When to See Your Healthcare Provider for Nausea and Vomiting

Signs You Can Likely Use Self-Care

If you are in motion (car, bus, train, boat, plane, etc.) and had no symptoms prior to starting your journey, your nausea and vomiting may be motion sickness. Self-care is appropriate, as are over-the-counter motion sickness medications.

If you had nausea or diarrhea prior to vomiting, these are signs that your vomiting is most likely due to a stomach bug. It could be a virus such as gastroenteritis or bacteria such as E. coli or salmonella. While most cases get better on their own, children and those with weak immune systems can develop complications.

Food poisoning can be suspected if others who dined with you in the past few hours are also having symptoms of nausea, vomiting, or diarrhea. You may also have painful abdominal cramps and could have a low-grade fever.

Most cases of food poisoning will resolve with self-care so long as dehydration or more concerning symptoms do not develop, or any cramping or fever do not become progressively worse.

Starting a new medication or treatment (such as chemotherapy) may produce nausea and vomiting. Self-care is usually appropriate if there are no other symptoms, but you should call your healthcare provider to report your symptoms and get advice about whether to change medications.

Signs such as a missed menstrual period and new onset of nausea and vomiting may indicate morning sickness common to pregnancy. If you could possibly be pregnant, take a pregnancy test. If you are pregnant, self-care is appropriate for morning sickness, but you should see a healthcare provider for prenatal care.

It is common to have nausea and vomiting after drinking alcohol, as it can upset the stomach both at the time you are drinking and when experiencing a hangover. Use self-care to feel better.

Typical Appearance of Vomit

Most vomit starts out looking like whatever it was you ate last. An orange color is expected if you are vomiting hours after eating, as food that is being digested will give vomit this hue.

If you have been vomiting repeatedly, your vomit will often become clear as all of the food has been ejected and only digestive juices remain. These characteristics do not point to serious causes, but they do not rule them out either.

Self-Care Strategies

If you have a stomach bug or any other more benign cause of vomiting, lay down and do not attempt to participate in any physical activities while you are sick.

If you do not vomit for a period of 15 to 20 minutes, you can try to introduce small sips of clear liquids (water or an electrolyte drink such as Gatorade or Pedialyte). Continue clear liquids for at least six hours.

Once you are able to keep clear liquids down for six hours or more, you can progress to a bland diet. After the risk of vomiting has subsided, continue to avoid spicy, fatty, and salty foods, as well as those that have a strong odor, until you are tolerating food well.

When to Schedule an Appointment

Regardless of what you think is causing your nausea or vomiting, see your healthcare provider if you have these symptoms. These can point to more concerning causes that need to be further screened for and monitored:

• Inability to keep down any liquids or food and have vomited three or more times in a day
• Vomiting that does not stop in 24 hours (adults and children) or 12 hours (infants)
• Recurrent bouts of nausea or vomiting
• Stomach or abdominal pain
• Nausea for more than two days
• Fever over 100 degrees F in children under age 6, over 102 degrees F in children age 6 and over, or over 101 degrees F in adults

Your healthcare provider may recommend over-the-counter or prescription medications that are appropriate for your age, other health conditions, and cause of your symptoms.

If you note vomiting after eating certain foods, you may have a food allergy or intolerance. In most food allergies, a reaction to the food happens soon after ingestion. However, in food protein-induced enterocolitis syndrome (FPIES), the reaction may be delayed for hours, so it is harder to identify the trigger.

When to Get Urgent Care

Some illnesses that cause vomiting require immediate medical attention. You may need to go to an urgent care clinic or an emergency room for these symptoms:

• Signs of dehydration, which can include dark-colored urine or no urination for 12 hours, thirst, dry mouth or eyes, fatigue, dizziness when standing
• History of head injury in the past 24 hours
• Severe abdominal pain
• Severe headache and/or stiff neck
• Confusion
• Fever
• Red, black, coffee-ground-like, green, or dark yellow vomit
• Hives or swelling of the face, lips, or tongue
• In infants, green vomit or persistent vomiting

Vomit that is shades of green or dark yellow is typically due to bile, a digestive fluid released from the gallbladder into the first section of the small intestine. For children, this can signal a blockage or torsion of the stomach or small intestine that requires immediate medical attention.

It can also occur when a person has vomited so much that there is no food or liquid left in their stomach. In this case, it may be an indication of dehydration. In adults, vomit that is green from bile may also be due to a bowel blockage.

Signs of blood in vomit may or may not be obvious. If you are vomiting bright red, it could be blood. Black vomit or vomit that looks like coffee grounds may also be blood.

When to Call 911

Nausea and vomiting can be signs of a heart attack, severe allergic reaction, brain injury, meningitis, bowel obstruction, or poisoning.

These accompanying symptoms and scenarios warrant getting emergency medical assistance by calling 911:

• Chest pain
• Rapid breathing or pulse
• High fever with stiff neck
• Severe abdominal pain
• Signs of anaphylaxis, such as trouble swallowing or breathing
• You suspect poisoning as a cause
• Brown vomit that smells like feces