Ver el código de «Nausea and vomiting»

{{Adult top}} [[nausea and vomiting (peds)]]. For nausea and vomiting during pregnancy, see [[hyperemesis gravidarum]].''
==Background==
[[File:Nausea_and_vomiting.png|thumb|Nausea and Vomiting Algorithm]]

==Clinical Features==
*Nausea and/or vomiting
*Additional features of underlying process

==Differential Diagnosis==
{{Nausea and vomiting DDX}}

===By organ system===
====GI====
*[[Peptic ulcer disease]]
*[[Bowel obstruction|Obstruction]]
**Adhesion
**[[Small bowel obstruction]]/LBO
***[[SMA syndrome]]
**Gastric outlet obstruction
**[[Gastric volvulus]]
**[[Bezoar]]
*[[Pancreatitis]]
*[[Gastroparesis]]
*[[Appendicitis]]
*[[Cholecystitis]]
*[[Cholangitis]]
*[[Acute Hepatitis]]
*[[IBD]]
*[[Intussusception]]
*Tumor
*Strangulated [[hernia]]
*[[Volvulus]]
*[[Mesenteric ischemia]]
*Esophageal disorders (e.g. [[achalasia]])
*Functional disorders
**Psychogenic
**[[IBS]]
*[[Pyloric Stenosis]]

====Neurologic====
*[[Head injury]]
*[[CVA]]
*[[Idiopathic intracranial hypertension]]
*[[Hydrocephalus]]
*[[Intracranial mass|Mass lesion]]
*[[Meningitis]]
*[[Migraine]]
*[[Labyrinthitis]]
*[[Meniere's disease]]
*[[Motion sickness]]
*[[Cannabinoid hyperemesis syndrome]]

====Infectious====
*[[Bacteria]]l toxins
*[[Pneumonia]]
*[[SBP]]
*[[UTI]]
*Viruses ([[adenovirus]], [[norovirus]], [[rotavirus]])

====Drugs/Toxins====
*Toxic doses
**[[Digoxin toxicity]]
**[[Aspirin toxicity]]
**[[Acetaminophen toxicity]]
**[[Ipecac toxicity]]
*[[NSAIDs]]
*[[Opioids]]
*[[Alcohol]]
*[[Anticonvulsants]]
*[[Antibiotics]]
*[[Antiarrhythmics]]
*Toxins
**[[Organophosphates]]
**[[Carbon monoxide]]
**[[Ricin]]
*[[Acute radiation syndrome]]

====Endocrine====
*[[Pregnancy]], [[hyperemesis gravidarum]]
*[[Hyponatremia]]
*[[Adrenal insufficiency]]
*[[DKA]]
*[[Thyroid]]/parathyroid disorders
*[[Uremia]]

====Miscellaneous====
*[[ACS]]
*[[Ovarian torsion|ovarian]]/[[testicular torsion]]
*[[Nephrolithiasis]]
*Pain
*[[Acute angle-closure glaucoma]]
*[[Anorexia nervosa]]/[[bulimia nervosa]]
*[[Depression]]

==Evaluation==
''Varies widely depending on clinical presentation''
*CBC
*Chemistry
*Urine pregnancy
*[[LFTs]]
*Lipase
*APAP, ASA, digoxin levels
*[[Urinalysis]]
*?[[Abdominal xray]]
*?CT
*?[[Ultrasound]]

==Management==
*Treat underlying pathology
*Address [[electrolyte derangements]] and [[dehydration]] as needed
*[[Antiemetics]]
*Inhaled isopropyl alcohol (sniffing an alcohol wipe) has been shown to reduce mild to moderate nausea and vomiting<ref>Lindblad AJ, Ting R, Harris K. Inhaled isopropyl alcohol for nausea and vomiting in the emergency department. Can Fam Physician. 2018;64(8):580.</ref>

==Disposition==
*Depends on cause
*Most non-specific episodes of acute nausea and vomiting may be discharged, if:
**No emergent/urgent cause identified or suspected
**Patient tolerating fluids after treatment

==Complications==
*[[Hypovolemia]]
*[[Metabolic alkalosis]]
*[[Hypokalemia]]
*[[Mallory-Weiss]] (tear)
*[[Boerhaave]] (rupture)
*Aspiration

==See Also==
*[[Nausea and vomiting (peds)]]
*[[Nausea and vomiting of pregnancy]]
*[[Antiemetics]]

==External Links==

==References==
<references/>

[[Category:GI]]
[[Category:Symptoms]]