Headaches and digestion
Nausea & vomiting
For nausea, vomiting and motion sickness
with a medical interpreter
24 hours a day, 365 days a year
OK to consult together
payment information
About
About Nausea & vomiting
We treat nausea, vomiting and feeling sick. You can consult us about the likely cause and how to relieve uncomfortable symptoms.
Why it happens
Nausea and vomiting are responses triggered when the vomiting center in the brain receives signals from things like irritation of the stomach and bowel, disturbance of balance in the inner ear, medication or toxins, severe pain or stress. Besides infectious gastroenteritis and food poisoning, they can also occur with migraines, motion sickness, drinking too much and early pregnancy. Most cases are temporary, but repeated vomiting easily leads to dehydration and may be caused by an underlying condition in the abdomen or brain.
What's happening in the body
Nausea and vomiting are defensive responses to expel things that are harmful to the body. Part of the brain gives the command to vomit, and it receives signals through several pathways. One pathway comes from the digestive tract: when there are foreign substances or toxins in the stomach or bowel, that information travels to the brain through nerves. Another comes through the blood: an area that detects toxins and medication in the blood responds. There's also a pathway from the balance sense in the inner ear, which is why motion sickness and dizziness cause nausea. It can also be triggered by signals from the brain itself, such as severe anxiety or pain. Even though the response of vomiting is the same, the pathway behind it differs, and so does the treatment. We assess which pathway is involved based on the symptoms that come with it.
Main symptoms
- Nausea, queasiness
- Vomiting (increasing or repeated)
- Discomfort or pain in the upper stomach
- Loss of appetite
- With dizziness or unsteadiness
- Cold sweats, pale face
- May come with diarrhea or fever
- May come with a headache
When you can wait and see
What you can do yourself
- Take small sips (about 1 spoonful) every 5–10 minutes
- Don't force yourself to eat solid food until the nausea settles
- When lying down, lying on your right side with your upper body slightly raised may help
- Avoid strong-smelling and fatty food
- Once it settles, start again with easily digestible food such as thin rice porridge or soup
Please consult us
If any of the following apply
- Nausea or vomiting won't stop
- You're finding it hard to keep fluids down
- You also feel dizzy
Seek care right away
If any of the following apply
- Blood in vomit, or vomiting dark material
- Drowsiness or confusion, or slow to respond when spoken to
- Vomiting with severe headache or a stiff neck
- Ongoing severe stomach pain with a hard abdomen
- Has had a seizure, or too weak to stand
Don't wait for a Cotovia consultation; call the emergency number in your country.
See the emergency guide for each countryIf you're not sure, ask us on LINE
Differential
Telling it apart from similar conditions
Symptoms that look the same may need different care depending on the cause. Use this as a guide to find what's closest to your situation.
Infectious gastroenteritis
Vomiting first, then diarrhea, with people around you having the same symptoms
Preventing dehydration comes first
Food poisoning
Starts suddenly a few hours after a particular meal
Most cases get better on their own, but staying hydrated is important
Heatstroke
After activity in the heat, with headache, dizziness and fatigue
Cool down in a cool place and replace fluids and salt. Call emergency services if consciousness changes
Pregnancy
A late period, with nausea that's worse in the morning
Be sure to tell us if you could be pregnant
Head-related causes
With severe headache, paralysis in the arms or legs or changes in consciousness
Emergency care is needed
Appendicitis and similar conditions
Stomach pain comes first and moves to the lower right abdomen
Seek care urgently
* This is not a complete list. If you're not sure, please consult us.
When it might be something else
Course
Typical course
This is the general course. Actual progress varies from person to person.
- Onset to 6 hours
Nausea and vomiting are at their worst
Don't force yourself to eat or drink. Once it settles, take small sips of fluid
- 6–24 hours
Vomiting becomes less frequent
Take oral rehydration solution in small amounts, many times
- Days 1–2
Most people start to improve. It may turn into diarrhea
Gradually start eating again, beginning with easily digestible food
- If it lasts 2 days or more
If you still can't keep fluids down, dehydration gets worse
You may need fluids by IV drip. Please consult us
Local Insight
For people living in Southeast Asia
The climate, healthcare and access to medication differ from Japan. Here are points specific to this region.
In tropical heat you sweat a lot, and with vomiting on top of that, dehydration can set in quickly. Infants and older adults need particular care.
In dengue, persistent vomiting or severe stomach pain around the time the fever goes down is considered a warning sign, and extra care is needed at this stage. If you vomit after a fever, don't decide on your own; please consult us.
Infectious gastroenteritis from local food, water or ice is one of the common causes. Whether people who ate the same food have similar symptoms is also a useful clue.
Oral rehydration solution is often available at local pharmacies and supermarkets, and it's reassuring to keep some at home. Juice or soft drinks alone may not provide enough electrolytes.
