Nausea and vomiting natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]

• Nausea starts as an urge of vomiting. There is a diffuse sensation of unease and discomfort (often described as feeling sick or queasy feeling). Discomfort in chest, upper abdomen or back of throat might be present. It is often accompanied by excessive salivation. If vomiting follows, there is involuntary expulsion of stomach contents through mouth and sometimes nose. If nausea and vomiting are left untreated, the general feeing of distress can progress to life threatening complications.

• aspiration of gastric content ^[1]
• dehydration ^[2]
• electrolyte imbalance leading to metabolic alkalosis (increased blood pH), showing hypokalemia and hypochloremia ^{[2] [1]}

• cachexia due to loss of intake of food ^[2]
• antepartum hemorrhage of indeterminate origin in early pregnancy ^[3]
• callus formation and abrasions on skin of hands in case of self induced vomiting ^[1]

• pressure on ear, nose and eyes sometimes leading to subconjunctival hemorrhage and nose bleeds due to prolonged retching ^[1]

• dental erosion, discoloration and sensitivity of teeth, gum disease due to acidic gastric content ^[1]

• cracking of corners of lips ^[1]

• mucositis of hard palate and throat ^[1]

• hoarseness ^[1]

• salivary gland enlargement and parotid gland hypertrophy in bulimics ^{[1] [4]}

• GERD in case of frequent vomiting ^[1]

• Mallory-Weiss tear ^[1]

• Boerhaauve’s syndrome ^[1]

• elevated amylase level in case of repeated vomiting ^{[1] [4]}

• Cardiovascular symptoms including hypotention, sinus tachycardia, arrythmias and orthostasis in bulimic patients ^[1]

Prognosis for nausea and vomiting depends on the underlying cause.

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