Nausea and Vomiting, Age 12 and Older
Nausea and Vomiting, Age 12 and OlderSkip to the navigationTopic OverviewNausea 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: Nausea or vomiting also may be a symptom of a problem or a
disease, such as: Nausea and vomiting can quickly cause
dehydration. Older adults have an increased chance of
becoming dehydrated. Check your symptoms to decide if and when you
should see a doctor. Check Your SymptomsAre you nauseated or vomiting? Nauseated means you feel sick to your stomach, like you are going to vomit. How old are you? 11 years or younger 11 years or younger 12 to 55 years 12 to 55 years 56 years or older 56 years or older Have you had a head injury in the past 24 hours? Yes Head injury in past 24 hours No Head injury in past 24 hours Do you have moderate or severe belly pain? This is not the cramping type of pain you have with diarrhea. Are you pregnant? Yes, you know that you're pregnant. Pregnancy No, you're not pregnant, or you're not sure if you're pregnant. Pregnancy Do you have symptoms of shock? Moderate Moderate dehydration Are you having trouble drinking enough to replace the fluids you've lost? Little sips of fluid usually are not enough. You need to be able to take in and keep down plenty of fluids. Yes Unable to maintain fluid intake No Able to maintain fluid intake Yes Symptoms of serious illness No Symptoms of serious illness Within the past week, have you had an injury to the abdomen, like a blow to the belly or a hard fall? Yes Abdominal injury within past week No Abdominal injury within past week Have you vomited blood or what looks like coffee grounds? If there is only a streak or two of blood that you are sure came from your nose or mouth, you are not vomiting blood. Yes Has vomited blood or what looks like coffee grounds No Has vomited blood or what looks like coffee grounds How much blood have you vomited? Two or more streaks of blood, or any amount of material that looks like coffee grounds Has vomited material that looks like coffee grounds or at least 2 streaks of blood One streak of blood or less Has vomited 1 streak of blood or less Do you think you may have a fever? Did you take your temperature? How high is the fever? The answer may depend on how you took the temperature. High: 104°F (40°C) or higher, oral High fever: 104°F (40°C) or higher, oral Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral Mild: 100.3°F (37.9°C) or lower, oral Mild fever: 100.3°F (37.9°C) or lower, oral How high do you think the fever is? Moderate Feels fever is moderate Mild or low Feels fever is mild How long have you had a fever? Less than 2 days (48 hours) Fever for less than 2 days At least 2 days but less than 1 week Fever for at least 2 days but less than 1 week 1 week or more Fever for 1 week or more Do you have a health problem or take medicine that weakens your immune system? Yes Disease or medicine that causes immune system problems No Disease or medicine that causes immune system problems Do you have shaking chills or very heavy sweating? Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off you or soaking through your clothes. Yes Shaking chills or heavy sweating No Shaking chills or heavy sweating Is your diabetes getting out of control because you are sick? Yes Diabetes is affected by illness No Diabetes is affected by illness Is the plan helping get your blood sugar under control? Yes Diabetes illness plan working No Diabetes illness plan not working How fast is it getting out of control? Quickly (over several hours) Blood sugar quickly worsening Slowly (over days) Blood sugar slowly worsening Do you think that a medicine could be causing the nausea or vomiting? Think about whether the nausea or vomiting started after you began using a new medicine or a higher dose of a medicine. Yes Medicine may be causing nausea or vomiting No Medicine may be causing nausea or vomiting Is there any chance that you could be pregnant? Yes Possibility of pregnancy No Possibility of pregnancy Have your symptoms lasted longer than 1 week? Yes Symptoms have lasted longer than 1 week No Symptoms have lasted longer than 1 week Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
An illness plan for people with diabetes usually covers things like: - How often to test blood sugar and what the target
range is.
- Whether and how to adjust the dose and timing of insulin
or other diabetes medicines.
- What to do if you have trouble keeping
food or fluids down.
- When to call your doctor.
The plan is designed to help keep your diabetes in control even
though you are sick. When you have diabetes, even a minor illness can cause
problems. It is easy for your diabetes to become out of control when
you are sick. Because of an illness: - Your blood sugar may be too high or too
low.
- You may not be able take your diabetes medicine (if you are
vomiting or having trouble keeping food or fluids down).
- You may
not know how to adjust the timing or dose of your diabetes
medicine.
- You may not be eating enough or drinking enough
fluids.
Temperature varies a little depending on how you measure it.
For adults and children age 12 and older, these are the ranges for high,
moderate, and mild, according to how you took the temperature. Oral (by mouth) temperature - High:
104°F (40°C) and
higher
- Moderate:
100.4°F (38°C) to
103.9°F (39.9°C)
- Mild:
100.3°F (37.9°C) and
lower
A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature. Ear or rectal temperature - High:
105°F (40.6°C) and
higher
- Moderate:
101.4°F (38.6°C) to
104.9°F (40.5°C)
- Mild:
101.3°F (38.5°C) and
lower
Armpit (axillary) temperature - High: 103°F (39.5°C) and higher
- Moderate:
99.4°F (37.4°C) to
102.9°F (39.4°C)
- Mild: 99.3°F (37.3°C) and lower
If you're not sure if a fever is high, moderate, or mild,
think about these issues: With a high fever: - You feel very hot.
