emesis

Nausea is when you feel sick to your stomach, as if you are going to throw up. Vomiting is when you throw up.

Nausea and vomiting can be symptoms of many different conditions, including:

• Morning sickness during pregnancy
• Gastroenteritis (infection of your intestines) and other infections
• Migraines
• Motion sickness
• Food poisoning
• Medicines, including those for cancer chemotherapy
• GERD (reflux) and ulcers
• Intestinal obstruction

Nausea and vomiting are common. They are usually not serious. However, you should contact your health care provider immediately if you have:

• A reason to think that your vomiting is from poisoning
• Vomited for longer than 24 hours
• Blood in the vomit
• Severe abdominal pain
• Severe headache and stiff neck
• Signs of dehydration, such as dry mouth, infrequent urination or dark urine

Your health care provider will take your medical history, ask about your symptoms and do a physical exam. The provider will look for signs of dehydration. You may have some tests, including blood and urine tests. Women may also have a pregnancy test.

Treatments for nausea and vomiting depend on the cause. You may get treatment for the underlying problem. There are some medicines that can treatment nausea and vomiting. For severe cases of vomiting, you may need extra fluids through an IV (intravenous).

There are things that you can do to feel better:

• Get enough fluids, to avoid dehydration. If you are having trouble keeping liquids down, drink small amounts of clear liquids often.
• Eat bland foods; stay away from spicy, fatty, or salty foods
• Eat smaller meals more often
• Avoid strong smells, since they can sometimes trigger nausea and vomiting
• If you are pregnant and have morning sickness, eat crackers before you get out of bed in the morning

Gastroenteritis is an inflammation of the lining of the stomach and intestines. The main symptoms include vomiting and diarrhea. It is usually not serious in healthy people, but it can sometimes lead to dehydration or cause severe symptoms.

There can be many different causes of gastroenteritis:

• Viruses
• Bacteria
• Parasites
• Chemicals
• Reactions to certain medicines and food

Viral gastroenteritis is the most common type. It can be caused by many different viruses, including noroviruses and rotaviruses. Some people call viral gastroenteritis the "stomach flu." But this name is not medically correct. It is not caused by flu viruses. The flu is a respiratory infection that affects your nose, throat and lungs.

When gastroenteritis is caused by consuming foods or drinks contaminated with viruses, bacteria, parasites, or chemicals, this is called food poisoning.

The viruses, bacteria, and parasites that cause gastroenteritis can also spread from person to person. You could be infected when you touch something that has the germs on it and then touch your eyes, mouth, or nose.

The symptoms of gastroenteritis include:

• Diarrhea
• Pain or cramping in your abdomen (belly)
• Nausea
• Vomiting
• Sometimes fever

Gastroenteritis is usually not serious. But it can sometimes cause lead to dehydration or cause severe symptoms. Certain people are at higher risk for these problems. They include:

• Pregnant women
• Older adults
• People with weakened immune systems or other serious health conditions
• Infants
• Babies who were born prematurely or have other health conditions

If you or a family member are at higher risk and have symptoms of gastroenteritis, contact a health care provider right away. Even if you are not at high risk, it is possible to become dehydrated or have more serious symptoms. There are some warning signs to watch for. It's important to contact a provider right away if you or your child have any of them:

• For adults, they include:
  • Change in mental state, such as irritability or lack of energy
  • Diarrhea lasting more than 2 days
  • High fever
  • Vomiting often
  • Six or more loose stools in a day
  • Severe pain in the abdomen (belly) or rectum
  • Stools that are black and tarry or contain blood or pus
  • Symptoms of dehydration, such as thirst, dry mouth, headache, dark-colored urine, and urinating less than normal
• For infants and children, they include:
  • Change in the child's mental state, such as irritability or lack of energy
  • Diarrhea lasting more than a day
  • Any fever in infants
  • High fever in older children
  • Frequent loose stools
  • Vomiting often
  • Severe pain in the abdomen (belly) or rectum
  • Signs or symptoms of dehydration, such as thirst, dry mouth, urinating less than usual or no wet diapers for 3 hours or more, and no tears when crying
  • Stools that are black and tarry or contain blood or pus

To find out if you have gastroenteritis, your provider:

• Will do a physical exam
• Will ask about your symptoms
• May do tests of your stool

Usually, people with gastroenteritis get better on their own, with rest and plenty of fluids and electrolytes. Your provider may suggest that you take a probiotic. Studies suggest that some probiotics may help shorten a case of diarrhea.

