nausea

(nô'zē-ə, -zhə, -sē-ə, -shə)

1. A feeling of sickness in the stomach characterized by an urge to vomit. See Usage Note at nauseous.
2. Strong aversion; disgust.

[Middle English, from Latin, from Greek nautiā, nausiē, seasickness, from nautēs, sailor, from naus, ship.]

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The unpleasant sensation vaguely located in the upper abdomen and chest which heralds vomiting or fainting, but which may also occur without dramatic issue. Nausea is well known to accompany strong negative emotion — disgust, fear, horror — or severe pain; also a side-effect of some drugs and of chemotherapy and radiotherapy, and a feature of a variety of gastro-intestinal and other diseases. Its physical basis is the autonomic nervous system and the associated visceral afferents (nerves bringing in information from the gut) ; there may be nervous inputs from a diseased or insulted stomach or intestine, with appropriate reflex responses, or the system may be activated ‘inappropriately’ from higher regions of the brain.

— Stuart Judge

See visceral sensation; vomiting.

noun

Extreme repugnance excited by something offensive: disgust. See like/dislike.

A feeling of impending vomiting due to a change in the tone of muscles in the stomach and intestinal wall. The autonomic nervous system controls the vomiting response, and nausea can be brought about by some irritant or heightened emotional state, such as that of an athlete prior to competition. As nausea can also be an early symptom of some acute illnesses, it is generally advisable to seek medical advice if it persists and the cause is not known.

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Purging and getting rid of a sickening situation or condition in the dreamer's life can be indicated by this dream symbol.

A subjective sensation in humans which probably occurs in animals. It is an unpleasant sensation, vaguely referred to the epigastrium and abdomen, with a tendency to vomit. Nausea may be a symptom of a variety of disorders, some minor and some more serious.
Nausea is usually felt when nerve endings in the stomach and other parts of the body are irritated, e.g in motion sickness. The irritated nerves send messages to the center in the brain that controls the vomiting reflex. When the nerve irritation becomes intense, vomiting results.

A sensation often leading to the urge to vomit. Common causes are motion sickness, early pregnancy, intense pain, emotional stress, gallbladder disease, food poisoning, and various enteroviruses.

• Signs and Symptoms - nausea: feeling that one is about to vomit

"Wamble" redirects here. For the American guitarist, see Doug Wamble.

For other uses, see Nausea (disambiguation).

Nausea

A 1681 painting depicting a person vomiting
ICD-10	R11
ICD-9	787.0

Nausea (Latin nausea, from Greek ναυσίη, nausiē, "motion sickness", "feeling sick," "queasy" or "wamble"^[1]), is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit.^[2] It often, but not always, precedes vomiting. A person can suffer nausea without vomiting.

Some common causes of nausea are motion sickness, dizziness, fainting, gastroenteritis (stomach infection) or food poisoning. Side effects of many medications including cancer chemotherapy, nauseants or morning sickness in early pregnancy. Nausea may also be caused by anxiety, disgust and depression.^[3][4][5]

Medications taken to prevent nausea are called antiemetics and include diphenhydramine, metoclopramide and ondansetron.

Contents 1 Differential diagnosis 1.1 Food poisoning 1.2 Medications 1.3 Pregnancy 1.4 Disequilibrium 1.5 Stress and depression 1.6 Potentially serious 2 Diagnostic approach 3 Treatment 3.1 Medications 4 Prognosis 5 Epidemiology 6 References

Differential diagnosis

The causes of nausea are many. One organization listed 700 in 2009.^[6] Gastrointestinal infections (37%) and food poisoning are the two most common causes.^[2][7] While side effects from medications (3%) and pregnancy are also relatively frequent.^[2][7] In 10% of people the cause remains unknown.^[7]

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.^[8] It is due to toxins produced by bacteria in food.^[8]

Medications

Many medications can potentially cause nausea.^[8] Some of the most frequently associated include cancer chemotherapy regimens and 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.^[9] Pregnancy should therefore be considered as a possible cause of nausea in any women of child bearing age.^[8] While usually it is mild and self limiting severe cases known as hyperemesis gravidarum may require treatment.^[10]

Disequilibrium

A number of conditions involving balance such as motion sickness and vertigo can lead to nausea and vomiting.

