Nausea and Vomiting

Last updated by Peer reviewed by Dr Colin Tidy, MRCGP
Last updated Meets Patient’s editorial guidelines

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Nausea is the feeling of wanting to be sick (vomit). Vomiting is when you are sick, or 'throw up'. The contents of your stomach rise up your food pipe (gullet, or oesophagus) and spill out of your mouth or nose. Nausea and vomiting are controlled by a combination of the vomiting centre in your brain, and areas within your gut.

There are many causes of feeling sick and being sick (nausea and vomiting). The following is a list of some of the most common or important causes. See the links for more information about each condition.

Other causes

Appendicitis, inflammation of the pancreas (pancreatitis), kidney stones, stomach ulcers and gallstones can all cause severe tummy (abdominal) pain and nausea and vomiting. If severe, ring 111 for urgent advice or 999 to call for an ambulance if you feel it's a life-threatening emergency.

Blockage (obstruction) of the gut - repeated and severe vomiting may be due to a blockage anywhere along the gut (intestine). This could be a twisted loop of bowel, cancerous growth or non-cancerous narrowing. This will usually be associated with severe tummy pain. Because there is a blockage, usually you would be unable to open your bowels. This is an emergency and you need to call an ambulance.

Raised pressure in the brain - meningitis, brain tumours and head injuries can increase pressure in the brain, which can cause nausea and vomiting. Ring 999 to call for an ambulance if you suspect your child has meningitis.

Liver disease - for example, hepatitis A, hepatitis B, liver cirrhosis. There will be other symptoms, including yellowing of the skin and of the whites of the eyes (jaundice) and, usually, pain over the liver.

Kidney problems - for example, chronic kidney disease, which typically causes nausea when severe, and kidney stones (which may also cause pain).

You should get medical advice if you vomit repeatedly for more than 48 hours, feel weak, vomit blood or have problems with weight loss or difficulty swallowing. . If you vomit a large amount of blood then it may be more appropriate for you to go to Accident and Emergency.

Acute nausea and/or vomiting usually means lasting less than 24-48 hours. It is most commonly due to gastric infection or food poisoning and is self-limiting (ie each stops by itself). This sort of nausea and vomiting does not usually need any intervention unless it is very severe, the vomit is unusual (for example, bloody) or the person affected is a baby or young child and not managing fluids, or if lack of fluid in the body (dehydration) is a problem.

Persistent nausea and vomiting is that which lasts for 48 hours or more. It can have the same causes as acute nausea and vomiting, but simple infections and food poisoning start to look less likely as time goes on, and other possible causes come to the fore. Some are more serious than others, and many cause other symptoms too.

The doctor will want to know how long your feeling sick and being sick (nausea and vomiting) have lasted and whether you have any other symptoms. The doctor will particularly ask about symptoms which may suggest an underlying serious condition. These are known as 'red flags'. The sort of information your doctor will want to know includes the following:

  • Did it start suddenly or develop over time? Did anything trigger it? How long has it lasted?
  • When do you vomit? Is it worse when you move your head?
  • Do you feel feverish?
  • Are you coughing up blood or bile?
  • Do you feel ill? Do you have a high temperature (fever), weight loss or tummy (abdominal) pains? Do you have headaches?
  • How much alcohol do you drink?
  • When was your last period? Could you be pregnant?
  • Have you started any new medication recently?

This information will help the doctor to work out the cause of your nausea and/or vomiting. Your doctor will examine you. He or she will check your temperature, chest and abdomen. You may be asked to produce a urine sample and have a blood test. You may be asked to do a pregnancy test. Further tests of your stomach and abdomen may be advised. Referral to a specialist is possible.

  • Call 111 if being sick (vomiting) is severe and you are weak or have severe tummy (abdominal) pain. If you are so ill that you feel it is a life-threatening emergency, call 999.
  • See your doctor urgently (within a few days) if you develop 'red flag' symptoms.
  • See your doctor if your vomiting lasts for more than 48 hours and is not improving.
  • Avoid a lack of fluid in your body and signs of dehydration: drink little and often to replace any fluid you have lost. Consider using rehydration drinks, such as Dioralyte®.
  • If eating food makes you feel sick then it is fine if you want to try avoiding solid food, but you may find that a small amount of plain food doesn't worsen your symptoms.
  • If you have motion (travel) sickness and you do not have access to medicines:
    • Try breaking the journey to have some fresh air, drink some cold water and, if possible, take a short walk.
    • Try to change your seating (for example, move to the front of a car, or to the middle of the deck of a boat.
    • Breathe fresh air and avoid strong smells (for example, petrol and diesel fumes).
    • Close your eyes (and keep them closed for the whole journey). This reduces 'positional' signals from your eyes to your brain and reduces the confusion.
    • Don't try to read.
    • Try listening to an audio book with your eyes closed.
    • Try to sleep.
    • Do not read or watch a film.
    • Don't watch moving objects such as waves or other cars. Instead, look ahead, a little above the horizon, at a fixed place.
    • If you are the driver, offer to drive, as you are less likely to feel sick if you concentrate on the road ahead.

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The following features may indicate serious underlying disease:

Persistent nausea, which is that experienced in pregnancy, on a long sea voyage, when taking chemotherapy, or due to a chronic medical condition, can be very distressing. Severe nausea can be exhausting and depressing, and some people think it is worse than vomiting (which can feel like a relief to people with persistent nausea).

    • Repeated vomiting can cause dehydration, particularly in babies and small children.
    • Persistent vomiting leads to loss of water and salts from the body, including sodium, potassium and chloride. Altering the balance of the body's salts can lead to complications, including irregularities of the heart rhythm. It can be very difficult to replace lost fluids and salts whilst vomiting continues.
    • Tooth enamel damage is common in people with bulimia nervosa who induce vomiting on a regular basis as part of their illness. The acid from the stomach erodes and damages teeth, and digestive enzymes damage gums, leading to dental complications.
    • Tears of the oesophageal lining (Mallory-Weiss tears) can cause bleeding, and you may see blood in the vomit. Recurrent vomiting can also lead the stomach and gullet to become inflamed (gastritis and oesophagitis).
    • Vomiting whilst unconscious (for instance, after excess alcohol) can be very dangerous, as it can lead to stomach contents getting into your windpipe, and therefore into your lungs, where it can obstruct breathing or lead to severe lung inflammation.


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Further reading and references