Nausea and Vomiting, Age 12 and Older

	Topic Overview
	Check Your Symptoms
	Home Treatment
	Prevention
	Preparing For Your Appointment
	Related Information
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Nausea is a sick feeling in the pit of your stomach. When you are nauseated, you may feel weak and sweaty and have too much saliva in your mouth. You may even vomit. This forces your stomach contents up your esophagus and out of your mouth. Most of the time nausea and vomiting are not serious. Home treatment will often help you feel better.

Nausea and vomiting can be a symptom of another illness. Nausea and vomiting may be caused by:

• Illness caused by a virus, such as viral stomach illness (gastroenteritis).
• Food poisoning.
• Stress, nervousness, or a mental health problem, such as depression or an anxiety disorder.
• Medicines, such as antibiotics, birth control pills, or heart medicines.
• Pregnancy. "Morning sickness" may be one of your first symptoms.
• Problems with abdominal organs.
• Migraine headache.
• Heart attack.
• Stroke.
• Head injury.
• Alcohol or drug abuse or withdrawal.
• Overeating.
• Eating disorders, such as anorexia or bulimia.
• Disorders of the inner ear, such as labyrinthitis, Ménière's disease, or motion sickness.
• A side effect of radiation therapy.

Nausea or vomiting also may be a symptom of a problem or a disease, such as:

• Diabetes.
• Liver disease (hepatitis or cirrhosis).
• Inflammation of the pancreas (pancreatitis).
• Inflammation or irritation of the lining of the stomach (gastritis).
• Ulcer disease of the stomach or small intestine (peptic ulcers).
• Gallbladder problems (cholecystitis).
• Inflammation of the appendix (appendicitis).
• Kidney stones.
• Kidney disease (pyelonephritis or chronic kidney disease).
• Urinary problems, such as a urinary tract infection (UTI).
• Bowel problems, such as a bowel obstruction.
• Infection in or around the brain, such as meningitis, encephalitis, or a brain tumor.
• Infection of the pelvic organs (pelvic inflammatory disease).

Nausea and vomiting can quickly cause dehydration. Older adults have an increased chance of becoming dehydrated because they may:

• Not drink because they do not feel as thirsty as younger people.
• Have kidneys that do not work well.
• Choose to not drink because of the inability to control their bladders (incontinence).
• Have physical problems or a disease which makes it:
  • Hard to drink or hold a glass.
  • Painful to get up from a chair.
  • Painful or exhausting to go to the bathroom.
  • Difficult to talk or communicate to someone about their symptoms.
• Take medicines that increase urine output.
• Not have enough money to adequately feed themselves.

Use the Check Your Symptoms section to decide if and when you should see a doctor.

Home treatment may be all that is needed to treat occasional nausea.

• Watch for dehydration and treat it early. Older adults and young children can quickly become dehydrated.
• Use acetaminophen, such as Tylenol, instead of aspirin or a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, if you need to treat a fever or abdominal pain.
• Take an over-the-counter antinausea medicine, such as meclizine (Antivert or Bonine) or dimenhydrinate (Dramamine), or an antihistamine, such as Benadryl. Don't give antihistamines to your child unless you've checked with the doctor first.
• Try acupressure:
  • Place the tip of your right index finger on the underside of your left wrist, about 1.5 in. (4 cm) from your hand. Acupressure points are very small, so you may need to try this method more than one time.
  • Apply moderate pressure for 2 to 3 minutes.
  • Repeat as needed.
  • Acupressure bands, which are available for motion sickness, may help reduce nausea.
• Suck on peppermint candy or chew a stick of peppermint gum. Peppermint may relax tight muscles in your stomach and help decrease the stomach contractions that may be causing your nausea.

If you are vomiting:

• Rest in bed until you are feeling better.
• Sip a rehydration drink to restore lost fluids and nutrients.
• After vomiting has stopped for one hour, drink 1 fl oz (30 mL) of a clear liquid every 20 minutes for one hour. Clear liquids include apple or grape juice mixed to half strength with water, rehydration drinks, weak tea with sugar, clear broth, and gelatin dessert. Avoid orange juice, grapefruit juice, tomato juice, or lemonade. Avoid apple or grape juice if you also have diarrhea. Do not drink milk products, alcohol, or carbonated drinks such as sodas.
• If you do not have any more vomiting, increase the amount of fluid you drink to 8 fl oz (237 mL) during the second hour. If you are not vomiting after the second hour, make sure that you continue to drink enough to prevent dehydration.
• When you are feeling better, begin eating clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Gelatin dessert, dry toast, crackers, and cooked cereal are good choices. Try to stay away from strong food odors, which can make nausea worse.

