Diagnosis: identifying causes of nausea and vomiting

If nausea and vomiting are the result of a minor illness or short-term problem, there may be little cause for concern. Doctors usually start by taking a detailed history and performing a thorough physical examination. This usually provides your doctor with enough information to determine if you need to be admitted to a hospital, if you need testing that can be performed as an outpatient, and if medication may be beneficial. Hospital admission may be more likely for the very elderly and the very young, as they can become dehydrated quickly. If diarrhea, dehydration, or both are present, intravenous fluids may be needed, necessitating a visit to the physician’s office, the emergency room or admission to the hospital. Finally, even if nausea and vomiting are not particularly severe, hospital admission may be needed for tests and further treatment if symptoms do not improve after a few days.

Test ordered to evaluate nausea and vomiting may include:

• Blood tests (blood count, measurement of chemical levels in the blood, liver enzymes, pancreatic enzymes)
• X rays of the gastrointestinal tract, abdomen, or brain. These can include plain x rays, barium x rays, or specialized scans such as ultrasound, CT scans or MRI scans
• Endoscopy, which is the use of a long flexible tube with a video camera that allows direct visualization of the swallowing tube, stomach and first part of the small intestine. This test is performed to look for abnormalities in the lining of the upper gut that might be causing the nausea and vomiting
• Tests to assess the movement of food through the stomach and intestines (gastrointestinal motility testing)

If the cause of nausea and vomiting is not clear after a thorough search, and if the symptoms are not controlled with standard therapy, psychological tests and evaluation or psychiatric consultation may prove helpful. Psychogenic vomiting and eating disorders such as anorexia nervosa or bulimia are recognized causes of these symptoms.

 

Notes: Chandra Prakash.

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EditText of this page (last edited February 14, 2009)