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Nausea

MedGen UID:
10196
Concept ID:
C0027497
Sign or Symptom
Synonyms: Nauseated; Nauseous; Observation of nausea
SNOMED CT: Nausea (422587007); Observation of nausea (422587007); Nauseous (422587007); Nauseated (422587007)
 
HPO: HP:0002018

Definition

A sensation of unease in the stomach together with an urge to vomit. [from HPO]

Conditions with this feature

Fabry disease
MedGen UID:
8083
Concept ID:
C0002986
Disease or Syndrome
Fabry disease is the most common of the lysosomal storage disorders and results from deficient activity of the enzyme alpha-galactosidase A (a-Gal A), leading to progressive lysosomal deposition of globotriaosylceramide and its derivatives in cells throughout the body. The classic form, occurring in males with less than 1% a-Gal A enzyme activity, usually has its onset in childhood or adolescence with periodic crises of severe pain in the extremities (acroparesthesia), the appearance of vascular cutaneous lesions (angiokeratomas), sweating abnormalities (anhidrosis, hypohidrosis, and rarely hyperhidrosis), characteristic corneal and lenticular opacities, and proteinuria. Gradual deterioration of renal function to end-stage renal disease (ESRD) usually occurs in men in the third to fifth decade. In middle age, most males successfully treated for ESRD develop cardiac and/or cerebrovascular disease, a major cause of morbidity and mortality. Heterozygous females typically have milder symptoms at a later age of onset than males. Rarely, females may be relatively asymptomatic throughout a normal life span or may have symptoms as severe as those observed in males with the classic phenotype. In contrast, late-onset forms occur in males with greater than 1% a-Gal A activity. Clinical manifestations include cardiac disease, which usually presents in the sixth to eighth decade with left ventricular hypertrophy, cardiomyopathy, arrhythmia, and proteinuria; renal failure, associated with ESRD but without the skin lesions or pain; or cerebrovascular disease presenting as stroke or transient ischemic attack.
Chinese restaurant syndrome
MedGen UID:
891
Concept ID:
C0008127
Disease or Syndrome
Hereditary fructosuria
MedGen UID:
42105
Concept ID:
C0016751
Disease or Syndrome
Following dietary exposure to fructose, sucrose, or sorbitol, untreated hereditary fructose intolerance (HFI) is characterized by metabolic disturbances (hypoglycemia, lactic acidemia, hypophosphatemia, hyperuricemia, hypermagnesemia, hyperalaninemia) and clinical findings (nausea, vomiting, and abdominal distress; chronic growth restriction / failure to thrive). While untreated HFI typically first manifested when fructose- and sucrose-containing foods were introduced in the course of weaning young infants from breast milk, it is now presenting earlier, due to the addition of fructose-containing nutrients in infant formulas. If the infant ingests large quantities of fructose, the infant may acutely develop lethargy, seizures, and/or progressive coma. Untreated HFI may result in renal and hepatic failure. If identified and treated before permanent organ injury occurs, individuals with HFI can experience a normal quality of life and life expectancy.
Hyperlipoproteinemia, type I
MedGen UID:
7352
Concept ID:
C0023817
Disease or Syndrome
Familial lipoprotein lipase (LPL) deficiency usually presents in childhood and is characterized by very severe hypertriglyceridemia with episodes of abdominal pain, recurrent acute pancreatitis, eruptive cutaneous xanthomata, and hepatosplenomegaly. Clearance of chylomicrons from the plasma is impaired, causing triglycerides to accumulate in plasma and the plasma to have a milky (lactescent or lipemic) appearance. Symptoms usually resolve with restriction of total dietary fat to =20 g/day.
Ovarian hyperstimulation syndrome
MedGen UID:
38966
Concept ID:
C0085083
Disease or Syndrome
