Clinical investigations from the RACP

Investigation of nausea. How far to go before referral

Eliot Roach



A few basic tests will often rule out serious pathology in a patient with nausea. The GP must decide how far to investigate before taking an observational approach or referring the patient to a specialist.
A correction for this article was published in the August 2015 issue of Medicine Today, and the full text PDF for this article (see link above) has been corrected.

Key Points

  • Nausea is a common presenting symptom and is often idiopathic or functional.
  • Organic causes are usually apparent from a patient’s history and physical examination.
  • A few basic investigations will rule in or out most underlying causes.
  • Referral of patients to a gastroenterologist should be considered when the diagnosis is in doubt, there is the suspicion of an underlying gastrointestinal cause or to reassure the patient.
  • Consider anxiety as an underlying or contributing factor to nausea.

    Picture credit: © BSIP/Alice S/