Overview
Nausea and vomiting are among the most common reasons for seeking medical advice. Both are, in the first instance, protective reactions of the body: the vomiting centre in the brain is activated by stimuli from the gastrointestinal tract, the organ of balance or by messenger substances, triggering the urge to vomit or vomiting itself. In most cases the underlying cause is harmless and self-limiting, such as a gastrointestinal infection, spoiled food or motion sickness. Symptoms then often subside on their own within a few days; the most important thing is to replace lost fluids and electrolytes. In the OpenClinic24 video consultation, our doctors take your medical history, systematically narrow down possible causes and assess whether treatment at home is sufficient or an in-person examination is required. Following a medical assessment, a private prescription for suitable anti-nausea medication (antiemetics) may be issued. Billing is carried out as a private service under the German scale of medical fees (GOÄ) and is suitable for privately insured and self-paying patients.
Common causes
By far the most frequent cause of acute nausea with vomiting is viral gastrointestinal infection, for example with noro- or rotaviruses, as well as foodborne infections. Numerous other triggers are also possible: intolerances and functional dyspepsia, heartburn and inflammation of the stomach lining (gastritis), migraine attacks, disorders of the organ of balance such as motion or sea sickness, and side effects of medication, for example antibiotics or painkillers. Nausea is also very common in early pregnancy and usually harmless. Less frequently, conditions requiring treatment are the underlying cause, such as appendicitis, bowel obstruction, inflammation of the pancreas or gallbladder, metabolic derailments, or a heart attack, which can present with nausea particularly in women and older people. Accompanying symptoms, duration, fever, medication taken and pre-existing conditions are decisive for the medical assessment. Exactly these points are systematically covered in the video consultation.
When to see a doctor
Have nausea and vomiting medically assessed if symptoms last longer than two to three days, if you can hardly keep any fluids down, if you have a fever above 39 °C or if severe abdominal pain develops. An early medical assessment is also advisable in the case of repeated vomiting during pregnancy, in infants and young children, in elderly or chronically ill people, and after starting a new medication. Call the emergency number 112 immediately in the event of: vomiting blood or material resembling coffee grounds, extremely severe or board-like rigid abdominal pain, chest pain or shortness of breath, impaired consciousness, neck stiffness with headache and sensitivity to light, vomiting after a fall onto the head, or signs of severe dehydration such as confusion, very low urine output or circulatory weakness. In these situations immediate in-person examination and treatment are necessary; a video consultation is not the right service then.