Nausea and vomiting are common symptoms of numerous conditions. Most of the time, they do not require urgent medical attention.

However, if these symptoms continue for days, if they are severe, and/or if you cannot keep down any food or fluids, they may be signs of a more serious condition.

Dehydration is the primary concern with most vomiting episodes. The rate with you become dehydrated depends on your size, the frequency of the vomiting, and whether you also have diarrhea.

Infants with frequent vomiting and diarrhea are at the greatest risk for dehydration and need immediate medical attention.

Signs of dehydration include the following:

• Increased thirst
• Infrequent urination or dark yellow urine
• Dry mouth
• Eyes that appear sunken
• Crying without tears
• Skin has lost its normal elasticity (if you touch or squeeze the skin, it doesn't bounce back the way it usually does)

Possible causes of vomiting in adults:

• Viral infections
• Medications
• Seasickness or motion sickness
• Migraineheadaches
• "Morning sickness" during pregnancy
• Food poisoning
• Food allergies
• Chemotherapy in cancer patients
• Bulimia
• Alcoholism

• Congenital pyloric stenosis, a constriction in the outlet from the stomach. With this disorder, the infant vomits forcefully after each feeding but otherwise appears to be healthy.
• Disturbed equilibrium from bouncing the baby immediately after feeding
• Food allergies or milk intolerance
• Gastroenteritis (infection of the digestive tract that usually causes vomiting with diarrhea)
• Gastroesophageal reflux
• Hole in the bottle nipple may be wrong size, leading to overfeeding
• Infection, often accompanied by fever or runny nose
• Intestinal obstruction, evidenced by recurring attacks of vomiting and crying or screaming as if in great pain
• Accidental ingestion of a drug or poison

Call the doctor immediately or take the child to an emergency care facility if you suspect poison or drug ingestion!

When the cause of nausea and vomiting is known, it is important to treat the underlying disorder.

Whatever the cause of the vomiting, you need to take in as much fluid as possible without further upsetting your stomach. Sip clear fluids such as water, ginger ale, fruit juices, or sports drinks. Don’t drink too much at one time, and work slowly back to a normal diet.

Infants who are vomiting repeatedly should be seen be a physician. Do not give infants for than 1 or 2 ounces of plain water, as this may lead to electrolyte imbalances. Instead, maintain hydration by using half-strength formula or an oral rehydration solution such as Pedialyte, given in frequent small amounts.

Start with 1 teaspoon every 5 minutes and slowly increase the amount. Once full feeding amounts are reached and the infant has gone 8 hours without vomiting, return to regular feeding.

There is currently no treatment that has been approved by the FDA for morning sickness in pregnant women.

Treatment for motion sickness:

Lying down can often help. Over-the-counter antihistamines (such as Dramamine) may help.

Scopolamine skin patches (such as Transderm Scop) require a prescription and are useful for extended trips such as an ocean voyage. In order to prevent the onset of motion sickness, the patch should be placed 4 to 12 hours before setting sail.

Although scopolamine is effective, it may produce dry mouth, blurred vision and some drowsiness. Scopolamine is for adults only. It should not be given to children.

If you are vomiting blood or have severe abdominal pain, call your health care provider immediately! Some abdominal discomfort accompanies almost every case of vomiting, but severe pain is not common. You should also call if the following conditions apply:

• Headache and stiff neck are also present
• Lethargy or marked irritability in a young child
• Signs of dehydration, especially decreased urine output in an infant or a child
• A child is unable to retain any fluids for 8 hours or more or the vomiting is recurrent
• An adult is unable to retain any fluids for 12 hours or more
• Nausea persists for a prolonged period of time (in a person who is not pregnant)

Your health care provider will obtain your medical history and will perform a physical examination. The physical examination will include examination for signs of dehydration.

Medical history questions documenting nausea and vomiting may include:

• Quality
  • Are you vomiting fresh blood (hematemesis)?
  • Do you have repeated episodes of vomiting blood?
  • Are you vomiting material that looks like coffee grounds?
  • Are you vomiting undigested food?
  • Are you vomiting greenish (bilious) material?
  • Is the nausea or vomiting severe enough to cause unintentional weight loss?
• Aggravating factors
  • Is the vomiting self-induced?
  • Have you been traveling? Where?
  • What medication(s) do you take?
  • Did other people that ate at the same location as you experience the same symptoms?
  • Are you pregnant or could you be pregnant?

• Time pattern
  • When did the vomiting begin?
  • How long has it lasted?
  • Do you have morning nausea or vomiting?
  • Did it begin recently?
  • Is it recurrent?
  • Does it occur several hours after meals?
• What other symptoms are also present?
  • Is there abdominal pain?
  • Is there a fever?
  • Is there diarrhea?
  • Is there poor skin turgor or other signs of dehydration?
  • Is there abdominal swelling?
  • Are there headaches?

Diagnostic tests that may be performed include:

• Blood tests (such as CBC with differential and basic electrolytes)
• Urinalysis
• X-rays of the abdomen

If dehydration is severe, you may need intravenous fluids. This may require hospitalization, although it can often be done in the doctor’s office. The use of antivomiting drugs (anti-emetics) is controversial, and they should be used only in severe cases.