Andrea Bernhard, MD

Dr. Bernhard became a physician in order to make a positive difference in people’s lives. Her goal is to treat every patient with respect and dignity, and to deliver the highest quality care. Dr. Bernhard has lived in Hawaii for 10 years, and even completed her residency at the University of Hawaii. In her own words, “I get to care for wonderful people in one of the most beautiful places in the world.”


Nausea and Vomiting

In brief, nausea is the feeling that you may be sick and throw up. In contrast, vomiting is the act of throwing up. If you experience nausea and vomiting symptoms for more than 48 hours, seek medical help.

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Nausea and Vomiting

Additionally, seek medical help if you feel extremely weak. Likewise, seek medication attention if you see blood in your vomit. Also, if you experience unexplained weight loss or difficulty in swallowing. Nausea and vomiting symptoms are listed below. 

What you should tell your doctor

To start, be honest with your provider. Tell your doctor exactly how long you have been experiencing nausea and vomiting symptoms. Also mention any other associated symptoms. To note, inform your doctor if, for example:

  • Firstly, provide an update on how nausea and vomiting symptoms started. Also, let them know if it suddenly or gradually.
  • Secondly, be detailed when explaining about possible causes of vomiting and nausea symptoms.
  • How long has nausea and vomiting lasted?
  • Also, specify if nausea or vomiting is worse at specific times of the day.
  • Does nausea or vomiting get worse if you move your head?
  • Too add, let them know if you develop a fever.
  • When you vomit, does it contain blood or bile?
  • Additionally, let them know if you’ve you experienced recent weight loss.
  • Have you experienced abdominal pains or headaches?
  • Also, how much alcohol do you drink in a day?
  • Importantly, are you pregnant or could be pregnant?
  • Finally, updated them on new medications.

Overall, be detailed. The information will help your doctor determine the cause. Additionally, an in-person abdomen and chest examination will also help determine the cause. To add, depending on your symptoms, clinicians may ask for a blood or urine test. You may also be referred to a specialist. Further, if you suspect a pregnancy, you will therefore need to take a pregnancy test.

What should you do if you develop nausea or experience vomiting?

  • Remember to drink plenty of fluids. This is to replace the lost fluids in the body, avoiding dehydration. For instance, you could use rehydration drinks.
  • Importantly, call 911 if the vomiting is severe. Likewise, if you feel extremely weak. Also, call 911 if you have severe abdominal pain.
  • To end, seek medical advice if the vomiting lasts for more than 48 hours.


‘Red flag’ symptoms

Although the condition may seem normal, certain red flag symptoms could state a serious underlying disease. Above all, if you experience any of these, you must seek immediate medical attention. In summation, red flag symptoms include, for instance:

  • To start, vomiting blood or bile.
  • Secondly, weight loss.
  • Thirdly, severe abdominal pain.
  • Also, high fever, stiff neck, rash, and an averseness to light.
  • In addition, increasing weakness or loss of consciousness
  • Lastly, continuous vomiting for more than 48 hours

Causes of nausea and vomiting

There could be many causes of nausea and vomiting.  To note, pay attention to the following, for example:

  • Gastroenteritis
  • Food poisoning
  • Excessive intake of alcohol
  • Pregnancy
  • Migraine
  • Problems with the inner ear
  • Motion sickness
  • Certain medications like chemotherapy
  • Urinary tract infections
  • Eating disorders
  • Stomach problems. For example, Gastro-oesophageal reflux disease, stomach ulcers, and pyloric stenosis (in babies). Additionally, people with gastroparesis. It is common in those who have had weight loss surgery.
  • Metabolic conditions including poorly controlled diabetes, Addison’s disease, and hypercalcemia.
  • Other possible causes include, for example:
  • Appendicitis
  • Inflammation of the pancreas
  • Kidney stones
  • Gallstones
  • Blockage of the gut
  • Head injury/brain tumor
  • Liver disease
  • Kidney disease

Importantly, ensure that you tell your doctor all your symptoms. Thus, allowing the doctor to make the correct diagnosis.

Acute and persistent nausea and vomiting

Acute nausea/vomiting occurs when symptoms lasts between 24-48 hours. Additionally, it is severe. Usually, food poisoning or gastric infections usually cause this. But, they are self-limiting in nature (stop by themselves). Thus, there is no required medical intervention. One only needs to ensure adequate hydration.

Nausea or vomiting that lasts for more than 48 hours is persistent nausea or vomiting. Also, in some cases, the cause may be the same as that of acute nausea or vomiting. But, as the time elapses, other underlying conditions may become more likely.

Problems caused by persistent nausea

Persistent nausea can be depressing. Thus, making a person feel sick and low all the time.

Problems caused by persistent vomiting

  • Dehydration
  • Disbalance of electrolytes
  • Damage to the tooth enamel because of stomach acid
  • Gastritis
  • Vomiting while unconscious. It can cause the vomit to enter the windpipe and, hence, lead to choking.



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