Nausea (Sickness): Or something else? Differential Diagnosis

Eyes and eye appendages (H00-H59).

Respiratory system (J00-J99)

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Diabetes mellitus (diabetes).
  • Diabetic coma
  • Fructose intolerance (fruit sugar intolerance)
  • Hyperglycemia (hyperglycemia)
  • Hyperthyroidism (hyperthyroidism)
  • Hypothyroidism (hypothyroidism)
  • Lactose intolerance (lactose intolerance).
  • Ketoacidosis – shift of acids and bases in the blood.
  • Adrenocortical insufficiency (NNR insufficiency; adrenocortical weakness).
  • Sorbitol intolerance (sorbitol intolerance)

Cardiovascular system (I00-I99)

  • Aneurysm rupture (rupture of an aneurysm/diseased bulge in the arterial wall).
  • Apoplexy (stroke)
  • Hypertension (high blood pressure)
  • Hypotension (low blood pressure)
  • Myocardial infarction (heart attack)

Infectious and parasitic diseases (A00-B99).

Liver, gallbladder, and biliary tract-pancreas (pancreas) (K70-K77; K80-K87).

  • Cholelithiais (gallstones).
  • Cholecystitis (inflammation of the gallbladder)
  • Biliary colic
  • Hepatic insufficiency (liver failure)
  • Neuroblastoma
  • Pancreatitis (inflammation of the pancreas)

Mouth, esophagus (esophagus), stomach, and intestines (K00-K67; K90-K93).

  • Appendicitis (appendicitis).
  • Arteria mesenterica superior syndrome – narrowing of the vessels supplying the intestine.
  • Colon obstruction – narrowing of the colon due to inflammation, tumor or foreign body.
  • Small intestinal obstruction – narrowing of the small intestine due to inflammation, tumor or foreign body.
  • Enteritis – inflammatory disease of the small intestine.
  • Gastroenteritis (gastrointestinal flu)
  • Gastrointestinal bleeding (GIB; bleeding from the gastrointestinal tract).
  • Gastroparesis – paralysis of the stomach.
  • Ileus (intestinal obstruction)
  • Gastrointestinal infections
  • Irritable bowel syndrome (IBS) (synonyms: Colon irritable; Colon irritabile; Colon spasticum; Colonic neurosis; Colonic irritability; Colonic spasm; IDS; Irretrievable bowel syndrome; Irritable bowel syndrome (IDS); Irritable colon; Colon irritable; Colonic irritability; Colonic neurosis; Irritable bowel syndrome; Irritable bowel syndrome; Irritable colon; Spastic colon; Irritable bowel syndrome) – functional bowel disorder in which no causative disorders can be found.
  • Irritable stomach
  • Duodenal ulcer (duodenal ulcer)
  • Ulcus ventriculi (gastric ulcer)

Musculoskeletal system and connective tissue (M00-M99)

Neoplasms – tumor diseases (C00-D48)

  • Brain tumors
  • Hepatocellular carcinoma
  • Gastric carcinoma (stomach cancer)
  • Pancreatic carcinoma (pancreatic cancer)
  • Neuroblastoma – malignant neoplasia (malignant neoplasm) of the autonomic nervous system.
  • Prolactinoma – benign neoplasm of the anterior pituitary gland (pituitary gland).

Ears – mastoid process (H60-H95).

Psyche – nervous system (F00-F99; G00-G99)

  • Alcohol abuse (alcohol dependence)
  • Anorexia nervosa (anorexia)
  • Bulimia nervosa (binge eating addiction)
  • Depression
  • Brain abscess
  • Cerebral hemorrhage
  • Hydrocephalus (hydrocephalus; abnormal dilation of the fluid-filled spaces (cerebral ventricles) of the brain).
  • Migraine
  • Panic disorders/anxiety attacks
  • Transient ischemic attack (TIA) – sudden onset of circulatory disturbance in the brain leading to neurological dysfunction that resolves within 24 hours

Pregnancy, childbirth and puerperium (O00-O99).

