odors, which can make nausea worse.
The acid in vomit can erode dental enamel and cause tooth decay (cavities). Rinse your mouth with water after you vomit. Brush your teeth if you can.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home treatment:
- Dehydration develops. Signs of dehydration include being thirstier than usual and having less urine than usual.
- A stiff neck develops.
- Severe vomiting develops.
- Vomit contains blood or material that looks like coffee grounds.
- Vomiting with fever of 103 °F (39.4 °C) or higher occurs or fever lasts longer than 2 days.
- Belly pain develops or gets worse.
- Your symptoms become more severe or more frequent.
Food poisoning is one of the most common causes of nausea and vomiting in adults. To prevent food poisoning:
- Follow the 2-40-140 rule. Don't eat meats, dressing, salads, or other foods that have been kept between 40 °F (4.4 °C) and 140 °F (60 °C) for more than 2 hours.
- Be especially careful with large cooked meats, such as your holiday turkey, which require a long time to cool. Thick parts of the meat may stay over 40 °F (4.4 °C) long enough to allow bacteria to grow.
- Use a thermometer to check your refrigerator. It should be between 34 °F (1.1 °C) and 40 °F (4.4 °C).
- Defrost meats in the refrigerator or the microwave, not on the kitchen counter.
- Wash your hands, cutting boards, and countertops often. After handling raw meats, especially chicken, wash your hands and utensils before preparing other foods.
- The U.S.
Department of Agriculture (USDA) recommends that you reheat meats to over
140 °F (60 °C) for at least 10
minutes to destroy bacteria. Even then the bacteria may not be destroyed.
- Cook all meats to the recommended temperature. See how to cook foods to prevent food poisoning.
- Cook hamburger well done. Cook chicken until the juices run clear.
- Cover meats and poultry during microwave cooking to heat the surface of the meat.
- Do not eat raw eggs or uncooked sauces made with eggs.
- Keep party foods on ice.
- When you eat out, avoid rare and uncooked meats or seafood. Eat salad bar and deli items before they get warm.
- Discard any cans or jars with bulging lids or leaks.
- Follow home canning and freezing instructions carefully. Contact your county agricultural extension office for advice.
- If you think that food may have been stored in your refrigerator for too long, don't take the chance. Throw it out.
For more information, see the topic Food Poisoning and Safe Food Handling.
Increase your chance of staying healthy by:
- Washing your hands often, especially during winter months when viral illnesses are most common.
- Keeping your hands away from your nose, eyes, and mouth. Viruses are most likely to enter your body through these areas.
- Eating a healthy and balanced diet.
- Getting regular exercise.
- Not smoking. Smoking irritates the lining of your nose, sinuses, and lungs, which may increase your risk for problems from a viral illness.
You can help prevent influenza by getting immunized with an influenza vaccine each year, as soon as it's available. The "flu shot" is given by injection. This form of the vaccine prevents most cases of the flu.
Even if a flu shot does not prevent the flu, the vaccine can make your flu symptoms milder and decrease the risk of problems from the flu.
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:
- Describe your nausea and vomiting:
- When did it start?
- How many times have you vomited?
- When did you last vomit?
- What does the vomit look like (blood, coffee grounds, bile, mucus, undigested food)?
- What prescription and nonprescription medicines are
- Are you taking any new prescription or nonprescription medicines?
- Have you recently increased the dose of a medicine?
- Are you taking a medicine more frequently?
- Have you recently been exposed to someone with a similar illness?
- Did your symptoms start after eating at a restaurant? Has anyone else who ate there with you become ill?
- Have you recently eaten raw or undercooked seafood?
- Do you think you have eaten any contaminated food?
- Have you recently drunk any untreated lake, stream, or well water?
- Have you recently gone on a cruise or traveled outside the country?
- Have you had any known exposure to toxic materials, chemicals, or fumes?
- Do you think that your vomiting is caused by alcohol or drug use?
- What home treatment measures have you tried? How well have they worked?
- Do you have any other symptoms, such as diarrhea, fever, headache, urinary problems, or belly pain?
- Do you ever force yourself to vomit?
- Have you ever been diagnosed with an eating disorder, such as anorexia or bulimia?
- Does anyone else in your family have problems with vomiting?
- Do you have any health risks?
|William H. Blahd, Jr., MD, FACEP - Emergency Medicine|
|H. Michael O'Connor, MD - Emergency Medicine|
|Last Revised||October 30, 2013|
Last Revised: October 30, 2013
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