People with more severe symptoms may need medicines to control nausea or vomiting. Providers may also give other medicines for certain types of gastroenteritis, such as antibiotics for some bacterial types and antiparasitic medicines for some parasitic types.

Gastroenteritis cannot always be prevented. But proper hand washing, cleaning surfaces that may be infected with germs, and safe food preparation may help prevent some of the infections that can cause gastroenteritis. There are vaccines for infants to protect against rotavirus infections.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

It is hard when your baby is sick. Common health problems in babies include colds, coughs, fevers, and vomiting. Babies also commonly have skin problems, like diaper rash or cradle cap.

Many of these problems are not serious. It is important to know how to help your sick baby, and to know the warning signs for more serious problems. Trust your intuition - if you are worried about your baby, call your health care provider right away.

Dehydration is a condition caused by the loss of too much fluid from the body. It happens when you are losing more fluids than you are taking in, and your body does not have enough fluids to work properly.

You can become dehydrated because of:

• Diarrhea
• Vomiting
• Sweating too much
• Urinating too much, which can happen because of certain medicines and illnesses
• Fever
• Not drinking enough water or other fluids

Certain people are more likely to develop dehydration:

• Older adults. Some people lose their sense of thirst as they age, so they don't drink enough fluids.
• Infants and young children, who are more likely to have diarrhea or vomiting
• People with chronic illnesses that cause them to urinate or sweat more often, such as diabetes, cystic fibrosis, or kidney problems
• People who take medicines that cause them to urinate or sweat more
• People who exercise or work outdoors during hot weather

In adults, the symptoms of dehydration include:

• Feeling very thirsty
• Dry mouth
• Urinating and sweating less than usual
• Dark-colored urine
• Dry skin
• Feeling tired
• Dizziness

In infants and young children, the symptoms of dehydration include:

• Dry mouth and tongue
• Crying without tears
• No wet diapers for 3 hours or more
• A high fever
• Being unusually sleepy or drowsy
• Irritability
• Eyes that look sunken

Dehydration can be mild, or it can be severe enough to be life-threatening. Get medical help right away if the symptoms also include:

• Confusion
• Fainting
• Lack of urination
• Rapid heartbeat
• Rapid breathing
• Shock

To find out if you dehydration, your health care provider will:

• Do a physical exam
• Check your vital signs
• Ask about your symptoms

Your provider may also order tests, such as:

• Blood tests to check your electrolyte levels, especially potassium and sodium. Electrolytes are minerals in your body that have an electric charge. They have many important jobs, including helping to keep a balance of fluids in your body.
• Blood tests to check your kidney function.
• Urine tests to check for dehydration and its cause.

The treatment for dehydration is to replace the fluids and electrolytes that you have lost. For mild cases, you may just need to drink lots of water. If you lost electrolytes, sports drinks may help. There are also oral rehydration solutions for children. You can buy those without a prescription.

Severe cases may be treated with intravenous (IV) fluids with salt in a hospital.

The key to preventing dehydration is making sure that you get enough fluids:

• Drink enough water every day. Each person's needs can be different, so ask your health care provider how much you should be drinking each day.
• Avoid drinks that have sugar and caffeine.
• Drink extra fluids when the weather is hot, especially if you are exercising or working outside. If you are losing a lot of minerals in sweat, sports drinks can help you. But some sports drinks have lots of sugar, so be careful not to drink too much of them.
• Get extra fluids when you are sick. If you are having trouble keeping liquids down, you can try taking small sips of water or sucking on ice chips.

Dengue is a viral infection. It can be caused by four related viruses. You can get it if an infected mosquito bites you. It is common in warm, wet areas of the world. Although rare, it can be found in some parts of the United States. Outbreaks are more common during rainy seasons.

