Nausea and vomiting: reasons, how to relieve it, how to stop it

Vomiting is a reflex eruption of the contents of the stomach and sometimes the duodenum through the mouth.

The gag reflex is quite complex - it involves various muscle groups. It is controlled by the vomiting center located in the brain stem. By its nature, vomiting is a mechanism by which the body protects itself from poisoning. Normally, vomiting is a reaction to toxic substances entering the gastrointestinal tract or simply something that cannot be digested - for example, too fatty foods. Therefore, after an attack of vomiting, a person often feels relief: the body has been cleansed.

However, the intoxication that caused vomiting may have an internal source, that is, be a consequence of some pathology or disease. It is also possible that the irritation of the nervous system leading to vomiting is not related to the condition of the stomach at all. This makes us perceive vomiting as a very serious, and even ominous, symptom. An attack of vomiting is almost always a sufficient reason to consult a doctor. In case of repeated attacks, you should definitely consult a doctor!

Nausea, vomiting in women (including during pregnancy)

Nausea and vomiting, along with a throbbing headache, depressed mood, increased sweating and numbness of the hands, characterize the cephalgic form of premenstrual syndrome (PMS).
At the same time, blood pressure remains within normal limits. Unpleasant symptoms occur 2-10 days before menstrual bleeding in women with irregular cycles, a history of abortion or depression. Considering that the nervous system in women is more excitable than in men, nausea and vomiting during menstruation can be triggered by any unpleasant odor. Often, prolonged nausea without vomiting in women is a consequence of following a strict diet for a long time. The use of dubious food additives, a lack of essential microelements and vitamins, and the abuse of laxatives leads to chronic stress and disruption of the digestive tract. In addition to this, dysbacteriosis develops. The feeling of nausea goes away only after the intestinal microflora is normalized.

Nausea for no apparent reason is often the first sign of pregnancy. The unpleasant sensation is associated with a sharp increase in the level of the hCG hormone. Further hormonal changes in the female body, changes in metabolism and psychological stress often provoke vomiting 1-2 times a day, more often in the morning. The state of health returns to normal by the 13th week of pregnancy.

Early toxicosis (before 16-18 weeks of pregnancy)

Mild degree - vomiting up to 5 times a day, the condition of the pregnant woman is satisfactory, the fetus is not in danger.
Early toxicosis of moderate severity - vomiting up to 10 times a day, weight loss up to 3 kg, rapid pulse (up to 100 beats/min), acetone in the urine.
Excessive vomiting of pregnancy (grade three) - vomiting up to 25 times a day, weight loss of more than 5%, dehydration and electrolyte imbalance. Immediate medical intervention is required.

Important! Severe vomiting in early pregnancy may indicate a hydatidiform mole.

Regularly occurring nausea and vomiting in late pregnancy makes one suspect the development of preeclampsia, the third stage of late toxicosis (preeclampsia). This condition is preceded by the appearance of swelling of the limbs and face (stage 1), increased a/d and protein in the urine (nephropathy, stage 2 of gestosis). Without timely treatment of preeclampsia, seizures (eclampsia) develop and the risk of stroke is high. For the fetus, late toxicosis is fraught with hypoxia, delayed development and perinatal pathologies. There is a high risk of placental abruption and premature birth.

Important! Nausea and vomiting in a pregnant woman can also be caused by taking iron supplements to treat anemia, common gastroenteritis, or another disease.

Treatment methods

Treatment tactics depend on the exact cause of poor health. The drugs should eliminate not only the symptoms, but also the causes of headache, nausea, vomiting, and high fever. Treatment can be carried out both at home and in a hospital, to allow round-the-clock monitoring of the patient.

Antibiotic therapy is the main method of treating bacterial diseases and preventing purulent inflammation. Antibiotics are prescribed in the form of tablets or injections.
Other drugs - the treatment regimen may include taking anti-inflammatory drugs, enterosorbents for disorders of the digestive tract, antispasmodics and drugs for correcting blood pressure.
Diet is a necessary condition for poisoning, diseases of the stomach and intestines. The diet should not contain fatty foods, sweets, or fried foods, as they can provoke attacks of nausea, vomiting, and headaches.
Surgical treatment is rarely prescribed. Surgery may be necessary for hematomas in the brain, tumors and other formations that interfere with normal blood circulation.

The Clinical Brain Institute offers comprehensive diagnostic and treatment programs for headaches that are accompanied by nausea, vomiting, and fever. Doctors warn that it is important not to self-medicate, but to contact specialists at the first signs of deterioration in health. Our center has modern, multifunctional equipment, and there is also the opportunity to undergo examinations by specialist and general doctors.