Care
What Cotovia can do
- Assessing your symptoms through a consultation
- Advice on anti-nausea medication and oral rehydration (prescribing is at the doctor's discretion)
- Referral to in-person care (IV drip) if you're severely dehydrated
Tests you may have
Not knowing what will happen can make people hesitate to seek care, so here's what actually takes place.
Consultation and abdominal examination
Narrowing down the pathway causing it
Blood test
Assessing dehydration, electrolyte imbalance and inflammation
Urine test
Checking dehydration and pregnancy
Abdominal imaging
Assessing conditions that need surgery, such as appendicitis
Treatment options
Rehydration with oral rehydration solution
Prevents dehydration
Drinking a lot at once makes you more likely to vomit. It's recommended to take small amounts, many times
Anti-nausea medication
Eases nausea
The right medication depends on the cause. Prescribing is at the doctor's discretion
IV drip
Fluids when you can't drink
An option when dehydration is getting worse
Treating the cause
Treatment for infection or other conditions
If the cause is identified, treating it takes priority
* Tests, procedures and prescriptions are decided by the doctor after a consultation. Services may vary by country and location.
Preparation
Before your visit
When seeing a doctor abroad, simply organizing what you need to say makes a big difference.
What to bring
- Passport or residence card
- Insurance card and your insurer's contact details
- Your medication record and the medication you take
What to tell us
- When it started and how many times you've vomited
- What the vomit looks like (whether it contains blood or bile)
- Whether you have stomach pain, diarrhea or fever
- What you ate before it started
- Whether you could be pregnant, and the date of your last period
Self Care
What you can do yourself
Along with seeing a doctor, here are things to keep in mind in daily life.
Prevention
- Pay attention to food hygiene (cook food thoroughly, wash hands, be careful with ice and raw food)
- Avoid overeating and drinking too much
- If you get motion sickness easily, ask a doctor about prevention in advance
- Prevent dehydration in hot conditions
How to Consult
How to be seen
Choose from 3 ways to be seen, depending on your symptoms and schedule. If you're not sure, we'll guide you on LINE.
Online consultations
See a doctor by video call from home or the office. Medication delivered or from a pharmacy.
Available for this symptom
In-person care
In-person consultations at our clinics and partner hospitals, including tests and procedures.
Available for this symptom
Cotovia Counter
Support with an interpreter for visits to general hospitals.
Available for this symptom
If an online consultation finds that tests or procedures are needed, we'll guide you to in-person care or Cotovia Counter.
From consultation to receiving medication
Add us on LINE and consult
Tell us your symptoms, and we'll recommend the right way to be seen.
Book and be seen
See a doctor online or at the nearest location, with an interpreter present.
Receive your medication
Have it delivered or pick it up at a pharmacy or the clinic (varies by country).
Follow-up
You can also consult us on LINE about how you're doing afterward.
Special Care
People who need extra care
Children
Dehydration sets in quickly. Seek care urgently if your child hasn't passed urine for half a day or more, cries without tears or is limp
Older adults
They may not notice they're dehydrated or that it's getting worse
Pregnant women
If you still can't keep fluids down, treatment may be needed. Please consult us
People with diabetes
It's recommended to check in advance what to do with your medication when you can't eat
FAQ
FAQ
Common questions before a visit, and common assumptions that lead people to judge for themselves.
QI feel so bad I can't even drink water.
You may be getting dehydrated. If the doctor decides an IV drip is needed, we'll guide you to in-person care. If you're limp and slow to respond, it's urgent, so please consider local emergency services.
QMy child keeps vomiting. What should I look out for?
Passing urine less often, no tears, a dry mouth, and being irritable and limp are signs of dehydration. Please consult us early.
QCan I just get anti-nausea medication prescribed?
Treatment depends on the cause, so we'll first ask how your symptoms have developed. Whether to prescribe is up to the doctor.
Common misconceptions
Myth You should drink water right after vomiting
Fact Drinking a lot at once makes you more likely to vomit again. It's recommended to take small amounts at a time
Myth Anti-nausea medication also cures the cause
Fact It only relieves symptoms. The cause needs to be treated separately
Myth You'll feel better if you vomit, so you should make yourself throw up
Fact Making yourself vomit can damage your esophagus
Myth Nausea is only a stomach problem
Fact There are also causes outside the digestive system, such as the head, inner ear, pregnancy and medication
Myth Sports drinks can replace oral rehydration solution
Fact They're high in sugar and low in salt, so they may not be enough when you're dehydrated
Feel free to ask us on LINE first
It's fine to contact us even if you're not sure you need to see a doctor. We're available in Japanese 24 hours a day, 365 days a year.
- Symptoms
- When it started
- Your country of residence
- How you'd like to be seen
Sending these 4 things helps us respond faster. It's fine if you don't have them all.
Ask us on LINE