Dengue spreads to people through the bite of an infected mosquito. It does not spread directly from person to person. However, a pregnant person can pass the infection on to the baby. In rare cases, it can spread through a blood transfusion, organ transplant, or needle stick injury (an accidental injury from a used needle)..

About one in four people infected with dengue will get sick. For those who do get sick, the infection can be mild or severe. The symptoms of dengue include:

• A high fever
• Nausea and vomiting
• Rash
• Aches and pains (eye pain, usually behind the eyes, and pain in the muscles, joints, or bones)

The symptoms usually last two to seven days.

Severe dengue is a serious form of the illness. About 1 in 20 people who get sick with dengue will develop severe dengue. It can cause shock, internal bleeding, and even death. People are more likely to develop severe dengue if they have had dengue before, are pregnant, or are infants.

Watch for signs and symptoms of severe dengue. Warning signs usually begin about 24 - 48 hours after your fever has gone away. If you or your family member have these signs, get immediate medical care:

• Severe abdominal (belly) pain and tenderness
• Vomiting at least 3 times in 24 hours
• Bleeding from the nose or gums
• Vomiting blood, or blood in the stool (poop)
• Feeling tired, restless, or irritable

There is a blood test which can show if you have been infected with dengue.

There is no specific medicine to treat dengue. Most people will get better after about a week. But if you think you might have dengue:

• See a health care provider and mention any recent travel.
• Rest as much as possible.
• Take acetaminophen to control fever and relieve pain. But do not take aspirin or ibuprofen.
• Drink plenty of fluids to prevent dehydration.

Severe dengue often requires care at a hospital.

In the United States, a dengue vaccine is approved for children who are ages 9 - 16. They must also have previously had dengue and live in areas where dengue is common.

You can also help prevent dengue by avoiding mosquito bites:

• Wear insect repellent with DEET or another U.S. Environmental Protection Agency (EPA)-registered insect repellent. Make sure to follow the instructions for using the repellant.
• Wear clothes that cover your arms, legs and feet.
• Close unscreened doors and windows.

Centers for Disease Control and Prevention

Your abdomen extends from below your chest to your groin. Some people call it the stomach, but your abdomen contains many other important organs. Pain in the abdomen can come from any one of them. The pain may start somewhere else, such as your chest. Severe pain doesn't always mean a serious problem. Nor does mild pain mean a problem is not serious.

Call your health care provider if mild pain lasts a week or more or if you have pain with other symptoms. Get medical help immediately if:

• You have abdominal pain that is sudden and sharp
• You also have pain in your chest, neck or shoulder
• You're vomiting blood or have blood in your stool
• Your abdomen is stiff, hard and tender to touch
• You can't move your bowels, especially if you're also vomiting

Cancer chemotherapy is a type of cancer treatment. It uses medicines to destroy cancer cells.

Normally, the cells in your body grow and die in a controlled way. Cancer cells keep growing without control. Chemotherapy works by killing the cancer cells, stopping them from spreading, or slowing their growth.

Chemotherapy is used to:

• Treat cancer by curing the cancer, lessening the chance it will return, or stopping or slowing its growth.
• Ease cancer symptoms by shrinking tumors that are causing pain and other problems.

Chemotherapy does not just destroy cancer cells. It can also harm some healthy cells, which causes side effects.

You may have a lot of side effects, some side effects, or none at all. It depends on the type and amount of chemotherapy you get and how your body reacts.

Some common side effects are:

• Mouth sores
• Fatigue
• Nausea and vomiting
• Pain
• Hair loss

There are ways to prevent or control some side effects. Talk with your health care provider about how to manage them. Healthy cells usually recover after chemotherapy is over, so most side effects gradually go away.

You may get chemotherapy in a hospital or at home, a doctor's office, or a medical clinic. You might be given the medicines by mouth, in a shot, as a cream, through a catheter, or intravenously (by IV).

Your treatment plan will depend on the type of cancer you have, which chemotherapy medicines are used, the treatment goals, and how your body responds to the medicines.

