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Vomiting associated with nausea

This is most frequently due to a cause affecting the chemoreceptor trigger zone (medulla oblongata).

1. Neurological

Accompanying neurological manifestations

  • Migraine
    Clinical suspicion: nausea & headache
  • Labyrnthine disorders:
    Clinical suspicion: nausea & vertigo
  • Cerebral lesion (increase ICT)
    Clinical suspicion: blurring of vision, headache, projectile vomiting, focal neurological manifestations.

2. Metabolic

Toxic, maybe delirious,
Labs, pH, electrolytes

  • DKA
  • Metabolic acidosis
  • Electrolyte abnormalities

  • Renal failure
  • Hepatic failure

  • Hypothyroidism
  • Adrenal insufficiency

  • Drugs & toxins

  • Pregnancy (Morning sickness, hyperemesis gravidarum)
  • Food allergy

3. GIT Causes

  • Over-eating or drinking too much alcohol
  • Many patients experience nausea after eating spoiled food
  • Gallstones, gastroenteritis and stomach ulcer may cause nausea and vomiting
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4. Other Causes

  • Motion sickness can be induced by traveling in a vehicle, plane, or on a boat.

3. Psychogenic


By exclusion

Persistent, unexplained, or recurring nausea and vomiting can be symptoms of a variety of serious illnesses. You should seek medical assessment if:

  • After eating rich or spoiled food or taking a new medication
  • Repeatedly or for 48 hours or longer
  • Following intense dizziness.

It is important to see a doctor if nausea and vomiting are accompanied by:

  • Jaundice
  • Pain in the chest or lower abdomen
  • Trouble with swallowing or urination
  • Dehydration or extreme thirst
  • Drowsiness or confusion
  • Constant, severe abdominal pain
  • A fruity breath odor
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