Phenomenology of vomiting and nausea

Feelings of nausea (N) and actual vomiting (V) are universal experiences of human beings and probably also of many animals. Most of the time both N and V are acute experiences that pass quickly and are of little medical or health significance. However, severe and/or prolonged N and/or V can be very distressing and even life threatening; for example in children when V is associated with diarrhoea and dehydration, or people who die through choking on their vomit.

As Stern (2002) has recently highlighted, N, like pain, fatigue and itchiness, is a private, subjective experience but one which is highly dependent upon the interplay of profound physiological and psychological factors. Both V and N share much in common as far as causal factors are concerned but V, unlike N, is an observable and objectively verifiable event. This has implications for medical assessment and treatment so that N may be under-recognized and under-treated compared with V. This is particularly pertinent in chemotherapy for cancer (e.g. Sun et al., 2002) (see ‘Chemotherapy’).

N and V are associated with many aspects of illness and healthcare and frequently are of clinical significance (e.g. bulimia with induced vomiting; viral infections; side effects of treatments, such as chemotherapy (Osaba et al., 1997) and in pregnancy (Chou et al., 2003), where clear relationships have been found between depression and N and V.