A rare non-malformative gynecological disease affecting pre-menopausal women usually following treatment with ovarian stimulating hormones, characterized by ovarian enlargement and, to varying degrees, shift of serum from the intravascular space to the third space, mainly into the peritoneal, pleural, and to a lesser extent to the pericardial cavities. Presenting symptoms include abdomen distention, pain, nausea, and vomiting. Severity ranges from mild to life-threatening and is complicated by increased risk of thrombosis, acute hepato-renal failure, acute respiratory distress syndrome, and ovarian torsion and rupture.
Cyclical vomiting syndrome
MedGen UID:
57509
Concept ID:
C0152164
Disease or Syndrome
A condition characterized by recurrent, self-limiting episodes of vomiting associated with intense nausea, pallor, and lethargy. It is commonly a migraine precursor.
Acute intermittent porphyria
MedGen UID:
56452
Concept ID:
C0162565
Disease or Syndrome
Acute intermittent porphyria (AIP), an autosomal dominant disorder, occurs in heterozygotes for an HMBS pathogenic variant that causes reduced activity of the enzyme porphobilinogen deaminase. AIP is considered "overt" in a heterozygote who was previously or is currently symptomatic; AIP is considered "latent" in a heterozygote who has never had symptoms, and typically has been identified during molecular genetic testing of at-risk family members. Note that GeneReviews does not use the term "carrier" for an individual who is heterozygous for an autosomal dominant pathogenic variant; GeneReviews reserves the term "carrier" for an individual who is heterozygous for an autosomal recessive disorder and thus is not expected to ever develop manifestations of the disorder. Overt AIP is characterized clinically by life-threatening acute neurovisceral attacks of severe abdominal pain without peritoneal signs, often accompanied by nausea, vomiting, tachycardia, and hypertension. Attacks may be complicated by neurologic findings (mental changes, convulsions, and peripheral neuropathy that may progress to respiratory paralysis), and hyponatremia. Acute attacks, which may be provoked by certain drugs, alcoholic beverages, endocrine factors, calorie restriction, stress, and infections, usually resolve within two weeks. Most individuals with AIP have one or a few attacks; about 3%-8% (mainly women) have recurrent attacks (defined as >3 attacks/year) that may persist for years. Other long-term complications are chronic renal failure, hepatocellular carcinoma (HCC), and hypertension. Attacks, which are very rare before puberty, are more common in women than men. Latent AIP. While all individuals heterozygous for an HMBS pathogenic variant that predisposes to AIP are at risk of developing overt AIP, most have latent AIP and never have symptoms.
Choroid plexus papilloma
MedGen UID:
64439
Concept ID:
C0205770
Neoplastic Process
Choroid plexus tumors are of neuroectodermal origin and range from benign choroid plexus papillomas (CPPs) to malignant choroid carcinomas (CPCs). These rare tumors generally occur in childhood, but have also been reported in adults. Patients typically present with signs and symptoms of increased intracranial pressure including headache, hydrocephalus, papilledema, nausea, vomiting, cranial nerve deficits, gait impairment, and seizures (summary by Safaee et al., 2013).
Inborn glycerol kinase deficiency
MedGen UID:
82803
Concept ID:
C0268418
Disease or Syndrome
