Causes of acute nausea and vomiting

Always assess and manage patients for complications of nausea and vomiting (eg dehydration in adults, dehydration in children, electrolyte or acid-base disturbance). Hydration (ie with intravenous fluids) may improve the patient’s symptoms.

In acute nausea and vomiting, a cause is often identified. In some cases the likely precipitant is obvious, such as acute gastroenteritis, food poisoning, motion sickness, chemotherapy-induced nausea and vomiting or postoperative nausea and vomiting in adults or children. In people of childbearing age, consider pregnancy as the cause of symptoms (see Nausea and vomiting during pregnancy). Additionally, acute nausea and vomiting may be symptoms of a medical or surgical condition such as raised intracranial pressure, Addisonian crisis, diabetic ketoacidosis or an acute abdominal emergency.

If a cause of nausea and vomiting is identified, it should be treated. In adults with acute nausea and vomiting, spontaneous improvement is likely if no cause is identified; however, antiemetic therapy can be considered for symptom relief (see Antiemetic drugs in adults). In children, symptom relief can be considered if nausea and vomiting is caused by acute gastroenteritis (see Antiemetic drugs for acute gastroenteritis); refer all other children with acute nausea and vomiting to a paediatrician for assessment of the cause.