Nausea

Nausea is a very vague symptom, yet it is a common complaint. By itself, it may not be very serious, but when it is associated with vomiting it requires investigation for its etiology.

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Since there are literally at least 100 causes for nausea, I would like to cover only the most common. In a female, of child-bearing age, pregnancy needs to be considered before all other possibilities. If sexually active, if birth control methods are not perfectly followed, and if a menstrual period is missed, think of possible pregnancy.

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Irritable bowel syndrome is the most common cause in females and males. Drugs and gastroenteritis would be the next etiologies to consider.

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Finally there is a long list of medical problems with which nausea is associated, including: diabetes, gastritis, viral illnesses, renal failure, kidney stones, heart attacks, inner ear problems, brain tumors, etc.

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Depending on what other concomitant symptoms one has, evaluation should begin with a history and physical exam, but may require blood work, upper endoscopy, abdominal ultrasound and small bowel x-rays as part of the gastrointestinal work up. If that is all negative, other specialties may need to evaluate the patient for causes of nausea.