NR0B1-related adrenal hypoplasia congenita includes both X-linked adrenal hypoplasia congenita (X-linked AHC) and Xp21 deletion (previously called complex glycerol kinase deficiency). X-linked AHC is characterized by primary adrenal insufficiency and/or hypogonadotropic hypogonadism (HH). Adrenal insufficiency is acute infantile onset (average age 3 weeks) in approximately 60% of affected males and childhood onset (ages 1-9 years) in approximately 40%. HH typically manifests in a male with adrenal insufficiency as delayed puberty (i.e., onset age >14 years) and less commonly as arrested puberty at about Tanner Stage 3. Rarely, X-linked AHC manifests initially in early adulthood as delayed-onset adrenal insufficiency, partial HH, and/or infertility. Heterozygous females very occasionally have manifestations of adrenal insufficiency or hypogonadotropic hypogonadism. Xp21 deletion includes deletion of NR0B1 (causing X-linked AHC) and GK (causing glycerol kinase deficiency), and in some cases deletion of DMD (causing Duchenne muscular dystrophy). Developmental delay has been reported in males with Xp21 deletion when the deletion extends proximally to include DMD or when larger deletions extend distally to include IL1RAPL1 and DMD.
Familial hypokalemic alkalosis, Gullner type
MedGen UID:
78677
Concept ID:
C0268444
Disease or Syndrome
Multiple acyl-CoA dehydrogenase deficiency
MedGen UID:
75696
Concept ID:
C0268596
Disease or Syndrome
Multiple acyl-CoA dehydrogenase deficiency (MADD) represents a clinical spectrum in which presentations can be divided into type I (neonatal onset with congenital anomalies), type II (neonatal onset without congenital anomalies), and type III (late onset). Individuals with type I or II MADD typically become symptomatic in the neonatal period with severe metabolic acidosis, which may be accompanied by profound hypoglycemia and hyperammonemia. Many affected individuals die in the newborn period despite metabolic treatment. In those who survive the neonatal period, recurrent metabolic decompensation resembling Reye syndrome and the development of hypertrophic cardiomyopathy can occur. Congenital anomalies may include dysmorphic facial features, large cystic kidneys, hypospadias and chordee in males, and neuronal migration defects (heterotopias) on brain MRI. Individuals with type III MADD, the most common presentation, can present from infancy to adulthood. The most common symptoms are muscle weakness, exercise intolerance, and/or muscle pain, although metabolic decompensation with episodes of rhabdomyolysis can also be seen. Rarely, individuals with late-onset MADD (type III) may develop severe sensory neuropathy in addition to proximal myopathy.
Lysinuric protein intolerance
MedGen UID:
75704
Concept ID:
C0268647
Disease or Syndrome
Lysinuric protein intolerance (LPI) typically presents after an infant is weaned from breast milk or formula; variable findings include recurrent vomiting and episodes of diarrhea, episodes of stupor and coma after a protein-rich meal, poor feeding, aversion to protein-rich food, failure to thrive, hepatosplenomegaly, and muscular hypotonia. Over time, findings include: poor growth, osteoporosis, involvement of the lungs (progressive interstitial changes, pulmonary alveolar proteinosis) and of the kidneys (progressive glomerular and proximal tubular disease), hematologic abnormalities (normochromic or hypochromic anemia, leukopenia, thrombocytopenia, erythroblastophagocytosis in the bone marrow aspirate), and a clinical presentation resembling the hemophagocytic lymphohistiocytosis/macrophagic activation syndrome. Hypercholesterolemia, hypertriglyceridemia, and acute pancreatitis can also be seen.
Hyperthermia, cutaneous, with headaches and nausea
MedGen UID:
374453
Concept ID:
C1840373
Disease or Syndrome
Migraine with or without aura, susceptibility to, 6
MedGen UID:
334829
Concept ID:
C1843765
Finding
Migraine with or without aura, susceptibility to, 5
MedGen UID:
334831
Concept ID:
C1843771
Finding
For a phenotypic description and discussion of genetic heterogeneity of migraine headaches, see MGR1 (157300).
Migraine without aura, susceptibility to, 4
MedGen UID:
336040
Concept ID:
C1843773
Finding
An inherited susceptibility or predisposition to developing migraines without aura.
Migraine with or without aura, susceptibility to, 3
