Nausea: why it happens and what to do

Nausea is that queasy feeling in your stomach, with an urge to vomit. Sometimes it ends in vomiting and sometimes it doesn’t. It is a symptom, not a disease: what matters is finding the cause.

This page helps you narrow down the most likely cause and tells you when it is an emergency. If your child has vomiting and diarrhea, see diarrhea and vomiting in children.

According to MedlinePlus, the most frequent causes are:

• A stomach virus or food poisoning: see stomach bug
• Reflux or heartburn: see acid reflux and gastritis
• Migraine: see migraine
• Motion sickness on a boat, a cruise or in the car: see seasickness
• Medicines, such as some diabetes or weight-loss drugs, or chemotherapy
• Pregnancy (morning sickness)
• Severe pain, for example from a kidney stone
• A food allergy, or frequent marijuana use

Nausea is one of the first symptoms of pregnancy. If there is any chance, take a drugstore pregnancy test before you take medicine for nausea. Pregnancy care is not part of our visits: if the test is positive, book with an OB-GYN for prenatal care and ask them what you can take for nausea.

MedlinePlus recommends drinking small amounts of clear liquids often (water, oral rehydration solution, broth) rather than a lot at once, and stopping a medicine that may be causing the nausea only after talking to your doctor.

Watch for signs of dehydration: dry mouth, more thirst, urinating less or dark yellow urine, sunken eyes or crying without tears. In Puerto Rico’s heat, vomiting can dehydrate you quickly: see dehydration.

You see Dr. Diana Nieves Castro, a Puerto Rico-licensed general practice physician with several years of emergency-department experience, in English or Spanish. She asks when the nausea started, whether you are vomiting and how often, whether you have pain, fever or diarrhea, what you ate, whether you traveled, which medicines you take and whether you could be pregnant.

We evaluate, diagnose and treat. If appropriate, the doctor prescribes a medicine for the nausea or its cause, and we send your prescription to your pharmacy. If needed, we give you a lab order for a lab near you: for example a blood count, electrolytes, liver and kidney tests, or a urine test.

An online doctor visit costs US$79, the same price for every age. If the patient is under 21, a parent or legal guardian stays on camera for the whole visit and shows ID. Request a visit online 24/7 — we confirm your time by email or text.

According to MedlinePlus, call 911 or go to the ER if you think the vomiting is from a poison or a substance, or if you see blood or dark material like coffee grounds in the vomit. Get medical care right away if:

• You have severe stomach or belly pain
• You have a bad headache or a stiff neck
• You have been vomiting for more than 24 hours, or can’t keep fluids down for 12 hours or more
• You vomited 3 or more times in a day, or haven’t urinated for 8 hours or more
• You have nausea with chest pain or pressure, or shortness of breath: it may be your heart, call 911
• You are confused or very drowsy