Stress and depression

Nausea may be caused by stress and depression.^[3][4][5]

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.^[2]

Diagnostic approach

Often no investigations are needed, however basic lab tests may be appropriate.^[2] If a bowel obstruction is possible, abdominal x-rays may be useful.^[2]

Treatment

If dehydration is present due to loss of fluids from severe vomiting and/or accompanying diarrhea, rehydration with oral electrolyte solutions is preferred.^[2] If this is not effective or possible, intravenous rehydration may be required.^[2]

Medications

Main article: Antiemetic

Dimenhydrinate (Gravol) is an inexpensive and effective medication for preventing postoperative nausea and vomiting.^[11] Meclozine is another antihistamine antiemetic. In certain people, cannabinoids may be effective in reducing chemotherapy associated nausea and vomiting.^[12][13] Ondansetron (Zofran) is effective for nausea and vomiting but is expensive.^[8] Pyridoxine or metoclopramide are the first line treatments for pregnancy related nausea and vomiting.^[10] 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.^[7] However only 25% of people with nausea visit their family physician.^[2] It is most common in those 15–24 years old and less common in other ages.^[7]

References

1. ^ "Wamble definition". MedTerms Medical Dictionary. http://www.medterms.com/script/main/art.asp?articlekey=33156. 
2. ^ ^{a b c d e f g h i} Metz A, Hebbard G (September 2007). "Nausea and vomiting in adults--a diagnostic approach". Aust Fam Physician 36 (9): 688–92. PMID 17885699. 
3. ^ ^{a b} "Stress symptoms: Effects on your body, feelings and behavior". Mayo Clinic. http://www.mayoclinic.com/health/stress-symptoms/SR00008_D. 
4. ^ ^{a b} "Diagnostic Criteria: Clinical Guidelines for the Management of Anxiety". PubMed. http://www.ncbi.nlm.nih.gov/books/NBK45852/. 
5. ^ ^{a b} "Disease Information for Stress/Emotional/Physical: Clinical Manifestations". http://en.diagnosispro.com/disease_information-for/clinical-manifestations-stress-emotional-physical/19955-104.html. 
6. ^ "Differential Diagnosis for Nausea". http://en.diagnosispro.com/differential_diagnosis-for/nausea/37707-154.html. 
7. ^ ^{a b c d e} Helena Britt; Fahridin, S (September 2007). "Presentations of nausea and vomiting". Aust Fam Physician 36 (9): 673–784. PMID 17885697. http://www.racgp.org.au/afp/200709/200709beach.pdf. 
8. ^ ^{a b c d e} Scorza K, Williams A, Phillips JD, Shaw J (July 2007). "Evaluation of nausea and vomiting". Am Fam Physician 76 (1): 76–84. PMID 17668843. 
9. ^ Koch KL, Frissora CL (March 2003). "Nausea and vomiting during pregnancy". Gastroenterol. Clin. North Am. 32 (1): 201–34, vi. doi:10.1016/S0889-8553(02)00070-5. PMID 12635417. 
10. ^ ^{a b} Sheehan P (September 2007). "Hyperemesis gravidarum--assessment and management". Aust Fam Physician 36 (9): 698–701. PMID 17885701. 
11. ^ Kranke P, Morin AM, Roewer N, Eberhart LH (March 2002). "Dimenhydrinate for prophylaxis of postoperative nausea and vomiting: a meta-analysis of randomized controlled trials". Acta Anaesthesiol Scand 46 (3): 238–44. doi:10.1034/j.1399-6576.2002.t01-1-460303.x. PMID 11939912. 
12. ^ Tramèr MR, Carroll D, Campbell FA, Reynolds DJ, Moore RA, McQuay HJ (July 2001). "Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review". BMJ 323 (7303): 16–21. doi:10.1136/bmj.323.7303.16. PMC 34325. PMID 11440936. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=34325. 
13. ^ Drug Policy Alliance (2001). "Medicinal Uses of Marijuana: Nausea, Emesis and Appetite Stimulation". http://www.drugpolicy.org/marijuana/medical/challenges/litigators/medical/conditions/nausea.cfm. Retrieved 2007-08-02. 

Look up nausea in Wiktionary, the free dictionary.