Nausea and vomiting in children

Frequent regurgitation of infants in most cases is caused by gastroesophageal reflux (reflux of food into the esophagus due to incompetence of the lower sphincter). However, this condition has nothing to do with vomiting. A one-time gag reflex against the background of a normal general condition also does not require special attention. Repeated vomiting in a newborn often indicates illness.

Pyloric stenosis (manifests at 3-12 weeks) - vomiting “fountain” soon after finishing feeding. Unlike systemic diseases, vomiting with pyloric stenosis does not contain bile, and the baby sucks the breast with appetite.
Intestinal obstruction - occurs due to intestinal atresia, obstruction of the ileum by extremely viscous meconium (meconium ileus), volvulus, or intestinal stenosis. From the first days the baby suffers from vomiting, and the general condition rapidly deteriorates.
Intussusception (3-36 months) - often caused by viral enteritis and leads to intestinal obstruction. Attacks of severe abdominal colic and vomiting every 15-20 minutes lead to ischemia of the intestinal area, gangrene and perforation.

Nausea and vomiting in a child can be caused by unusual foods, nervous stress and various odors.

The main causes of vomiting in older children:

viral/bacterial gastroenteritis - often occurs with diarrhea and fever;
influenza, acute respiratory infections, childhood infections (for example, scarlet fever) - against the background of a high temperature, the child often develops vomiting and convulsions are possible;
helminthic infestation - the child complains of nausea without vomiting, the parents note that the child has bad breath, rumbling in the stomach, itching in the anus and grinding of teeth at night;
errors in nutrition - too fatty, spicy or fried foods provoke nausea, diarrhea and sometimes vomiting without fever;
appendicitis - pain can begin in the stomach, near the navel or lower in the right side, the child becomes lethargic and drowsy, any painkillers for abdominal pain are strictly prohibited;
poisoning with drugs and household chemicals - often causes an extremely serious condition, the symptoms depend on the toxic substance;
sunstroke (heatstroke) - when overheated, the body temperature rises to 40ºC, the skin turns red and sweats significantly, nausea/vomiting and headache occur, breathing and heart rate increase;
taking antibiotics almost always provokes intestinal dysbiosis (feeling of nausea after eating without vomiting, loss of appetite, constipation/diarrhea). To maintain intestinal microflora, antibacterial courses are combined with the intake of probiotics.

Causes of vomiting

In most cases, vomiting is caused by irritation of the stomach receptors or, in medical terms, has a visceral

origin. The cause is most often acute or chronic diseases of the stomach itself (acute food poisoning, gastritis, stomach ulcers, food allergies). Also, stomach receptors can react to diseases of other organs - the gallbladder, uterus, heart (vomiting is part of the complex of possible symptoms of myocardial infarction).

Vomiting may also be central

origin, that is, caused by pathologies of the central nervous system (brain), such as meningitis, encephalitis, trauma and brain tumors. Vomiting is quite common during migraines. Inner ear problems can also lead to vomiting (in this case, vomiting may occur along with dizziness). If the receptors of the inner ear are excessively irritated (with motion sickness), even a healthy person can vomit, especially if the vestibular apparatus is not trained. Sometimes vomiting is caused by emotional distress (stress) or is a reaction to something that causes extreme disgust (conditioned vomiting).

Irritation of the vomiting center can be caused by toxic substances carried by the bloodstream ( hematogenous-toxic

vomit). Toxic substances can enter the body from the outside (for example, chlorine or carbon monoxide through inhalation), or they can be produced in the body itself as a result of impaired liver or kidney function.

Nausea and vomiting with coronavirus

Severe complications and high mortality with COVID-19 force us to more carefully study the first symptoms of the disease. The difficulty lies in the fact that the virus rapidly mutates, and the clinical manifestations of the disease also change. In 2022, typical symptoms of coronavirus infection were fever, loss of smell and taste, muscle pain, and only then a cough. Only some patients experienced nausea and vomiting a little later. In 2022, the majority of cases are caused by the Indian strain of COVID-19, which is characterized by higher infectiousness and a “stomach” syndrome. Against the background of fever and catarrhal symptoms (runny nose, sore throat, cough), every third patient with coronavirus experiences nausea/vomiting and pain in the stomach. A little later, diarrhea and hearing problems appear, and the sense of smell disappears less often.

The "Delta" strain most often affects young people and children. And previously worked out treatment regimens give a noticeably less effect. This is why vaccination of the population, including those who have previously had coronavirus, is so important. Although a two-time vaccination does not completely eliminate infection, it will help avoid severe disease, complications and death. Among the sick, the percentage of vaccinated people does not exceed 1%.

Important! Nausea after vaccination against coronavirus occurs in every tenth vaccinated person. Vomiting is a rare side effect. All unpleasant consequences of the vaccine disappear within 3 days.