  • Hyperemesis gravidarium (nausea of pregnancy).
  • Pregnancy-induced hypertension (synonyms: EPH-gestosis; eclampsia; premature gestosis; gestational hypertension; gestosis; gravidity – gestosis; gravid toxicosis; HELLP syndrome (H = hemolysis/dissolution of erythrocytes (red blood cells) in the blood), EL = elevated liver enzymes, LP = low platelets); Hypertension in pregnancy (HIS); hypertensive encephalopathy of pregnancy (HES); graft gestosis; preeclampsia; propfgestosis; preeclampsia; pregnancy hypertension; pregnancy-induced hypertension; pregnancy toxicosis; late gestosis; toxicosis; hypertensive encephalopathy of pregnancy).

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99)

  • Acute abdomen (symptom complex characterized by the following involved symptoms: abdominal pain (abdominal pain), nausea (nausea)/vomiting – this often accompanies the abdominal pain, peritonitis (peritonitis with guarding), and impaired general condition (possibly shock)).
  • Increased intracranial pressure
  • Meningismus (painful stiffness of the neck)
  • Tetany – syndrome of neuromuscular hyperexcitability.
  • Thoracic pain (chest pain)
  • Uremia (occurrence of urinary substances in the blood above normal values).

Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).

  • Acute scrotum – acute (sudden) pain in the scrotum (scrotum) associated with redness and swelling.
  • Dysmenorrhea (painful menstruation).
  • Endometritis (inflammation of the uterus)
  • Testicular torsion – reduced blood flow to the testis due to the sudden rotation of the testicle around its vascular pedicle.
  • Pyelonephritis (inflammation of the renal pelvis).
  • Urolithiasis (urinary stones)

Injuries, poisonings, and other consequences of external causes (S00-T98).

  • Alcohol intoxication (alcohol poisoning).
  • Commotio cerebri (concussion of the brain)
  • Heat stroke and sunstroke
  • Pseudoallergy
  • Quincke’s edema – massive swelling of the subcutis (submucosa) or submucosa (submucosal connective tissue), which usually affects the lips and eyelids, but can also affect the tongue or other organs.
  • Motion sickness or seasickness
  • Traumatic brain injury (TBI)
  • Whiplash
  • Radiation sickness
  • Spoiled food

Factors affecting health status leading to health care utilization (Z00-Z99).

  • Food allergy

Further

  • Behavioral causes
    • Nutrition
      • Spoiled food

      Pleasure food consumption

      • Alcohol – Excessive alcohol consumption
    • Psycho-social situation
  • Gravidity (pregnancy)

Medication

  • Antiarrhythmicsdrugs used to treat cardiac arrhythmias, such as digoxin or adenosine.
  • Antibioticsdrugs used to treat bacterial infections, such as penicillin or cephazolin.
  • Non-steroidal anti-inflammatory drugspain medications such as ibuprofen or diclofenac.
  • Oral antidiabetics – medications used to treat diabetes mellitus (diabetes) – such as glibenclamide or metformin.
  • Oral anticonceptives – drugs used for contraception such as ethinyl estradiol / norgestrel.
  • Cytostatic drugs – drugs used to treat cancer.
    • High emetogenicity (> 90%; “emetic“): carboplatin (AUC ≥ 4 mg/ml/min), cisplatin, doxorubicin (≥ 60 mg/m2), ifosfamide (> 2 g/m2 per administration).
    • Moderate emetogenicity (30-90%): carboplatin (AUC < 4 mg/ml/min), doxorubicin (< 60 mg/m2), epirubicin ≤ 90 mg/m2,, ifosfamide (< 2 g/m2 per administration)
    • Low emetogenicity (10-30%): axitinib, atezolizumab, cabazitaxel, docetaxel, doxorubicin (liposomal), everolimus, etoposide, 5-fluorouracil, gemcitabine, interferon α 5-10 million IU/m2, mitoxantrone, olaparib, paclitaxel, pazopanib, pemetrexed, sunitinib, vinflunine
    • Minimal emetogenicity (< 10%): bevacizumab, bleomycin, interferon α ≤ 5 million IU/m2, ipilimumabb, methotrexate ≤ 50 mg/m2, nivolumab, pembrolizumab, sorafenib, temsirolimus, vinblastine
  • See also under drug side effects “Gastrointestinal discomfort caused by drugs”.

Environmental exposures – intoxications (poisonings).

  • Alcohol intoxication (poisoning)
  • Spoiled food