Ongoing Nausea: Common Causes and When Nausea Needs a Visit

What it involves

MedlinePlus defines nausea as the urge to vomit, often called being sick to your stomach, and vomiting as the contents of the stomach being forced up and out of the mouth. It lists many possible causes and says nausea and vomiting are common and usually not serious, although they can be an early sign of more serious problems.

Who this is for

• Adults whose nausea has lasted more than a few days or keeps returning
• Patients who feel sick after meals or on an empty stomach
• Patients who started a new medicine and then felt queasy
• Adults who are losing weight or eating less because of nausea

What to expect

• Questions about timing, meals, other symptoms, travel, weight change and the medicines you take
• A physical exam, including a check for signs of dehydration
• Blood work or a urine test if your provider thinks it will help find the cause
• A referral for imaging, a scope or a stomach emptying study if the pattern points that way

The common causes

The MedlinePlus encyclopedia lists food allergies, infections of the stomach or bowels such as the stomach flu, food poisoning, stomach contents leaking upward in gastroesophageal reflux, migraine headaches, morning sickness, motion sickness, severe pain such as kidney stones and slow emptying of the stomach, called gastroparesis. It also names medicines and medical treatments, including glutides, a type of medicine used to treat diabetes or obesity, cancer chemotherapy and radiation. The heartburn and acid reflux guide and the headache and migraine guide cover two of these causes in more detail.

Medicines are worth a second look

Because medicines are on the list of causes, the visit includes a careful look at what you take, including supplements and anything started recently. MedlinePlus says treatment can include stopping a medicine that might be causing the nausea, but the decision belongs to your provider, so do not stop a prescribed medicine on your own. If you are taking a diabetes or weight medicine and feel sick, say so early, since your provider can weigh that against the benefit. The diabetes management page explains how diabetes follow-up works at the practice.

Warning signs

MedlinePlus says to call 911 or go to an emergency room if you think vomiting is from poisoning or you notice blood or dark, coffee-colored material in the vomit. It says to contact your provider right away for vomiting longer than 24 hours, being unable to keep fluids down for 12 hours or more, headache or stiff neck, not urinating for 8 or more hours, severe stomach pain or vomiting three or more times in a day. The stomach flu and dehydration guide explains the dehydration signs it lists, such as dry mouth, increased thirst and dark yellow urine.

More serious causes that are checked for

The encyclopedia also says nausea and vomiting may be early warning signs of more serious problems, and lists appendicitis, a blockage in the intestines, cancer or a tumor, ingestion of a medicine, drug or poison, and ulcers in the lining of the stomach or small intestine. This is not a prediction for any one person. It is the reason a provider asks about weight loss, belly pain, blood in the vomit or stool and how the symptoms are changing, and why nausea that does not settle should be examined rather than managed indefinitely. The abdominal pain guide covers the pain side of the picture.

What the visit looks like

MedlinePlus says the provider will do a physical exam and look for signs of dehydration, and will ask when the vomiting began, how long and how often it occurs, whether it follows eating or happens on an empty stomach, and whether there is abdominal pain, fever, diarrhea or headache. Other questions cover weight loss, travel, medicines, whether others who ate the same food were ill, pregnancy and marijuana use. Tests that may be performed include blood tests, a urinalysis, imaging of the abdomen, an upper endoscopy and a gastric emptying study, and the last three would be referrals from this practice.

Helping yourself in the meantime

MedlinePlus suggests drinking small amounts of clear liquids often, eating bland foods, avoiding spicy, fatty or salty foods, eating smaller meals more often and avoiding strong smells that can trigger nausea. Those are comfort measures while the cause is found, not a substitute for finding it. If appetite has dropped alongside the nausea, the loss of appetite guide explains what a provider looks for, and the bloating and gas guide covers a related digestive complaint.

Sources

• MedlinePlus — Nausea and vomiting, adults (medical encyclopedia)
• MedlinePlus — Nausea and Vomiting (health topic)