Nausea and Vomiting, Non-specific
Description General Measures Medicine Treatment Referral ICD-10 code: R11 DESCRIPTION There are many possible causes of nausea and vomiting. Some important causes to exclude are: gastro-intestinal disease alcohol abuse liver disease early pregnancy renal failure medicines Establish if the vomiting is associated with: abdominal pain headache diarrhoea constipation Establish if the vomiting is asso
ICD-10 code: R11
DESCRIPTION
There are many possible causes of nausea and vomiting. Some important causes to exclude are:
- gastro-intestinal disease
- alcohol abuse
- liver disease
- early pregnancy
- renal failure
- medicines
Establish if the vomiting is associated with:
- abdominal pain
- headache
- diarrhoea
- constipation
Establish if the vomiting is associated with:
- Abdominal pain
- Headache
- Diarrhoea
- Constipation
GENERAL MEASURES
- Maintain adequate hydration with clear fluids see Diarrhoea.
- Neonates and infants should not stop feeds for more than 1 hour. Restart feeds in smaller and more frequent amounts.
- Exclude pregnancy in women of child bearing age.
MEDICINE TREATMENT
Children
Do not use anti-emetics. Give small volumes of fluids more frequently.
Adults
- Metoclopramide, IM/IV, 10 mg 8 hourly
OR
- Metoclopramide, oral, 10 mg 8 hourly
REFERRAL
Refer urgently if any of these are noted:
- Severe dehydration.
- Severe pain.
- Shock.
- Wasting.
- Diabetes.
- Jaundice.
- Clinical features of sepsis.
- Associated abdominal tenderness with guarding during peri-umbilical percussion
- Signs of intestinal obstruction i.e. no stool or flatus passed.
- Infants with that have projectile vomiting or are vomiting everything.
- Vomiting with presence of fresh or digested blood/ melaena.
Click here for the NEMLC Recommendations for medicine amendments (2020-4 review cycle).
Standard Treatment Guidelines And Essential Medicines List For South Africa, Primary Healthcare, 2020-4_Version 1_June 2024
Chapter 2: Gastro-Intestinal Conditions, 2.4 Nausea and Vomiting, Non-specific