Nausea and vomiting

Nausea and vomiting are common, frequently distressing and occasionally disabling symptoms that can occur due to a variety of causes. Although a diagnosis is possible in most cases of acute nausea and vomiting after completing a thorough history and examination, for those whose symptoms persist or are chronic and the diagnosis remains uncertain, further testing guided by the clinical presentation is generally indicated. Additional testing may include laboratory studies, radiologic and endoscopic imaging studies, and occasionally, an assessment of gastrointestinal motor activity. The standard approach to the management of nausea and vomiting includes correction or fluid, electrolyte and nutritional deficiencies, treatment of the underlying cause if known, and suppression of the symptoms using dietary, pharmacological and, sometimes surgical interventions. Importantly, correction of clinical consequences of vomiting such as dehydration, electrolyte abnormalities and malnutrition, and suppression of symptoms should be initiated either before or concurrently with the diagnostic evaluation.