MedGen UID:
375283
Concept ID:
C1843782
Finding
Episodic ataxia type 3
MedGen UID:
376220
Concept ID:
C1847839
Disease or Syndrome
A very rare form of hereditary episodic ataxia with characteristics of vestibular ataxia, vertigo, tinnitus and interictal myokymia.
Episodic ataxia type 4
MedGen UID:
376222
Concept ID:
C1847843
Disease or Syndrome
A very rare form of hereditary episodic ataxia with characteristics of late-onset episodic ataxia, recurrent attacks of vertigo and diplopia.
Migraine, familial typical, susceptibility to, 2
MedGen UID:
341144
Concept ID:
C1848066
Finding
Migraine with or without aura, susceptibility to, 11
MedGen UID:
387900
Concept ID:
C1857751
Finding
Migraine with or without aura, susceptibility to, 10
MedGen UID:
341839
Concept ID:
C1857752
Finding
Migraine, familial hemiplegic, 2
MedGen UID:
355962
Concept ID:
C1865322
Disease or Syndrome
Familial hemiplegic migraine (FHM) falls within the category of migraine with aura. In migraine with aura (including FHM) the neurologic symptoms of aura are unequivocally localizable to the cerebral cortex or brain stem and include visual disturbance (most common), sensory loss (e.g., numbness or paresthesias of the face or an extremity), and dysphasia (difficulty with speech). FHM must include motor involvement, such as hemiparesis (weakness of an extremity). Hemiparesis occurs with at least one other symptom during FHM aura. Neurologic deficits with FHM attacks can be prolonged for hours to days and may outlast the associated migrainous headache. FHM is often earlier in onset than typical migraine, frequently beginning in the first or second decade; the frequency of attacks tends to decrease with age. Approximately 40%-50% of families with CACNA1A-FHM have cerebellar signs ranging from nystagmus to progressive, usually late-onset mild ataxia.
Migraine with or without aura, susceptibility to, 12
MedGen UID:
388698
Concept ID:
C2673676
Finding
Episodic ataxia type 6
MedGen UID:
390739
Concept ID:
C2675211
Disease or Syndrome
An exceedingly rare form of hereditary episodic ataxia with varying degrees of ataxia and associated findings including slurred speech, headache, confusion and hemiplegia.
Mitochondrial DNA depletion syndrome 11
MedGen UID:
767376
Concept ID:
C3554462
Disease or Syndrome
Mitochondrial DNA depletion syndrome-11 is an autosomal recessive mitochondrial disorder characterized by onset in childhood or adulthood of progressive external ophthalmoplegia (PEO), muscle weakness and atrophy, exercise intolerance, and respiratory insufficiency due to muscle weakness. More variable features include spinal deformity, emaciation, and cardiac abnormalities. Skeletal muscle biopsies show deletion and depletion of mitochondrial DNA (mtDNA) with variable defects in respiratory chain enzyme activities (summary by Kornblum et al., 2013). For a discussion of genetic heterogeneity of autosomal recessive mtDNA depletion syndromes, see MTDPS1 (603041).
Migraine with or without aura, susceptibility to, 1
MedGen UID:
854348
Concept ID:
C3887485
Finding
Migraine is the most common type of chronic, episodic headache, as summarized by Featherstone (1985). One locus for migraine with or without aura (MGR1) has been identified on chromosome 4q24. Other loci for migraine have been identified on 6p21.1-p12.2 (MGR3; 607498), 14q21.2-q22.3 (MGR4; 607501), 19p13 (MGR5; 607508), 1q31 (MGR6; 607516), 15q11-q13 (MGR7; 609179), 5q21 (with or without aura, MGR8, 609570; with aura, MGR9, 609670), 17p13 (MGR10; 610208), 18q12 (MGR11; 610209), 10q22-q23 (MGR12; 611706), and the X chromosome (MGR2; 300125). Mutation in the KCNK18 gene (613655) on chromosome 10q25 causes migraine with aura (MGR13; 613656). See also familial hemiplegic migraine-1 (FHM1; 141500), a subtype of autosomal dominant migraine with aura (MA).
Hepatitis, fulminant viral, susceptibility to
MedGen UID:
1684882
Concept ID:
C5231406
Finding