Diagnostic methods

Timely diagnosis of high fever, headache, nausea and vomiting is the key to effective treatment. It is important to determine what causes the symptoms and prescribe a treatment regimen that can eliminate the root cause of poor health. To fully understand the picture of the disease, the following examination methods may be prescribed:

blood pressure measurement and control at home;
a general blood test is the easiest way to detect inflammatory processes in the body;
Ultrasound of the gastrointestinal tract;
culture for suspected bacterial infection with isolation of the exact pathogen;
MRI or CT scan of the brain if there is a history of traumatic brain injury, as well as if neoplasms are suspected.

The Clinical Brain Institute offers individual diagnostic programs. They are selected taking into account the patient’s complaints and examination data. The scheme includes only those techniques that will reliably determine the cause of high fever, nausea and vomiting, and headache.

Specific features of nausea and vomiting

To identify the cause of poor health and assess the patient's condition, the duration of nausea and vomiting is important. Acute vomiting (1-2 days) is often caused by medications, infections, poisoning (such as alcohol), kidney damage, and diabetes. Chronic vomiting (more than 1 week) is characteristic of long-term gastrointestinal diseases and mental disorders.

Features of vomiting and nausea

Vomiting immediately after eating is characteristic of stomach lesions. If the gag reflex occurs 2-3 hours after eating, pathology of the duodenum is possible.
Nausea and vomiting of acid are observed with gastritis with increased secretion and stomach ulcers.
Vomiting of bile (greenish-yellow color) is caused by pathology of the hepatobiliary system (liver, gallbladder) or pancreas.
Bloody vomit (red or brown) indicates gastrointestinal bleeding.
Vomiting mucus is characteristic of diseases of the respiratory system (smoker's bronchitis), which occurs with a debilitating cough. Patients with alcoholism often complain of foamy vomiting in the morning (on an empty stomach).
Vomiting with fever indicates the infectious nature of the disease. With a viral infection, the temperature can reach 39-40ºС. Nausea, vomiting and temperature up to 37.5-37.8ºС are more typical for bacterial infections.
Vomiting with diarrhea/constipation without fever suggests an intolerance or allergy to certain nutrients, such as lactose.
Constant nausea without vomiting and fatigue often occur with hypothyroidism.
Vomiting and pain in the upper abdomen makes it necessary to exclude myocardial infarction, but is more often associated with gastrointestinal pathology.
Fecal vomiting (dark vomit with a characteristic smell of feces) occurs with intestinal obstruction, tumors, and gastrointestinal fistulas.

Vomiting and other symptoms

Vomiting is usually preceded by nausea, because, in essence, vomiting is the resolution of nausea, its logical conclusion. The fact that nausea turned into vomiting indicates the severity of the pathological process. Vomiting spasms can be observed against a background of elevated temperature, accompanied by diarrhea. In addition to food debris, gastric juice and mucus, vomit may contain bile, blood, and pus.

Repeated, periodically recurring and indomitable vomiting exhausts and dehydrates the body, leading to disruption of mineral metabolism and acid-base balance.

Diarrhea and vomiting

Vomiting and fever

When medical attention is needed

Call an ambulance if nausea/vomiting is accompanied by:

severe or increasing abdominal pain;
chest pain;
high temperature;
neck muscle tension;
anuria (lack of urine, less than 100 ml per day);
confusion, unconsciousness;
dehydration;
numbness and paralysis of the limbs, asymmetrical smile and speech problems;
vomiting feces or blood;
uncontrollable vomiting.

Make an appointment with a doctor at the First Family Clinic of St. Petersburg if:

in an infant, vomiting does not stop for 12 hours, in a child under 2 years old - 24 hours, in an adult - more than 2 days;
nausea and vomiting occur at least once a week for 1 month;
nausea and vomiting are accompanied by weight loss.

When vomiting is scary

Any attack of vomiting is a very unpleasant experience. Even if a person experiences relief with the resolution of the attack, the vomiting itself is perceived as an extraordinary event, which should not normally occur. Shock to the body, everyday and social inconveniences - all this makes vomiting a process of a different order compared to other reflex actions, such as coughing or sneezing. We always react sharply to vomiting (we don’t ignore it), and rightly so.

However, in some cases, vomiting worries us especially strongly. This is vomiting bile , vomiting blood . Parents are concerned about cases of vomiting in children . Quite often, vomiting is observed during pregnancy , attracting increased attention.

These cases are worth mentioning separately:

Vomiting bile

Vomiting blood

Vomiting during pregnancy

Vomiting in a child

Diagnostics

Patient examination

Assessing the degree of dehydration.
Determination of symptoms of acute surgical pathology.
Neurological status, assessment of clarity of consciousness.