Chemotherapy may be given alone or with other treatments. You may get treatment every day, every week, or every month. You may have breaks between treatments so that your body has a chance to build new healthy cells.

NIH: National Cancer Institute

Brain tumors are abnormal growths inside the skull. They are among the most common types of childhood cancers. Some are benign tumors, which aren't cancer. They can still be serious. Malignant tumors are cancerous.

Childhood brain and spinal cord tumors can cause headaches and other symptoms. However, other conditions can also cause the same symptoms. Check with a doctor if your child has any of the following problems:

• Morning headache or headache that goes away after vomiting
• Frequent nausea and vomiting
• Vision, hearing, and speech problems
• Loss of balance or trouble walking
• Unusual sleepiness
• Personality changes
• Seizures
• Increased head size in infants

The symptoms are not the same in every child.

Doctors use physical and neurological exams, lab tests, and imaging to diagnose brain tumors. Most childhood brain tumors are diagnosed and removed in surgery.

Treatment for children is sometimes different than for an adult. Long-term side effects are an important issue. The options also depend on the type of tumor and where it is. Removal of the tumor is often possible. If not, radiation, chemotherapy, or both may be used.

NIH: National Cancer Institute

Ebola, also known as Ebola virus disease (EVD), is a type of hemorrhagic fever. It is a rare and often deadly disease. It can be caused by several different types of Ebola viruses. There are occasional outbreaks of Ebola, and they mostly occur in Africa.

Researchers believe that the virus first spreads from an infected animal to a human. Ebola can then spread from human to human through direct contact with:

• Blood or body fluids of a person who is sick with or has died from Ebola.
• Objects (such as clothes, bedding, needles, and medical equipment) contaminated with body fluids from a person who is sick with or has died from Ebola.
• Semen (through oral, vaginal, or anal sex) from a man who has recovered from Ebola. The virus can remain in semen and other body fluids, even if the person no longer has symptoms.

When people become infected with Ebola, they do not start developing signs or symptoms right away. They cannot spread Ebola to others until after they develop symptoms.

The symptoms of Ebola may appear anywhere from 2 to 21 days after exposure to the virus. The average is about 8 to 10 days. The symptoms usually include:

• Fever
• Headache
• Joint and muscle aches
• Weakness and fatigue
• Sore throat
• Gastrointestinal symptoms including abdominal (belly) pain, diarrhea, and vomiting
• Loss of appetite
• Unexplained bleeding or bruising

Other symptoms may include a rash, red eyes, and hiccups.

The early symptoms of Ebola are similar to other more common diseases. This makes it difficult to diagnose Ebola in someone who has been infected for only a few days. If a person has the symptoms of Ebola and may have been exposed to the virus, the health care provider can do a blood test for Ebola. It can take a few days after the symptoms start before Ebola shows up in the blood test.

In the United States, there are two approved medicines to treat Ebola that is caused by one specific type of virus (Zaire ebolavirus). These medicines have not been evaluated to treat Ebola caused by other types of Ebola viruses. The medicines are monoclonal antibodies, which are immune system proteins that are created in the lab.

Whether or not there are medicines to treat a case of Ebola, there is supportive care. This type of care can improve the chances of survival, especially when given early. Supportive care includes:

• Giving fluids and electrolytes
• Giving medicines to support blood pressure, reduce vomiting and diarrhea, and to manage fever and pain
• Giving oxygen
• Treating any other complications or infections

People who recover may still have side effects afterwards, such as fatigue, muscle aches, eye and vision problems, and stomach pain.

In the United States, there is one vaccine that has been approved to prevent Ebola caused by one specific type of Ebola virus (Zaire ebolavirus). It may be given to health care providers who will be or may be treating Ebola patients and people who work with live Ebola virus in labs.

