Nausea and vomiting in adults

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 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

Nausea and vomiting are common in the early stages of pregnancy. This is commonly referred to as 'morning sickness' but it can happen as any time of the day.  

For most people, morning sickness begins within the first few weeks of pregnancy and stops sometime in the second trimester around weeks 16 to 20. near the end of the first trimester, about weeks 16 to 20. However, for some people it can continue throughout the pregnancy.

Read more about morning sickness and 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. Medicines for motion sickness include:

• Hyoscine (also called scopolamine) skin patches which are applied to the skin behind your ear. They should be applied at least 5 hours before you travel. Hyoscine can make you sleepy, so avoid using it if you're planning to drive
• Antihistamines, eg, cyclizine (Nausicalm), meclozine (Sea Legs) and promethazine (Phenergan or Allersoothe). These are not as good at treating motion sickness as 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 or noise, or an 'aura' (neurological symptoms such as visual disturbances, dizziness, or 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.

Other causes

As nausea and vomiting can be part of a COVID-19 infection, it's important to test for this. 

COVID-19 symptoms can include:

• a new or worsening cough in children or adults
• sore throat
• shortness of breath
• runny nose or other cold symptoms
• fever
• loss of smell or change in taste
• upset stomach, possibly with diarrhoea (runny poo/hamuti) or vomiting (throwing up).

The following things can help 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.

Get some fresh air

Drink clear drinks

• Drink water, or diluted fruit juice or rehydration solutions.
• Sip your drink slowly – have regular sips rather than drinking a lot at a time.
• You may find it helps to drink liquids between (instead of during) meals.
  
  

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Eat small meals throughout the day instead of 3 large meals 

• Eat light, bland foods (such as water crackers or plain bread).
• Avoid fried, greasy, spicy or sweet foods, and alcohol and caffeine.
• 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. You can try ginger-containing foods, such ginger biscuits, ginger tea or ginger capsules from your pharmacy. 

Acupuncture can help relieve and prevent nausea and vomiting.

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

Drink clear liquids

• You need to replace fluids lost by vomiting to prevent dehydration.
• If you vomit, wait 5 to 10 minutes before you start drinking, then take a sip of water every 2 to 3 minutes.
• Take small, regular sips and aim to drink 2 to 3 litres of fluid a day.
• Water, clear soup, a rehydration drink such as Gastrolyte or Pedialyte, or diluted fruit juice (1 part fruit juice to 5 parts water) are good options.
• Avoid milk or milk products, fizzy drinks, full-strength fruit juice or sports drinks such as Powerade.
• If your vomiting and diarrhoea last more than 24 hours, use an oral rehydrating solution 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, rice, apple sauce and bread (BRAT diet). Bread should be wholemeal or white, avoid seeded and grainy bread. 
• Avoid foods high in fibre, whole uncooked fruits (except bananas) or vegetables, spicy or fatty foods, alcohol and caffeinated drinks. 

Rest

Stop the spread: Vomiting is often caused by a tummy bug so do what you can to stop spreading the infection, eg wash your hands often and don't prepare food for other people. 

Be careful with medicines

• If you're taking a medicine that you think may be making your nausea or vomiting worse ask your healthcare provider 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 the medicine works. Get advice from your healthcare provider or pharmacist if you're not sure. Common medicines to consider include:
• some medicines for diabetes such as empagliflozin (Jardiance), metformin and sulfonylureas – read more about sick day plans for type 1 diabetes and type 2 diabetes
• medications for blood pressure such as diuretics (water pills) and ACE inhibitors
• Lithium
• anti-inflammatory medications such as ibuprofen (Nurofen) and diclofenac (voltaren).

 
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 with 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 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
• have difficulty breathing or chest pain
• have a headache, stiff neck, light sensitivity (bright lights hurt your eyes) or unusual rash
• show signs of dehydration, such as a dry mouth, not passing urine for 8 hours or more, or you have dark (concentrated) urine
• are very drowsy or have unusual neurological symptoms such as being confused or having altered sensation or strength in parts of your body.