Recommended tests

Blood tests (general, biochemistry, thyroid hormones, sugar levels).
General urine test and pregnancy test.
Stool analysis (coprogram, worm eggs, culture).

Recommended Research

Ultrasound of the abdominal cavity and endoscopy.
X-ray and colonoscopy.
CT/MRI of the intestine, brain.

Treatment

Therapeutic tactics depend on the causative disease, the presence of accompanying symptoms of nausea/vomiting and the general condition of the patient.

Treat dehydration and electrolyte imbalance with oral medications or IV infusions.
Antiemetics. In severe cases, the use of 5-HT3 receptor antagonists and corticosteroids is acceptable.
Causative therapy aimed at eliminating the causative disease.

Self-administration of various tablets for nausea/vomiting is not recommended. Only a doctor, after conducting the necessary research, will determine the cause of poor health and prescribe effective and safe treatment.

Treatment and first aid

If dangerous signs are detected, the main goal is to transport the child to a medical facility to provide qualified medical care.

If vomiting is not associated with dangerous pathologies, parents can alleviate the child’s condition using the following measures:

Drink plenty of fluids. The liquid should be slightly cool. If vomiting is mild and infrequent, you can give your child green tea without sugar.
Provide physical and emotional peace.
When lying down, turn the child's head to the side to prevent vomit from entering the respiratory tract.
Use of rehydration agents for prolonged and profuse vomiting. If vomiting continues and oral administration is not possible, seek medical attention for intravenous fluids and electrolytes.

Depending on the identified cause of vomiting, the doctor may prescribe the following medications:

Antibiotics and antiviral drugs.
Anti-inflammatory drugs.
Antiemetic drugs.
Antispasmodics and antipyretics.
Antihistamines.

Parents are not recommended to use medications on their own, since their action can change the clinical picture of the pathology.

This video will tell you how to help your child if he is vomiting:

https://www.youtube.com/watch?v=RFnlu5BFkjE

How to relieve nausea and vomiting at home

Drink more fluids. The daily intake for adults is 30 ml/kg body weight. It is advisable to use decoctions of chamomile and mint. Drink slowly, in small sips. You should not drink only after bloody vomiting.
Eat small meals. Food should be warm. Avoid hard, fried, spicy, fatty and sweet foods. But if you experience uncontrollable vomiting, you should refuse to eat.
If an unconscious patient is vomiting, turn the head to the side to avoid aspiration.
If you have severe nausea, you should lie down. Open windows for fresh air. Avoid strong odors and other irritants. Do not brush your teeth immediately after eating.
If you suspect poisoning (vomiting and diarrhea), you can take activated carbon (1 tablet per 10 kg of weight), smecta, phosphalugel or polysorb.
Measure your blood pressure. If the readings are high, take an antihypertensive drug prescribed by your doctor or call an ambulance.
For low blood pressure, it is enough to drink a cup of tea or coffee and sniff ammonia.
For motion sickness, it is permissible to take antihistamines or special medications (for example, Dramamine).

If nausea or vomiting continues for more than 2 days and your general condition is affected, you should consult a doctor. At the First Family Clinic of St. Petersburg, you will undergo all the necessary tests and instrumental studies in order to quickly identify the cause of the disease and prescribe effective treatment.

Literature used in writing

"Gastroenterology - National Guide" (2008). Authors: Ivashkin V.T., Lapina T.L.
“Diseases of the digestive system in pregnant women. Gastroenterology" (2011). Author: Eremina E.Yu.
"Manual of Gastroenterology, Volume 1" (1995). Authors: Komarov F. I., Grebenev A. L.
“Gastroesophageal reflux disease in children” (2007). Authors: Prokhorova L.I., Davydova A.N.
“Inflammatory bowel diseases” (a practical guide for doctors, 2012). Author: Sitkin S.

When should you see a doctor if you are vomiting?

Vomit

- in many cases, a sign that the body is experiencing serious problems and needs cleansing, and therefore, most likely, treatment. If the disease is accompanied by vomiting, this usually indicates that the disease is quite severe.

If the attack of vomiting was a one-time occurrence and there is reason to believe that it was caused by overeating, motion sickness, alcohol poisoning or stress, there is no direct need to consult a doctor. In all other cases, consultation with a doctor is necessary. Especially if attacks are repeated for two days or more, as well as in the presence of diabetes mellitus or other chronic diseases.

Sometimes vomiting requires emergency treatment. You should call an ambulance if:

vomiting is accompanied by constant or severe abdominal pain;
there are repeated bouts of vomiting after a head injury;
along with vomiting, dehydration, dry mouth, and increased urination are observed;
with deterioration of mental and functional activity in older people;
there is blood in the vomit (for example, impurities in the form of “coffee grounds”).