Nausea and vomiting in adults

Key points about nausea and vomiting

  • Nausea and vomiting are common symptoms, which are uncomfortable, but usually not serious.
  • Nausea is a queasiness in your stomach that often comes with the urge or need to vomit (throw up).
  • Vomiting is your body's way of getting rid of stomach contents that are harmful or irritating, by forcibly emptying them back out of your mouth. 
  • Common causes of vomiting in adults include gastroenteritis (tummy bug), early pregnancy, motion sicknesses, certain drugs and medications, intense pain, emotional stress, various viruses and certain smells or odours.
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As nausea and vomiting can be part of a COVID-19 infection, it's important to test for this. 

COVID-19 symptoms can include:

The following actions can help to prevent and/or relieve nausea: 

  • Sit quietly when you feel sick
    • moving around can make you feel worse
    • rest after eating and keep your head elevated about above your feet
    • avoid activity straight after eating.
  • Drink clear drinks 
    • drink water or diluted fruit juice
    • sip your drink slowly
    • you may find it helps to drink liquids between (instead of during) meals.
  • Eat small meals throughout the day instead of three large meals
    • eat light, bland foods (such as water crackers or plain bread)
    • avoid fried, greasy, or sweet foods
    • don't mix hot and cold foods
    • if the smell of hot or warm foods makes you feel nauseous, eat foods that are cold or at room temperature
    • avoid brushing your teeth after eating.
  • If you feel nauseous when you wake up in the morning, eat a high protein snack (lean meat or cheese) before going to bed and eat some crackers before getting out of bed (keep them by your bedside).
  • Ginger – some people find ginger helps to relieve feelings of nausea, but this finding isn't clinically proven.
  • Acupuncture can be helpful in helping relieve and prevent nausea and vomiting.

If you or someone you're caring for has a vomiting episode, the follow simple measures may help.

  • Drink clear liquids: 
    • you need to replace fluids lost by vomiting to prevent dehydration
    • take small, regular sips and aim to drink 2 to 3 litres of fluid a day
    • water, clear soup, a rehydration drink like Gastrolyte or Pedialyte, or diluted fruit juice (1 part fruit juice to 5 parts water) are good options
    • avoid milk or milk products and fizzy drinks and full–strength fruit juice
    • if vomiting and diarrhoea last more than 24 hours, an oral rehydrating solution should be used to prevent and treat dehydration. These are available over-the-counter from your pharmacy.
  • Avoid solid food until vomiting has stopped:
    • when vomiting has stopped, try easily digested foods such as bananas, crackers, rice, pasta and bread
    • avoid foods high in fibre, whole fruits (except bananas) or vegetables, spicy or fatty foods, alcohol and caffeinated drinks. 
  • Rest.
  • Be careful with medicines:
    • if you're taking a medicine that you think may be making your nausea or vomiting worse check with your doctor or pharmacist if you can temporarily stop the medicine
    • if you miss a dose of medicine (eg, the contraceptive pill) due to vomiting this can interfere with how it works. Seek advice from your healthcare provider or pharmacist if this happens.

If these things don't help, or you're worried about your nausea or vomiting, talk to your pharmacist or call your healthcare team. Medicines for nausea and vomiting caused by motion sickness are available over-the-counter at your pharmacy. All other medicines for nausea and vomiting are available on a prescription from your doctor or nurse prescriber.


Medicines for nausea and vomiting

  • Vomiting associated with surgery, radiotherapy, chemotherapy and morphine can often be treated with another type of drug therapy.
  • There are also medicines that can be used to control nausea and vomiting associated with pregnancy, migraine, motion sickness, and vertigo.
  • You should talk to your healthcare provider before using these treatments.


Contact your healthcare provider for advice if you:

  • have been vomiting for longer than 24 hours
  • have been unable to keep any fluids down for 12 hours or more
  • have severe abdominal pain
  • experience headache and stiff neck
  • show signs of dehydration, such as dry mouth, infrequent urination (haven't urinated for 8 hours or more) or dark urine.