The acid in vomit can erode dental enamel and cause tooth decay (cavities). Rinse your mouth with water after you vomit. Brush your teeth if you can.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment:

• Dehydration develops.
• A stiff neck develops.
• Severe vomiting develops.
• Chest pain or other symptoms of a heart attack develop.
• Changes in mental alertness develop, such as extreme sleepiness, personality changes, confusion, irritability, or restlessness.
• Vomit contains blood or material that looks like coffee grounds.
• Vomiting with fever of 103°F (39.4°C) or higher occurs or fever lasts longer than 2 days.
• Belly pain develops or gets worse.
• Vomiting lasts longer than 2 days.
• Your symptoms become more severe or more frequent.

Food poisoning

Food poisoning is one of the most common causes of nausea and vomiting in adults. To prevent food poisoning:

• Follow the 2-40-140 rule. Don't eat meats, dressing, salads, or other foods that have been kept between 40°F (4.4°C) and 140°F (60°C) for more than 2 hours.
• Be especially careful with large cooked meats, such as your holiday turkey, which require a long time to cool. Thick parts of the meat may stay over 40°F (4.4°C) long enough to allow bacteria to grow.
• Use a thermometer to check your refrigerator. It should be between 34°F (1.1°C) and 40°F (4.4°C).
• Defrost meats in the refrigerator or the microwave, not on the kitchen counter.
• Wash your hands, cutting boards, and countertops often. After handling raw meats, especially chicken, wash your hands and utensils before preparing other foods.
• The U.S. Department of Agriculture (USDA) recommends you reheat meats to over 140°F (60°C) for at least 10 minutes to destroy bacteria. Even then the bacteria may not be destroyed.
  • Cook all meats to the recommended temperature. See cook foods to prevent food poisoning.
  • Cook hamburger well done. Cook chicken until the juices run clear.
  • Cover meats and poultry during microwave cooking to heat the surface of the meat.
• Do not eat raw eggs or uncooked sauces made with eggs.
• Keep party foods on ice.
• When you eat out, avoid rare and uncooked meats or seafood. Eat salad bar and deli items before they get warm.
• Discard any cans or jars with bulging lids or leaks.
• Follow home canning and freezing instructions carefully. Contact your county agricultural extension office for advice.
• If you think that food may have been stored in your refrigerator for too long, don't take the chance. Throw it out.

For more information, see the topic Food Poisoning and Safe Food Handling.

Viral illness

Increase your chance of staying healthy by:

• Washing your hands often, especially during winter months when viral illnesses like influenza are most common.
• Keeping your hands away from your nose, eyes, and mouth. Viruses are most likely to enter your body through these areas.
• Eating a healthy and balanced diet.
• Getting regular exercise.
• Not smoking. Smoking irritates the lining of your nose, sinuses, and lungs, which may increase your risk for problems from a viral illness.

You can help prevent influenza by getting immunized with an influenza vaccine each year, ideally in October or November. The "flu shot" is given by injection. This form of the vaccine prevents most cases of the flu.

Even if a flu shot does not prevent the flu, the vaccine can make your flu symptoms milder and decrease the risk of problems from the flu.

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

• Describe your nausea and vomiting:
  • When did it start?
  • How many times have you vomited?
  • When did you last vomit?
  • What does the vomit look like (blood, coffee grounds, bile, mucus, undigested food)?
• What prescription and nonprescription medicines are you taking?
  • Are you taking any new prescription or nonprescription medicines?
  • Have you recently increased the dose of a medicine?
  • Are you taking a medicine more frequently?
• Have you been under an unusual amount of stress at home, work, or both?
• Have you recently been exposed to someone with a similar illness?
• Did your symptoms start after eating at a restaurant? Has anyone else who ate there with you become ill?
• Have you recently eaten raw or undercooked seafood?
• Do you think you have eaten any contaminated food?
• Have you recently drunk any untreated lake, stream, or well water?
• Have you recently gone on a cruise or traveled outside the country?
• Have you had any known exposure to toxic materials, chemicals, or fumes?
• Do you think that your vomiting is caused by alcohol or drug use?
• What home treatment measures have you tried? How well have they worked?
• Do you have any other symptoms, such as diarrhea, fever, headache, urinary problems, or abdominal pain?
• Do you ever force yourself to vomit?
• Have you ever been diagnosed with an eating disorder, such as anorexia or bulimia?
• Does anyone else in your family have problems with vomiting?
• Have you or anyone else in your family been diagnosed with a mental health problem, such as depression or an anxiety disorder?
• Do you have any health risks?

• Dehydration
• Diarrhea, Age 11 and Younger
• Diarrhea, Age 12 and Older
• Poisoning
• Respiratory Problems, Age 11 and Younger
• Respiratory Problems, Age 12 and Older