- It is likely one of
the highest fevers you've ever had. High fevers are not that common, especially
in adults.
With a moderate fever: - You feel warm or hot.
- You know you have
a fever.
With a mild fever: - You may feel a little warm.
- You think
you might have a fever, but you're not sure.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are: - Diseases such as diabetes, cancer, heart disease,
and HIV/AIDS.
- Long-term alcohol and drug
problems.
- Steroid medicines, which may be used to treat a variety
of conditions.
- Chemotherapy and radiation therapy for
cancer.
- Other medicines used to treat autoimmune
disease.
- Medicines taken after organ transplant.
- Not
having a spleen.
You can get dehydrated when
you lose a lot of fluids because of problems like vomiting or fever. Symptoms of dehydration can range from mild to severe. For
example: - You may feel tired and edgy (mild dehydration), or
you may feel weak, not alert, and not able to think clearly (severe
dehydration).
- You may pass less urine than usual (mild
dehydration), or you may not be passing urine at all (severe
dehydration).
Severe dehydration means: - Your mouth and eyes may be extremely
dry.
- You may pass little or no urine for 12 or more
hours.
- You may not feel alert or be able to think
clearly.
- You may be too weak or dizzy to stand.
- You may
pass out.
Moderate dehydration means: - You may be a lot more thirsty than
usual.
- Your mouth and eyes may be drier than usual.
- You may
pass little or no urine for 8 or more hours.
- You may feel dizzy
when you stand or sit up.
Mild dehydration means: - You may be more thirsty than usual.
- You may pass less urine than usual.
Severe vomiting can mean that: - You vomit more than 10 times in 24
hours.
- For at least 24 hours, you vomit every time you try to drink
something.
- The vomit shoots out in large amounts and with great
force.
Many nonprescription and prescription medicines can cause
nausea or vomiting. A few examples are: - Antibiotics.
- Antidepressants.
- Aspirin, ibuprofen (such as Advil or
Motrin), and naproxen (such as Aleve).
- Medicines used to treat
cancer (chemotherapy).
- Opioid pain
medicines.
- Vitamins and mineral supplements, such as iron.
Starting a new medicine or increasing the dose can cause nausea
and vomiting. Nausea and vomiting also may mean that there is too much medicine
in your body, even if you took it properly. Shock is a life-threatening condition that may quickly occur
after a sudden illness or injury. Symptoms of shock (most of which will be present) include: - Passing out (losing consciousness).
- Feeling very dizzy or
lightheaded, like you may pass out.
- Feeling very weak or having
trouble standing.
- Not feeling alert or able to think clearly. You
may be confused, restless, fearful, or unable to respond to questions.
Shock is a life-threatening condition that may occur quickly
after a sudden illness or injury. Symptoms of shock in a child may include: - Passing out (losing consciousness).
- Being very sleepy or hard
to wake up.
- Not responding when being touched or talked to.
- Breathing much faster than usual.
- Acting confused.
The child may not know where he or she is.
Symptoms of a heart attack may
include: - Chest pain or pressure, or a strange feeling in the chest.
- Sweating.
- Shortness of
breath.
- Nausea or vomiting.
- Pain, pressure, or a
strange feeling in the back, neck, jaw, or upper belly, or in one or both
shoulders or arms.
- Lightheadedness or sudden
weakness.
- A fast or irregular heartbeat.
The more of these symptoms you have, the more likely it is that
you're having a heart attack. Chest pain or pressure is the most common
symptom, but some people, especially women, may not notice it as much as other
symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas. Symptoms of serious illness may
include: - A severe headache.
- A stiff
neck.
- Mental changes, such as feeling confused or much less
alert.
- Extreme fatigue (to the point where it's hard for you to
function).
- Shaking chills.
Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Make an Appointment Based on your answers, the problem may not improve without medical
care. - Make an appointment to see your doctor in the
next 1 to 2 weeks.
- If appropriate, try home treatment while you
are waiting for the appointment.
- If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. After you call
911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2
to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself. Head Injury, Age 4 and Older Nausea and Vomiting, Age 11 and Younger Pregnancy-Related Problems Abdominal Pain, Age 12 and Older Home TreatmentHome treatment may be all that is
needed to treat occasional nausea. - Watch for
dehydration, and treat it early. Signs of dehydration include being thirstier than usual and having less urine than usual. Older adults and young
children can quickly become dehydrated.
- Don't use aspirin or a
nonsteroidal anti-inflammatory drug (NSAID), such as
ibuprofen, to treat belly 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 1 hour, drink
1 fl oz (30 mL) of a clear
liquid every 20 minutes for 1 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, and lemonade. Avoid apple and 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 (240 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 treatmentCall your doctor if any of the following occur during home
treatment: - Dehydration
develops. Signs of dehydration include being thirstier than usual and having less urine than usual.
- A
stiff neck develops.
- Severe vomiting develops.
- 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.
- Your
symptoms become more severe or more frequent.
PreventionFood poisoningFood 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 that 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 how to
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 illnessIncrease your chance of staying healthy
by: - Washing your hands often, especially
during winter months when
viral illnesses 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.
Preparing For Your AppointmentTo 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 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
belly 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?
- Do you have any
health risks?
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Adam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine Current as ofMarch 20, 2017 Current as of:
March 20, 2017 Last modified on: 8 September 2017
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