If you live in or plan to travel to a region where Ebola virus may be present, you can help protect yourself by avoiding contact with:

• Blood and body fluids of people who are sick
• Semen from a man who has recovered from Ebola, until testing shows that the virus is gone from his semen
• Items that could be contaminated with blood or body fluids from someone who has Ebola
• Bats, forest antelopes, and nonhuman primates (such as monkeys and chimpanzees), including their blood, fluids, or meat

Centers for Disease Control and Prevention

Eosinophilic esophagitis (EoE) is a chronic disease of the esophagus. Your esophagus is the muscular tube that carries food and liquids from your mouth to the stomach. If you have EoE, white blood cells called eosinophils build up in your esophagus. This causes damage and inflammation, which can cause pain, trouble swallowing, and food getting stuck in your throat.

EoE is rare. But because it is a newly recognized disease, it is being diagnosed more often. Some people who think that they have reflux (GERD) may actually have EoE.

Researchers are not certain about the exact cause of EoE. They think that it is an immune system/allergic reaction to foods or to substances in your environment, such as dust mites, animal dander, pollen, and molds. Certain genes may also play a role in EoE.

EoE can affect anyone, but it is more common in people who:

• Are male
• Have other allergic diseases, such as hay fever, eczema, asthma and food allergies
• Have family members with EoE

The most common symptoms of EoE can depend on your age.

In infants and toddlers::

• Feeding problems
• Vomiting
• Poor weight gain and growth
• Reflux that does not get better with medicines

In older children::

• Vomiting
• Abdominal pain
• Trouble swallowing, especially with solid foods
• Reflux that does not get better with medicines
• Poor appetite

In adults::

• Trouble swallowing, especially with solid foods
• Food getting stuck in the esophagus
• Reflux that does not get better with medicines
• Heartburn
• Chest pain

To find out if you have EoE, your doctor will likely:

• Ask about your symptoms and medical history. Since other conditions can have the same symptoms of EoE, it is important for your doctor to take a thorough history.
• Do an upper gastrointestinal (GI) endoscopy. An endoscope is a long, flexible tube with a light and camera at the end of it. Your doctor will run the endoscope down your esophagus and look at it. Some signs that you might have EoE include white spots, rings, narrowing, and inflammation in the esophagus. However, not everyone with EoE has those signs, and sometimes they can be signs of a different esophagus disorder.
• Do a biopsy. During the endoscopy, the doctor will take small tissue samples from your esophagus. The samples will be checked for a high number of eosinophils. This is the only way to make a diagnosis of EoE.
• Do other tests as needed. You may have blood tests to check for other conditions. If you do have EoE, you may have blood or other types of tests to check for specific allergies.

There is no cure for EoE. Treatments can manage your symptoms and prevent further damage. The two main types of treatments are medicines and diet.

Medicines used to treat EoE are:

• Steroids, which can help control inflammation. These are usually topical steroids, which you swallow either from an inhaler or as a liquid. Sometimes doctors prescribe oral steroids (pills) to treat people who have serious swallowing problems or weight loss.
• Acid suppressors such as proton pump inhibitors (PPIs), which may help with reflux symptoms and decrease inflammation.
• Monoclonal antibodies, which can reduce inflammation and may help with swallowing. They can be used in adults and children over age 12.

Dietary changes for EoE include:

• Elimination diet. If you are on an elimination diet, you stop eating and drinking certain foods and beverages for several weeks. If you are feeling better, you add the foods back to your diet one at a time. You have repeat endoscopies to see whether or not you are tolerating those foods. There are different types of elimination diets:
• With one type, you first have an allergy test. Then you stop eating and drinking the foods you are allergic to.
• For another type, you eliminate foods and drinks that commonly cause allergies, such as dairy products, egg, wheat, soy, peanuts, tree nuts and fish/shellfish.
• Elemental diet. With this diet, you stop eating and drinking all proteins. Instead, you drink an amino acid formula. Some people who do not like the taste of the formula use a feeding tube instead. If your symptoms and inflammation go away completely, you may be able to try adding foods back one at a time, to see whether you can tolerate them.

Which treatment your doctor suggests depends on different factors, including your age. Some people may use more than one kind of treatment. Researchers are still trying to understand EoE and how best to treat it.

If your treatment is not working well enough and you have narrowing of the esophagus, you may need dilation. This is a procedure to stretch the esophagus. This makes it easier for you to swallow.