v d e Digestive system · Digestive disease · Gastroenterology (primarily K20–K93, 530–579) Upper GI tract Esophagus Esophagitis (Candidal, Herpetiform) · rupture (Boerhaave syndrome, Mallory-Weiss syndrome) · UES (Zenker's diverticulum) · LES (Barrett's esophagus) · Esophageal motility disorder (Nutcracker esophagus, Achalasia, Diffuse esophageal spasm, Gastroesophageal reflux disease (GERD)) · Laryngopharyngeal reflux (LPR) · Esophageal stricture · Megaesophagus Stomach Gastritis (Atrophic, Ménétrier's disease, Gastroenteritis) · Peptic (gastric) ulcer (Cushing ulcer, Dieulafoy's lesion) · Dyspepsia · Pyloric stenosis · Achlorhydria · Gastroparesis · Gastroptosis · Portal hypertensive gastropathy · Gastric antral vascular ectasia · Gastric dumping syndrome · Gastric volvulus Lower GI tract: Intestinal/ enteropathy Small intestine/ (duodenum/jejunum/ileum) Enteritis (Duodenitis, Jejunitis, Ileitis) — Peptic (duodenal) ulcer (Curling's ulcer) — Malabsorption: Coeliac · Tropical sprue · Blind loop syndrome · small bowel bacterial overgrowth syndrome  · Whipple's · Short bowel syndrome · Steatorrhea · Milroy disease · bile acid malabsorption Large intestine (appendix/colon) Appendicitis · Colitis (Pseudomembranous, Ulcerative, Ischemic, Microscopic, Collagenous, Lymphocytic) · Functional colonic disease (IBS, Intestinal pseudoobstruction/Ogilvie syndrome) — Megacolon/Toxic megacolon · Diverticulitis/Diverticulosis Large and/or small Enterocolitis (Necrotizing) · IBD (Crohn's disease) — vascular: Abdominal angina · Mesenteric ischemia · Angiodysplasia — Bowel obstruction: Ileus · Intussusception · Volvulus · Fecal impaction — Constipation · Diarrhea (Infectious) · Intestinal adhesions Rectum Proctitis (Radiation proctitis) · Proctalgia fugax · Rectal prolapse · Anismus Anal canal Anal fissure/Anal fistula · Anal abscess  · Anal dysplasia  · Pruritus ani GI bleeding/BIS Upper (Hematemesis, Melena) · Lower (Hematochezia) Accessory Liver Hepatitis (Viral hepatitis, Autoimmune hepatitis, Alcoholic hepatitis) · Cirrhosis (PBC) · Fatty liver (NASH) · vascular (Budd-Chiari syndrome, Hepatic veno-occlusive disease, Portal hypertension, Nutmeg liver) · Alcoholic liver disease · Liver failure (Hepatic encephalopathy, Acute liver failure) · Liver abscess (Pyogenic, Amoebic) · Hepatorenal syndrome · Peliosis hepatis Gallbladder Cholecystitis · Gallstones/Cholecystolithiasis · Cholesterolosis · Rokitansky-Aschoff sinuses · Postcholecystectomy syndrome · Porcelain gallbladder Bile duct/ other biliary tree Cholangitis (PSC, Secondary sclerosing cholangitis, Ascending) · Cholestasis/Mirizzi's syndrome · Biliary fistula · Haemobilia · Gallstones/Cholelithiasis common bile duct (Choledocholithiasis, Biliary dyskinesia) · Sphincter of Oddi dysfunction Pancreatic Pancreatitis (Acute, Chronic, Hereditary, Pancreatic abscess) · Pancreatic pseudocyst · Exocrine pancreatic insufficiency · Pancreatic fistula Abdominopelvic Hernia Diaphragmatic (Congenital) · Hiatus Inguinal (Indirect, Direct) · Umbilical · Femoral · Obturator · Spigelian lumbar (Petit's, Grynfeltt-Lesshaft) undefined location (Incisional · Internal hernia) Peritoneal Peritonitis (Spontaneous bacterial peritonitis) · Hemoperitoneum · Pneumoperitoneum M: DIG anat(t, g, p)/phys/devp/enzy noco/cong/tumr, sysi/epon proc, drug(A2A/2B/3/4/5/6/7/14/16), blte

v d e Symptoms and signs: digestive system and abdomen (R10–R19, 787,789) GI tract Upper GI tract Nausea/Vomiting · Heartburn · Dysphagia (Oropharyngeal, Esophageal) Halitosis Lower GI tract gas: Flatulence · Abdominal distension · Bloating · Belching · Tympanites stool: Fecal incontinence (Encopresis) · Rectal tenesmus blood: Fecal occult blood Diarrhea Football sign Psoas sign · Obturator sign · Rovsing's sign Accessory Hepatosplenomegaly/Hepatomegaly Jaundice Abdominopelvic Ascites Abdominal – general Abdominal pain (Acute abdomen, Colic, Baby colic) Splenomegaly Abdominal guarding · Abdominal mass · Rebound tenderness Shifting dullness · Bulging flanks · Puddle sign · Fluid wave test M: DIG anat(t, g, p)/phys/devp/enzy noco/cong/tumr, sysi/epon proc, drug(A2A/2B/3/4/5/6/7/14/16), blte

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Dansk (Danish)
n. - kvalme

Nederlands (Dutch)
misselijkheid, afkeer

Français (French)
n. - nausée

Deutsch (German)
n. - Übelkeit

Ελληνική (Greek)
n. - ναυτία, αναγούλα, αηδία

Italiano (Italian)
nausea

Português (Portuguese)
n. - náusea (f), nojo (m)

Русский (Russian)
тошнота, отвращение

Español (Spanish)
n. - náusea, asco

Svenska (Swedish)
n. - kväljningar, illamående, äckel, sjösjuka (med.)

中文（简体）(Chinese (Simplified))
反胃, 恶心, 晕船

中文（繁體）(Chinese (Traditional))
n. - 反胃, 噁心, 暈船

한국어 (Korean)
n. - 뱃멀미, 지겨움

日本語 (Japanese)
n. - 吐き気, 船酔い, 嫌悪

العربيه (Arabic)
‏(الاسم) غثيان, دوار البحر‏

עברית (Hebrew)
n. - ‮בחילה, תיעוב‬

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