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- Home treatment:
- Healthcare professionals recommend that individuals experiencing nausea and vomiting: drink clear liquids only, but in specified amounts depending upon size and weight of the individual; eat no solid food until the vomiting episode has passed; get plenty of rest as more movement and exertion may worsen the symptoms of nausea and vomiting; and stop all medicine temporarily until the vomiting subsides. Alerting a doctor is recommended by healthcare professionals in the following situations: if the individual is on medications for serious illnesses such as diabetes and heart conditions; if vomiting persists more than one day; or if vomiting and diarrhea are both present.
- Oral rehydration therapy (ORT):
- Oral rehydration therapy (ORT) is a simple, cheap, and effective treatment for diarrhea-related dehydration. ORT consists of a solution of salts and other substances such as glucose, sucrose, citrates, or molasses that is administered orally. It is used around the world, but is most important in developing countries, where it saves millions of people from diarrhea. Diarrhea is the leading cause of death in developing countries. Commercial examples of ORT include sports drinks (such as Gatorade ®), Ceralyte ®, and Pedialyte ®. Dehydration is the most important complication of persistent vomiting. If the following symptoms are present, oral rehydration therapy should be given immediately: vomiting and fever over 101 degrees are present; vomiting and diarrhea are present; vomiting alone persists for more than 12 hours in children under six years or 24 hours in older children and adults; any physical signs of dehydration are present such as dry lips and mouth membranes, sunken eyes and fontanelle (soft spot on baby's head), and rapid breathing or pulse.
- Over-the-counter (OTC) medicines:
- Bismuth subsalicylate: Bismuth subsalicylate (Kaopectate ®, Pepto-Bismol ®) may help treat some types of nausea and vomiting, such as from the flu (influenza). Bismuth subsalicylate preparations are also used for upset stomach and as an anti-diarrheal (medicine to treat diarrhea). It is not recommended to take bismuth subsalicylate if the individual ever had an allergy to aspirin or any other product that contains salicylates. Also, bismuth subsalicylate should not be given to children who may have any viral infection such as the flu or chickenpox because they will have a higher risk of Reye's Syndrome (a condition affecting all organs, especially the liver and brain).
- Antihistamines: Certain antihistamines may help prevent nausea and vomiting caused by motion sickness. These include dimenhydrinate (Dramamine ®) and meclizine hydrochloride (Bonine ®). Meclizine is also available as a prescription drug (Antivert ®). OTC antihistamines for nausea and vomiting may cause drowsiness, sedation, dry mouth, and constipation.
- Phosporylated carbohydrate syrup (Emetrol ®): Emetrol ® is a pleasant tasting syrup that has a soothing effect on irritated stomach lining, over eating, food intolerance, or other types of indigestion.
- Carbohydrate and electrolyte powder packets (Kaolectrolyte ®): Carbohydrate and electrolyte powder packets (Kaolectrolyte ®) closely approximate World Health Organization (WHO) guidelines on oral rehydrating solutions. Because they come in small, easily transportable packets and dissolve in 8 oz. of water in seconds, they are more convenient than pre-mixed solutions or liquids. They also come in several flavors (artificial), including grape and bubble gum.
- Prescription medicines:
- Prescription medications for nausea and vomiting include: the antidepressant drugs amitriptyline (Elavil ®) and nortriptyline (Pamelor ®), the anti-anxiety drug lorazepam (Ativan ®), and the antihistamine patch scopolamine (Transderm-Scop ®). These medications may cause drowsiness, dry mouth, and fatigue.
- 5-HT3 inhibitors: 5-HT3 inhibitors help prevent and relieve nausea and vomiting from surgery or chemotherapy. Researchers believe that nausea and vomiting during chemotherapy is associated with the release of 5-HT3 (serotonin) from special cells in the small intestine. 5-HT3 inhibitors blocks these nerve endings in the intestine and prevent signals to the central nervous system. 5-HT3 inhibitors may cause drowsiness, sedation, constipation, and dry mouth. Examples of 5-HT3 inhibitors include ondansetron (Zofran ®), dolasetron (Anzemet ®), and granisetron (Kytril ®).
- Prochlorperazine (Compazine ®): Prochlorperazine (Compazine ®) helps control nausea and vomiting after surgery or chemotherapy. Prochlorperazine is available in capsule, tablet, liquid, suppository, or injection. Prochlorperazine can cause drowsiness and may interact with other medications or alcohol. Prochlorperazine may cause drowsiness, sedation, constipation, and dry mouth.
- Promethazine (Phenergan ®): Promethazine (Phenergan ®) has sedative, antihistamine, and mild anti-nausea properties. It may be used to help prevent or treat nausea due to chemotherapy. Promethazine may be available in tablet form or as an oral syrup, suppository, or injection. Promethazine may cause drowsiness, sedation, constipation, and dry mouth.
- Corticosteroids. Corticosteroids, including methylprednisolone (Medrol ®), have been reported effective in relieving nausea and vomiting associated in women with refractory hyperemesis gravidarum. Corticosteroid therapy generally is considered safe during pregnancy, but side effects such as water retention are monitored closely.
- Intravenous fluids: Individuals who, despite the previously discussed treatments, are unable to keep down liquids will probably require intravenous (IV) fluids, such as normal saline. IV fluids may provide relief from nausea and vomiting, but many individuals also require an anti-emetic administered orally, rectally, or by infusion. Depending on the severity of the symptoms, intravenous fluid therapy may be given in the hospital or at home by a visiting nurse.
- Enteral or parenteral nutrition: Enteral (feeding through a tube into the stomach or small intestine) and total parenteral nutrition (TPN, or feeding through the veins) are last-resort treatments for individuals who continue to vomit and lose weight despite aggressive treatment.
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