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Nausea et vomitus
Not how strong it is but when it comes and what comes with it leads to the cause — and in women of childbearing age the pregnancy test comes first.
Also known as: nausea · vomiting · upset stomach
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Nausea and vomiting are not an illness but a protective reflex that can be triggered from very different places. The digestive tract is only one of them: the balance organ in the inner ear, the head, the metabolism and almost any medicine can set it off. What helps most is therefore not the question of how strong it is, but when it comes and what comes with it. Shortly after eating points more to the stomach, hours later to delayed emptying, in the morning to pregnancy, to alcohol or — with headache — to raised pressure in the head. Together with spinning dizziness the origin lies in the inner ear; together with dislike of light and one-sided headache, in migraine. In women of childbearing age a pregnancy test belongs at the beginning, not at the end. Medicines are often overlooked: opioids, antibiotics, iron preparations and the newer treatments for blood sugar and weight very often cause nausea. Practically decisive is the fluid balance — small sips at short intervals achieve more than a large glass that comes straight back up. Anyone who keeps nothing down for a day needs help; for a child, half that time.
One or two sips every few minutes, cool, still, by the spoonful if need be. A large glass stretches the stomach and reliably comes back — that is the commonest mistake.
Rusk, rice, potato, banana, pretzel sticks. Fatty things, sweet things and milk later. The stomach takes carbohydrates back most quickly.
In travel sickness and in pregnancy one of the few home remedies with a usable basis. With heavy vomiting it does not replace treatment.
It is cheap, quick and changes every subsequent decision. No X-ray and no medicine without this result.
What has been added in the last two weeks, what has been increased in dose? This one question explains a surprisingly large share of cases.
After several days of vomiting, potassium and sodium are often shifted. Muscle weakness and a stumbling heartbeat are then not a new problem but a consequence — and quickly put right.
Nausea over weeks, in the morning and after eating, is part of the picture of giardia in children.
One to two grams of fresh ginger spread over the day — as thin slices, as tea or chewed.
Six level teaspoons of sugar and half a teaspoon of salt in a litre of boiled water — sipped through the day.
Stomach cramps with vomiting a few hours after sushi or marinated anchovies are a picture of their own. Deep-frozen fish is safe, fresh is not always.
The drugs act at different docking sites, so not every one fits every cause: ondansetron at serotonin — strong in chemotherapy and gut infection, without effect in travel sickness; metoclopramide and domperidone at dopamine and at stomach movement; dimenhydrinate and scopolamine at the balance organ. Ginger has been studied in pregnancy and after surgery. For all of them: small amounts often rather than a lot at once.
Vomiting in a gut infection usually stops within twenty-four hours, the diarrhoea lasts longer. After the last vomit, five to ten millilitres every five minutes is the start — larger amounts set off vomiting again. Vomiting without diarrhoea, with headache or after a head injury, or with belly pain lasting over six hours, is something else and belongs under examination. In pregnancy, nausea affects seven to eight in ten women and usually ends around the twelfth to sixteenth week.
Fresh blood or dark, grainy content means bleeding in the upper digestive tract. That belongs clarified at once and not left until the next morning.
Vomiting together with a violent headache, a stiff neck, fever or after a fall on the head points in a quite different direction and is urgent.
Vomiting with no stool and no wind, together with a distended, tender belly, speaks for an obstruction. That is a surgical emergency.
Opioids, antibiotics, iron and the newer medicines for diabetes and overweight very often cause nausea. It is the quickest explanation of all to check.
Dry lips, hardly any nappies, a listless child — here time counts differently than in adults. Green vomit in a baby belongs looked at at once.
The first step in any woman of childbearing age — however unlikely it seems. It changes everything that follows, from imaging to medication.
With longer vomiting the salt balance tips. A low sodium explains confusion and weakness and can itself become a cause of the nausea.
Lost together with the stomach juice. Muscle weakness, calf cramps and a stumbling heartbeat after days of vomiting almost always come from here.
The value that shows how much fluid is already missing. It is also the reason why certain medicines are paused temporarily during vomiting.
Well studied for nausea: 1–1.5 g of powder a day, split into several doses. The evidence is strongest in pregnancy and after operations; in travel sickness it acts on the nausea, not on the dizziness.
With lasting vomiting potassium and sodium go too. Oral rehydration replaces both; plain water alone does not cover the loss and can dilute it further.
The pregnancy hormone rises steeply in the first weeks, and the course of the nausea follows it: peak around the ninth week, mostly easing afterwards. With twins the value is higher — and the nausea often stronger.
With slowed stomach emptying the contents back up, and nausea arises without any infection. That explains why it sometimes stays for months with long-standing diabetes and after viral infections.
With adrenal insufficiency nausea, vomiting and belly pain are among the first signs — and are regularly taken for a stomach bug. Craving salt and darker skin are the points that then do not fit.
Ginger eases nausea.
The pressure point at the wrist is used in clinics; the data are mixed, the risk is zero.
As a tea in small sips. Little and often is the whole art here — a full glass at once comes back.
Traditionally used for nausea from tension. For nausea in pregnancy, ginger is by far the better-studied remedy.