Professional guidelines

PubMed

Gan TJ, Belani KG, Bergese S, Chung F, Diemunsch P, Habib AS, Jin Z, Kovac AL, Meyer TA, Urman RD, Apfel CC, Ayad S, Beagley L, Candiotti K, Englesakis M, Hedrick TL, Kranke P, Lee S, Lipman D, Minkowitz HS, Morton J, Philip BK
Anesth Analg 2020 Aug;131(2):411-448. doi: 10.1213/ANE.0000000000004833. PMID: 32467512
Committee on Practice Bulletins-Obstetrics
Obstet Gynecol 2018 Jan;131(1):e15-e30. doi: 10.1097/AOG.0000000000002456. PMID: 29266076
Bornstein SR, Allolio B, Arlt W, Barthel A, Don-Wauchope A, Hammer GD, Husebye ES, Merke DP, Murad MH, Stratakis CA, Torpy DJ
J Clin Endocrinol Metab 2016 Feb;101(2):364-89. Epub 2016 Jan 13 doi: 10.1210/jc.2015-1710. PMID: 26760044Free PMC Article

Recent clinical studies

Etiology

Kovac AL
Paediatr Drugs 2021 Jan;23(1):11-37. Epub 2020 Oct 27 doi: 10.1007/s40272-020-00424-0. PMID: 33108649
Lacy BE, Parkman HP, Camilleri M
Am J Gastroenterol 2018 May;113(5):647-659. Epub 2018 Mar 15 doi: 10.1038/s41395-018-0039-2. PMID: 29545633
Adel N
Am J Manag Care 2017 Sep;23(14 Suppl):S259-S265. PMID: 28978206
Veiga-Gil L, Pueyo J, López-Olaondo L
Rev Esp Anestesiol Reanim 2017 Apr;64(4):223-232. Epub 2016 Dec 29 doi: 10.1016/j.redar.2016.10.001. PMID: 28041609
Metz A, Hebbard G
Aust Fam Physician 2007 Sep;36(9):688-92. PMID: 17885699

Diagnosis

Frazier R, Li BUK, Venkatesan T
Am J Gastroenterol 2023 Jul 1;118(7):1157-1167. Epub 2023 Feb 15 doi: 10.14309/ajg.0000000000002216. PMID: 36791365
Lowe SA, Steinweg KE
Emerg Med Australas 2022 Feb;34(1):9-15. Epub 2021 Dec 6 doi: 10.1111/1742-6723.13909. PMID: 34872159
Lacy BE, Parkman HP, Camilleri M
Am J Gastroenterol 2018 May;113(5):647-659. Epub 2018 Mar 15 doi: 10.1038/s41395-018-0039-2. PMID: 29545633
Committee on Practice Bulletins-Obstetrics
Obstet Gynecol 2018 Jan;131(1):e15-e30. doi: 10.1097/AOG.0000000000002456. PMID: 29266076
Metz A, Hebbard G
Aust Fam Physician 2007 Sep;36(9):688-92. PMID: 17885699

Therapy

Sodhi V, Kronsberg KA, Clark M, Cho JC
Pharmacotherapy 2021 Sep;41(9):748-761. Epub 2021 Aug 17 doi: 10.1002/phar.2614. PMID: 34370326
Kaur Gill A, Bansal Y, Bhandari R, Kaur S, Kaur J, Singh R, Kuhad A, Kuhad A
Drugs Today (Barc) 2019 Jul;55(7):423-437. doi: 10.1358/dot.2019.55.7.2958474. PMID: 31347611
Hines S, Steels E, Chang A, Gibbons K
Cochrane Database Syst Rev 2018 Mar 10;3(3):CD007598. doi: 10.1002/14651858.CD007598.pub3. PMID: 29523018Free PMC Article
Carlisle J, Stevenson CA
Cochrane Database Syst Rev 2017 Jul 17;7(7):CD004125. doi: 10.1002/14651858.CD004125.pub3. PMID: 28715610Free PMC Article
Doty P, Rudd GD, Stoehr T, Thomas D
Neurotherapeutics 2007 Jan;4(1):145-8. doi: 10.1016/j.nurt.2006.10.002. PMID: 17199030Free PMC Article

