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Biography
Redirect|Wamble|the American guitarist|Doug WambleOther usesSignSymptom infobox |Name = Nausea | Image = 3205 - Milano, Duomo - Giorgio Bonola - Miracolo di Marco Spagnolo (1681) - Foto Giovanni Dall'Orto, 6-Dec-2007-cropped.jpg | Caption = A 1681 painting depicting a person vomiting | ICD10 = ICD10|R|11||r|10 | ICD9 = ICD9|787.0 |
Nausea ( Latin nausea , from Greek language|Greek lang|grc|?a?s??, nausie , " motion sickness ", "feeling sick," "queasy" or "wamble"Cite web |url= http://www.medterms.com/script/main/art.asp? articlekey=33156 |title=Wamble definition |work= MedTerms Medical Dictionary |accessdate=), is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit . It often, but not always, precedes vomiting. A person can suffer nausea without vomiting.
Nausea is a non-specific symptom , which means that it has many possible causes. Some common causes of nausea are motion sickness , dizziness , migraine , fainting , gastroenteritis (stomach infection) or food poisoning . Side effects of many medications including cancer chemotherapy, Nauseant|nauseants or morning sickness in early pregnancy. Nausea may also be caused by anxiety , disgust and Depression (mood)|depression .Cite web|url= http://www.mayoclinic.com/health/stress-symptoms/SR00008_D |title=Stress symptoms: Effects on your body, feelings and behavior|work= Mayo Clinic Cite web|url= http://www.ncbi.nlm.nih.gov/books/NBK45852/ |title=Diagnostic Criteria: Clinical Guidelines for the Management of Anxiety|work= PubMed Cite web|url= http://en.diagnosispro.com/disease_information-for/clinical-manifestations-stress-emotional-physical/19955-104.html |title=Disease Information for Stress/Emotional/Physical: Clinical Manifestations |work=
Medications taken to prevent nausea are called antiemetic s and include diphenhydramine , metoclopramide and ondansetron .
Differential diagnosis
The causes of nausea are many. One organization listed 700 in 2009.Cite web|url= http://en.diagnosispro.com/differential_diagnosis-for/nausea/37707-154.html |title=Differential Diagnosis for Nausea |work= |accessdate= Gastroenteritis|Gastrointestinal infections (37%) and food poisoning are the two most common causes.Cite journal|author=Metz A, Hebbard G |title=Nausea and vomiting in adults--a diagnostic approach |journal=Aust Fam Physician |volume=36 |issue=9 |pages=688–92 |year=2007 |month=September |pmid=17885699 |doi= |url= While side effects from medications (3%) and pregnancy are also relatively frequent. In 10% of people the cause remains unknown.
Food poisoning
Food poisoning usually causes an abrupt onset of nausea and vomiting one to six hours after ingestion of contaminated food and lasts for one to two days.Cite journal|author=Scorza K, Williams A, Phillips JD, Shaw J |title=Evaluation of nausea and vomiting |journal=Am Fam Physician |volume=76 |issue=1 |pages=76–84 |year=2007 |month=July |pmid=17668843 |doi= |url= It is due to toxins produced by bacteria in food.
Medications
Many medications can potentially cause nausea. Some of the most frequently associated include cancer chemotherapy regimens and general anaesthesia|general anaesthetic agents .
Pregnancy
Nausea or " morning sickness " is common during early pregnancy but may occasionally continue into the second and third trimesters. In the first trimester nearly 80% of women have some degree of nausea.Cite journal|author=Koch KL, Frissora CL |title=Nausea and vomiting during pregnancy |journal=Gastroenterol. Clin. North Am. |volume=32 |issue=1 |pages=201–34, vi |year=2003 |month=March |pmid=12635417 |doi= 10.1016/S0889-8553(02)00070-5|url= Pregnancy should therefore be considered as a possible cause of nausea in any women of child bearing age. While usually it is mild and self limiting severe cases known as hyperemesis gravidarum may require treatment.Cite journal|author=Sheehan P |title=Hyperemesis gravidarum--assessment and management |journal=Aust Fam Physician |volume=36 |issue=9 |pages=698–701 |year=2007 |month=September |pmid=17885701 |doi= |url=
Disequilibrium
A number of conditions involving balance such as motion sickness and Vertigo (medical)|vertigo can lead to nausea and vomiting.
Stress and depression
Nausea may be caused by Stress (biology)|stress and Depression (mood)|depression .
Potentially serious
While most causes of nausea are not serious, some serious causes do occur. These include: diabetic ketoacidosis , brain tumor , surgical problems, pancreatitis , small bowel obstruction , meningitis , appendicitis , cholecystitis , Addisonian crisis , Choledocholithiasis (from gallstones) and hepatitis , as a sign of carbon monoxide poison and many others.
Diagnostic approach
Often no investigations are needed, however basic lab tests may be appropriate. If a bowel obstruction is possible, abdominal x-rays may be useful.
Treatment
If dehydration is present due to loss of fluids from severe vomiting and/or accompanying diarrhea , rehydration with oral electrolyte solutions is preferred. If this is not effective or possible, intravenous rehydration may be required.
Medications
Main|Antiemetic Dimenhydrinate (Gravol) is an inexpensive and effective medication for preventing postoperative nausea and vomiting.Cite journal|author=Kranke P, Morin AM, Roewer N, Eberhart LH |title=Dimenhydrinate for prophylaxis of postoperative nausea and vomiting: a meta-analysis of randomized controlled trials |journal=Acta Anaesthesiol Scand |volume=46 |issue=3 |pages=238–44 |year=2002 |month=March |pmid=11939912 |doi= 10.1034/j.1399-6576.2002.t01-1-460303.x|url= Meclozine is another antihistamine antiemetic . In certain people, cannabinoids may be effective in reducing chemotherapy associated nausea and vomiting.Cite journal|author=Tramèr MR, Carroll D, Campbell FA, Reynolds DJ, Moore RA, McQuay HJ |title=Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review |journal=BMJ |volume=323 |issue=7303 |pages=16–21 |year=2001 |month=July |pmid=11440936 |pmc=34325 |doi= 10.1136/bmj.323.7303.16|url=Cite web| url = http://www.drugpolicy.org/marijuana/medical/challenges/litigators/medical/conditions/nausea.cfm | title = Medicinal Uses of Marijuana: Nausea, Emesis and Appetite Stimulation | accessdate = 2007-08-02 | year = 2001 | author = Drug Policy Alliance Ondansetron (Zofran) is effective for nausea and vomiting but is expensive. Pyridoxine or metoclopramide are the first line treatments for pregnancy related nausea and vomiting. Medical marijuana may be prescribed where allowed for certain indications.
Prognosis
While short-term nausea and vomiting are generally harmless, they may sometimes indicate a more serious condition. When associated with prolonged vomiting, it may lead to dehydration and/or dangerous electrolyte imbalances.
Epidemiology
Nausea and or vomiting is the main complaint in 1.6% of visits to family physicians in Australia.Cite journal|author=Helena Britt |title=Presentations of nausea and vomiting |journal=Aust Fam Physician |volume=36 |issue=9 |pages=673–784|year=2007 |month=September |pmid= 17885697|doi= |url= http://www.racgp.org.au/afp/200709/200709beach.pdf|last2=Fahridin|first2=S However only 25% of people with nausea visit their family physician. It is most common in those 15–24 years old and less common in other ages.
References
Reflist Wiktionary GastroenterologyDigestive system and abdomen symptoms and signs Category:Symptoms and signs: Digestive system and abdomen Category:Greek loanwords Category:Vomiting
