When to See Your Doctor for Nausea and Vomiting

Nausea and vomiting have many possible causes, some benign and some serious. No matter what's at the root of nausea and vomiting, it can feel awful and even be debilitating—and a sudden episode can be unsettling. The first step to getting better is narrowing down why you got sick in the first place.

It's important to know whether to get medical attention or focus on nursing yourself back to health at home—or a combination of these. The following suggestions can help you make that call.

Whatever the cause, prolonged vomiting can cause dehydration, which can become a medical issue on its own.

Possible Cause Signs and Symptoms Emergency?
Motion sickness
  • Nausea
  • Vomiting
Unlikely
Morning sickness in pregnancy
  • Nausea
  • Vomiting
  • Possible dizziness or headache
Unlikely
Food poisoning
  • Nausea
  • Vomiting
  • Stomach cramps
  • Diarrhea
  • Fever (possible)
Possibly
Viral gastroenteritis (stomach flu)
  • Nausea
  • Vomiting
  • Watery diarrhea
  • Abdominal cramps
  • Low-grade fever
Unlikely
Alcohol ingestion, intoxication, or hangover
  • Nausea
  • Vomiting
  • Headache
  • Vertigo
  • Sensitivity to light and sound
Unlikely
Food allergies
  • Nausea
  • Vomiting
  • Wheezing
  • Hoarse voice
  • Swelling face, lips, tongue
  • Diarrhea
  • Possibly anaphylaxis
Possibly
Gastrointestinal reflux disease (GERD)
  • Nausea
  • Vomiting
  • Heartburn pain in chest
Unlikely
Migraine
  • Headache
  • Sensitivity to light, noise, and odors
  • Nausea and vomiting
Unlikely
Medications (including chemotherapy)
  • Nausea
  • Vomiting
Possibly
Appendicitis
  • Abdominal pain (becoming sharp and severe)
  • Nausea
  • Vomiting
  • Fever
  • Loss of appetite
Yes
Poison or medication overdose
  • Nausea
  • Vomiting
  • Other symptoms depending on the substance, including rash, diarrhea, trouble breathing, seizure, loss of consciousness
Yes
Intestinal blockage
  • Abdominal swelling
  • Abdominal pain and cramps
  • Constipation or diarrhea
  • Can't pass gas
  • Vomiting (may be green from bile or brown from feces)
Yes
Peptic ulcer
  • Abdominal pain
  • Chronic nausea
  • Vomiting (may be red or coffee-ground appearance from blood)
  • Bloody or dark, tarry stools
  • Heartburn or chest pain
  • Fatigue
Possibly
Meningitis
  • Sudden high fever
  • Severe headache
  • Stiff neck
  • Nausea or vomiting
Yes
Concussion or brain injury
  • Headache
  • Neck pain
  • Nausea or vomiting
  • Ringing in the ears
  • Dizziness
  • Tiredness
  • Seizures
  • Confusion
Yes
Cyclic vomiting disorder
  • Nausea
  • Vomiting
  • Cyclic attacks
Unlikely
Heart attack
  • Chest pain
  • Shortness of breath
  • Cold sweat
  • Nausea and/or vomiting
  • Fainting
  • Fatigue
  • Feeling of impending doom
Yes

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 doctor 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.

While actively vomiting, it is best to avoid eating and stick with sips of clear liquids. This will help prevent dehydration and it reduces the risk of choking when vomiting.

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 screen 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.

Although there may not be active internal bleeding, vomit that looks like coffee grounds is still considered a medical emergency.

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
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Article Sources
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  1. Cleveland Clinic. Nausea & vomiting: possible causes. July 23, 2019.

  2. MedlinePlus. Nausea and vomiting.

  3. MedlinePlus. When you have nausea and vomiting. Updated July 12, 2018.

  4. Clevland Clinic. Nausea & vomiting: when to call the doctor. Updated July 23, 2019.

  5. American Academy of Allergy Asthma and Immunology. Food protein-induced enterocolitis syndrome (FPIES).

  6. American Academy of Pediatrics. Infant vomiting. Updated November 21, 2015.

  7. Standford Children's Health. Could that stomachache in your child be appendicitis? Updated 2019.

  8. National Health Service. Vomiting in adults. Updated September 30, 2019.

  9. Obokhare I. Fecal impaction: a cause for concern?. Clin Colon Rectal Surg. 2012;25(1):53–58. doi:10.1055/s-0032-1301760

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