Differential Diagnosis
Other conditions that should be ruled out in the diagnosis of nausea and vomiting include:
- Drug use or toxicity
- Endocrine: Uremia, adrenal insufficiency, thyroid disorders
- Gastrointestinal: Peritonitis, gastric outlet or bowel obstruction, peptic ulcer disease, hepatitis, gastroenteritis
- Genitourinary: Urinary tract infection, nephrolithiasis
- Neurologic: Meningitis, migraine, central nervous system (CNS) tumor
- Other: Sepsis, myocardial infarction, psychiatric disorders
- Vestibular: Benign paroxysmal peripheral vertigo (BPPV), motion sickness, labyrinthitis
Differential Diagnoses for Nausea and Vomiting of Pregnancy
Nausea and vomiting that begins after the ninth week of gestation is not characteristic of nausea and vomiting of pregnancy and should be investigated further. Headache, fever, and abdominal pain or tenderness is not typical in nausea and vomiting of pregnancy.
Diseases that may present as nausea and vomiting in pregnant patients include the following:
- Pregnancy-related conditions: Preeclampsia, acute fatty liver of pregnancy
- Gastrointestinal (GI) diseases: Gastroenteritis, biliary tract disease, hepatitis, peptic ulcer disease (PUD), appendicitis, gastroparesis, intestinal obstruction, pancreatitis, achalasia
- Neurologic diseases: Migraines, central nervous system (CNS) tumors, vestibular lesions, lymphocytic hypophysitis
- Genitourinary tract diseases: Urinary tract infection, pyelonephritis, kidney stones, uremia, ovarian torsion, degenerating uterine leiomyoma, hydatidiform mole
- Other conditions: Diabetic ketoacidosis, drug-related toxicity, eating disorders, psychologic conditions, labyrinthitis, motion sickness, hyperthyroidism, hyperparathyroidism, Addison's disease