Many drugs and medications cause nausea, vomiting, and diarrhea as adverse effects. A detailed drug and medication history must be obtained. In mild cases, cessation followed by reuse of the medication may establish a causal relationship. Commonly responsible medications include antacids containing magnesium, antibiotics, antihelminthics, cytotoxics (used in cancer therapy), colchicine, digoxin, heavy metals, laxatives, immunotherapy, and radiation therapy. Use of antibiotics may lead to Many drugs and medications cause nausea, vomiting, and diarrhea as adverse effects. A detailed drug and medication history must be obtained. In mild cases, cessation followed by reuse of the medication may establish a causal relationship. Commonly responsible medications include antacids containing magnesium, antibiotics, antihelminthics, cytotoxics (used in cancer therapy), colchicine, digoxin, heavy metals, laxatives, immunotherapy, and radiation therapy. Use of antibiotics may lead toClostridioides difficile–induced diarrhea. Diarrhea and other symptoms in C. difficile infection may be more severe than antibiotic-associated diarrhea and persist after completion or cessation of antibiotics.
Iatrogenic, accidental, or intentional heavy-metal poisoning frequently causes nausea, vomiting, abdominal pain, and diarrhea.
Laxative abuse, which patients may be reluctant to discuss with clinicians, may lead to weakness, vomiting, diarrhea, electrolyte depletion, and metabolic disturbances. Stool testing, specifically for stool osmolality and magnesium, can help differentiate diarrhea resulting from osmotic laxative abuse from diarrhea resulting from other causes, with low stool osmolality and/or elevated stool magnesium suggests laxative use as a cause.
Testing for specific causes will depend on the history and the suspected substance; treatment will depend upon the cause identified.
(See also Overview of Gastroenteritis.)