Prognosis

Advani RH, Moskowitz AJ, Bartlett NL, Vose JM, Ramchandren R, Feldman TA, LaCasce AS, Christian BA, Ansell SM, Moskowitz CH, Brown L, Zhang C, Taft D, Ansari S, Sacchi M, Ho L, Herrera AF
Blood 2021 Aug 12;138(6):427-438. doi: 10.1182/blood.2020009178. PMID: 33827139
Kovac AL
Paediatr Drugs 2021 Jan;23(1):11-37. Epub 2020 Oct 27 doi: 10.1007/s40272-020-00424-0. PMID: 33108649
Uy GL, Aldoss I, Foster MC, Sayre PH, Wieduwilt MJ, Advani AS, Godwin JE, Arellano ML, Sweet KL, Emadi A, Ravandi F, Erba HP, Byrne M, Michaelis L, Topp MS, Vey N, Ciceri F, Carrabba MG, Paolini S, Huls GA, Jongen-Lavrencic M, Wermke M, Chevallier P, Gyan E, Récher C, Stiff PJ, Pettit KM, Löwenberg B, Church SE, Anderson E, Vadakekolathu J, Santaguida M, Rettig MP, Muth J, Curtis T, Fehr E, Guo K, Zhao J, Bakkacha O, Jacobs K, Tran K, Kaminker P, Kostova M, Bonvini E, Walter RB, Davidson-Moncada JK, Rutella S, DiPersio JF
Blood 2021 Feb 11;137(6):751-762. doi: 10.1182/blood.2020007732. PMID: 32929488Free PMC Article
Wilky BA, Trucco MM, Subhawong TK, Florou V, Park W, Kwon D, Wieder ED, Kolonias D, Rosenberg AE, Kerr DA, Sfakianaki E, Foley M, Merchan JR, Komanduri KV, Trent JC
Lancet Oncol 2019 Jun;20(6):837-848. Epub 2019 May 8 doi: 10.1016/S1470-2045(19)30153-6. PMID: 31078463
DiNardo CD, Pratz K, Pullarkat V, Jonas BA, Arellano M, Becker PS, Frankfurt O, Konopleva M, Wei AH, Kantarjian HM, Xu T, Hong WJ, Chyla B, Potluri J, Pollyea DA, Letai A
Blood 2019 Jan 3;133(1):7-17. Epub 2018 Oct 25 doi: 10.1182/blood-2018-08-868752. PMID: 30361262Free PMC Article

Clinical prediction guides

Qin KR, Qu LG
J Urol 2022 Jul;208(1):62-70. Epub 2022 Mar 3 doi: 10.1097/JU.0000000000002496. PMID: 35238603
Kattah JC
Stroke Vasc Neurol 2018 Dec;3(4):190-196. Epub 2018 Jun 23 doi: 10.1136/svn-2018-000160. PMID: 30637123Free PMC Article
Feig DS, Donovan LE, Corcoy R, Murphy KE, Amiel SA, Hunt KF, Asztalos E, Barrett JFR, Sanchez JJ, de Leiva A, Hod M, Jovanovic L, Keely E, McManus R, Hutton EK, Meek CL, Stewart ZA, Wysocki T, O'Brien R, Ruedy K, Kollman C, Tomlinson G, Murphy HR; CONCEPTT Collaborative Group
Lancet 2017 Nov 25;390(10110):2347-2359. Epub 2017 Sep 15 doi: 10.1016/S0140-6736(17)32400-5. PMID: 28923465Free PMC Article
Adike A, Corral J, Rybnicek D, Sussman D, Shah S, Quigley E
Methodist Debakey Cardiovasc J 2016 Oct-Dec;12(4):230-232. doi: 10.14797/mdcj-12-4-230. PMID: 28289500Free PMC Article
Hussein MR, Abdelwahed SR
Expert Rev Gastroenterol Hepatol 2015 Jan;9(1):67-78. Epub 2014 Sep 14 doi: 10.1586/17474124.2014.939632. PMID: 25220299

Recent systematic reviews

Rami Reddy SR, Cappell MS
Curr Gastroenterol Rep 2017 Jun;19(6):28. doi: 10.1007/s11894-017-0566-9. PMID: 28439845
McParlin C, O'Donnell A, Robson SC, Beyer F, Moloney E, Bryant A, Bradley J, Muirhead CR, Nelson-Piercy C, Newbury-Birch D, Norman J, Shaw C, Simpson E, Swallow B, Yates L, Vale L
JAMA 2016 Oct 4;316(13):1392-1401. doi: 10.1001/jama.2016.14337. PMID: 27701665
Whiting PF, Wolff RF, Deshpande S, Di Nisio M, Duffy S, Hernandez AV, Keurentjes JC, Lang S, Misso K, Ryder S, Schmidlkofer S, Westwood M, Kleijnen J
JAMA 2015 Jun 23-30;313(24):2456-73. doi: 10.1001/jama.2015.6358. PMID: 26103030
Giacosa A, Morazzoni P, Bombardelli E, Riva A, Bianchi Porro G, Rondanelli M
Eur Rev Med Pharmacol Sci 2015 Apr;19(7):1291-6. PMID: 25912592
Festin M
BMJ Clin Evid 2014 Mar 19;2014 PMID: 24646807Free PMC Article

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