Your Health

Tummy troubles

Tips for dealing with that queasy feeling

Tummy troubles

BY AUDRA KOLESAR
Winnipeg Health Region
Wave, May / June 2011

A friend of mine and her son both recently became very sick.

They were vomiting for several hours and had trouble keeping fluids down. What could cause this to happen?

Nausea and vomiting can be caused by many things. Nausea is the queasy feeling you usually have before you vomit. Vomiting is the forceful emptying (throwing up) of the stomach's contents through the mouth. Children can get these symptoms for a variety of reasons, including:

  • Motion sickness
  • Stomach flu
  • Food poisoning or other infections
  • Head injury
  • Stress and anxiety
  • Inner ear disorders
  • Exposure to unpleasant odors or sights
  • Inner ear disorders
  • The same holds true for adults, but they can also get sick from:
  • Alcohol use
  • Pregnancy
  • Heart attack
  • Menstruation

Sickness can also occur as a side-effect of some medicines.

Can vomiting pose a danger to your health?

That depends. Vomiting can protect the body by getting rid of harmful substances. However, vomiting often or for a long time can lead to dehydration, which is the loss of too much fluid from the body. Becoming dehydrated can be very dangerous, especially for children, the elderly, and some people who have other medical problems. To avoid this, you need to replace the lost fluids.

What's the best treatment?

At first, you should rest your stomach for a few hours by eating nothing solid and sipping only clear liquids. A little later you can eat soft, bland foods that are easy to digest. If you have been vomiting a lot, it is best to have only small, frequent sips of clear liquids. Drinking too much at once, even an ounce or two, may cause more vomiting.

Clear liquids you can drink are water, weak tea, bouillon, apple juice, and sport drinks. You may also drink soft drinks without caffeine (such as 7-Up) after letting them go flat (lose their carbonation). Chilling the liquids may help you keep them down. Suck on ice chips or popsicles if you feel too nauseated to drink fluids.

Your choice of liquids is important. If water is the only liquid you can drink without vomiting, that is okay for a few hours.

However, if you have been vomiting for several hours, you must replace the minerals (sodium and potassium) that are lost when you vomit. These minerals are also called electrolytes. Ask your healthcare provider about what sport drinks or other electrolyte replacement drinks could help you replace these minerals.

You can replace fluids and electrolytes by drinking sports drinks or other oral rehydration solutions. Drink the solution right away. Do not wait until dehydration becomes severe. For infants one year and younger:

  • Never give plain water unless and amount is directly specified by your child's doctor.
  • If bottle-fed, for vomiting once or twice, continue to offer formula, in smaller amounts, more frequently.
  • For vomiting three or more times, offer oral rehydration solutions. After your infant goes more than eight hours without vomiting, you can reintroduce breast feeding or formula slowly. Start with small (one to two ounces), more frequent feeds and slowly work your way up to your infant's normal feeding routine.

If parents cannot obtain regular oral hydration solutions, consider a homemade one. Mix 1/2 cup of dry infant rice cereal with two cups of water and 1/4 teaspoon of salt. For large children and adults, if you don't have a sports drink or oral hydration solution, you can make an oral rehydration solution using the following recipe: To one quart or litre of drinking water or boiled water, add the following: two tablespoons sugar and 1/2 teaspoon salt. Too much salt can lead to too much sodium in the blood, causing health problems. If possible, add 1/2 cup orange juice or some mashed banana to improve the taste and provide some potassium.

Avoid liquids that are acidic (such as orange juice) or caffeinated (such as coffee) or have a lot of carbonation. If you have diarrhea as well as nausea or vomiting, do not drink milk.

It is important to drink small amounts (1 to 4 ounces) often so that you do not become dehydrated. Gradually drink larger amounts of the clear fluids.

You may start eating soft, bland foods when you have not vomited for several hours and are able to drink clear liquids without further upset. Good first choices are:

  • Soda crackers
  • Toast
  • Plain noodles
  • Rice
  • Cooked cereal
  • Baked or mashed potatoes
  • Gelatin
  • Boiled or scrambled eggs
  • Apple sauce
  • Bananas

Eat slowly and avoid foods that are acidic, spicy, fatty, or fibrous (such as meats, coarse grains, and raw vegetables). Also avoid extremely hot or cold food. In addition, avoid dairy products if you have diarrhea. You may start eating these foods again in three days or so, when all signs of illness have passed.

Rest as much as possible. Sit or lie down with your head propped up. Do not lie flat for at least two hours after eating. Nausea and vomiting usually last only a short period of time. Do not take aspirin, ibuprofen, or other NSAIDS without checking first with your health-care provider. These medicines may make your stomach symptoms worse. Acetaminophen is different and usually does not upset the stomach.

If you have been vomiting for more than a day or have had diarrhea for over three days, you may need to have an exam by your provider, including a check for dehydration. If you are very dehydrated, you may need to be given fluids intravenously (IV). In children and older adults, dehydration can quickly become life-threatening.

When should I call my health-care provider?

Talk with your provider if you are unable to keep down fluids for more than 12 hours or if you have any of the following symptoms with nausea and vomiting:

  • High fever
  • Severe headache
  • Severe abdominal pain
  • Diarrhea and vomiting that last more than 24 hours
  • Blood in the vomited material that may look red, brown, or black, or like coffee grounds
  • Bloody diarrhea
  • Very forceful vomiting
  • Signs of dehydration such as dry mouth, excessive thirst, little or no urination, severe weakness, dizziness, or lightheadedness

Also call your provider if:

  • An infant is vomiting over and over again
  • A child is unable to keep down fluids for more than 8 hours
  • A young child is also acting very tired or very cranky
  • Infant has few or no tears when crying or has a dry mouth
  • No urination for six to eight hours in children, or fewer than six diapers per day in an infant, or more than four to six hours without a wet diaper in an infant under six months of age.

Audra Kolesar is a registered nurse and manager with Health Links - Info Santé, the Winnipeg Health Region's telephone health information service

Wave: May / June 2011

About Wave

Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.

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