Seek urgent medical advice if you or someone you are caring for develops any of these danger symptoms:  

  • If you think the vomiting is from poisoning
  • If you notice blood or dark, coffee–coloured material in the vomit.

Call 111 urgently and ask for an ambulance.

Apps reviewed by Healthify

You may find it useful to look at some Self-management and healthy living apps and Migraine and headache apps.

Nausea and vomiting are symptoms of many different conditions. Some of the more common causes are described below. 

Gastroenteritis

If you have diarrhoea as well as vomiting, it's likely to be gastroenteritis (tummy bug). This is the most common cause of vomiting in adults and may be caused by:

  • a virus picked up from someone who's ill, such as the norovirus
  • food poisoning caused by bacteria found in contaminated food.

Your immune system will fight off the bug and you should start to feel better within 1 to 2 days. Read more about gastroenteritis.


Pregnancy

In the early stages of pregnancy, nausea and vomiting are common. Nausea occurs in approximately 50 to 90% of all pregnancies; vomiting in 25 to 55%. This is commonly referred to as 'morning sickness' however it can occur at any time of the day.

For most people, morning sickness begins within the first few weeks of pregnancy and stops near the end of the first trimester, about weeks 16 to 20. However, for some people it can continue throughout the pregnancy and this is known as morning sickness.

Read more about morning sickness including what you can do to relieve symptoms.


Motion sickness

If you experience nausea and vomiting when travelling then this could be a sign of motion sickness. 

Mild symptoms of motion sickness may be relieved by techniques such as fixing your eyes on the horizon, getting fresh air and trying to distract yourself. If you experience more severe symptoms, you may wish to try medicine to help prevent the symptoms. These include:

  • hyoscine (also called scopolamine) skin patches which are applied to the skin behind the ear. They should be applied at least 5 hours before the journey. Hyoscine can cause drowsiness, so avoid using it if you're planning to drive
  • antihistamines, eg, cyclizine (Nausicalm), meclozine (Sea Legs) and promethazine (Phenergan or Allersoothe). These are less effective at treating motion sickness than hyoscine. They're usually taken 1 to 2 hours before your journey. They tend to cause drowsiness or sleepiness so aren't recommended if you need to stay alert, eg, if you're driving.

Read more about motion sickness.


Migraines

If you experience vomiting along with an intense headache on one side, sensitivity to light and 'aura' (eg, visual disturbances, dizziness, and pins and needles), you may be experiencing migraines.

Migraines can be painful and debilitating. See your healthcare provider if you experience migraines. There are medicines which can help prevent and treat them.

Read more about migraines.

There are many other causes of nausea and vomiting including:
  • medicines, eg, morphine and antibiotics
  • chemotherapy or radiotherapy
  • intense pain
  • emotional stress
  • vertigo
  • overeating
  • a reaction to certain smells or odours
  • drinking too much alcohol.

Nausea and vomiting may also be early warning signs of more serious medical problems, including:

  • appendicitis
  • blockage of the intestines
  • poisoning
  • gastroparesis or slow stomach emptying (a condition that can be seen in people with diabetes)
  • gallbladder disease
  • concussion or brain injury
  • stomach ulcers
  • certain cancers.

If you experience nausea and/or vomiting and are concerned about what's causing it, see your healthcare provider for a check up. 

Vomiting(external link) Health New Zealand | Te Whatu Ora
Nausea and vomiting in adults(external link) NHS Choices, UK

Apps

Self-management and healthy living apps
Migraine and headache apps

References

  1. Nausea and vomiting of pregnancy(external link) Gastroenterol Clin North Am. 2011
  2. Nausea – nutrition in cancer care(external link) PDQ Cancer Information Summaries, 2015
  3. Acupuncture(external link) PDQ Cancer Information Summaries, 2015
  4. Can nausea be treated with ginger extract?(external link) Eur Rev Med Pharmacol Sci. 2015

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