Nausea

• General feeling of being unwell
• Abdominal discomfort
• Sensation that vomiting may be imminent
• Vomiting may occur, but not always
• Retching may also occur; these are strong, vomiting-like movements, but they don’t produce vomit
• Accompanying symptoms may include pale complexion, sweating, rapid heartbeat, increased production of saliva and an urgent need to defecate

Most episodes of nausea and vomiting cease after a short period of time. Prolonged or exceptionally severe episodes of nausea and vomiting may indicate an underlying health problem or lead to potential complications (including dehydration). Medical investigation is required.

Vomiting is the body’s method of quickly removing unwanted substances from the digestive tract, and although its effects are felt in the stomach, it is actually initiated by a part of the brain known as the vomiting centre.

Nausea and vomiting may have a vast number of causes, ranging from transient and self-limiting problems to severe and life-threatening disease.  These are just a few examples:

• Food poisoning (gastroenteritis), which may occur after the ingestion of contaminated food or water.
• Morning sickness (nausea of pregnancy), which affects up to 90% of women in the early stages of pregnancy, usually ceasing around the end of the first trimester.
• Adverse effects of medical treatments, including chemotherapy, radiation treatment, some antibiotics, and many other prescribed medicines.
• Exposure to toxic substances such as alcohol, nicotine and a range of poisonous chemicals. Withdrawal from opiates, alcohol or other addictive substances may also cause nausea.
• Poor blood sugar control in diabetes.
• Motion sickness.
• Gallstones and liver disease or dysfunction.
• Peptic ulcer, indigestion and reflux.
• Kidney disease.
• Headache and migraine
• Stress
  
  

• Severe or ongoing nausea and vomiting should be investigated and treated by your doctor. The following diet and lifestyle suggestions are recommended as supportive measures for mild, self-limiting episodes of nausea, and are not intended to replace medical advice.
• Rest until the nausea or vomiting have passed.
• During an episode of vomiting, drink clear fluids (such as water), and avoid solid food until you are feeling better. If you cannot tolerate water, try sucking on small pieces of ice.
• An electrolyte replacement formula (available from your pharmacy) may help to reduce the risk of dehydration, and is particularly recommended for children.
• Once you feel up to eating (usually about six hours after vomiting has passed), start with bland foods such as toast, crackers and rice, and avoid heavy, fatty or spicy foods initially. 
• Some people become particularly sensitive to strong odours when they suffer from nausea. This can be a particular problem in pregnancy. You may feel better if you avoid restaurants and other places that smell strongly of food.
  

Seek urgent medical advice if: 

• An adult experiences nausea lasting more than a few days or nausea and vomiting lasting for more than 24 hours, or with severe symptoms. Severe pain, headache, fever, diarrhoea, thirst, or muscle cramps should always be medically investigated, as should decreased urination, or the presence of blood in the vomit which may look red or brown like coffee grounds.
• Vomiting in babies and children, the elderly, and those with chronic health problems should be investigated more quickly.
• In children and babies, sunken eyes and fontanelles, and the absence of urination or tears may be signs of dehydration, and should be addressed urgently.