Nausea and vomiting in adults--a diagnostic approach.

BACKGROUND: Most people experience nausea and vomiting at some stage, but when these symptoms recur frequently they can significantly reduce quality of life. In most cases, a thorough history, examination and simple investigations can yield a diagnosis. Chronic nausea is a more challenging problem with its many potential causes and with a significant number of patients remaining undiagnosed despite extensive investigation.
OBJECTIVE: This article discusses the assessment and management of acute and chronic nausea and vomiting in adults. DISCUSSION: Gastrointestinal infections and food poisoning are the most common causes of acute nausea and vomiting. Medication side effects and pregnancy should always be suspected. Hospitalisation may be required for severe metabolic abnormalities, dehydration or surgical causes. There are many potential causes of chronic nausea and vomiting and a comprehensive history and examination is required. Symptoms are poor predictors of functional versus pathological illness. Type and extent of investigation must be tailored to the individual patient.