Jeremy S Furyk, senior staff specialist, adjunct associate professor
Robert Meek, staff specialist in emergency medicine, adjunct lecturer
Suzanne McKenzie, associate professor, general practice and rural medicine, conjoint associate professor

A usually healthy 25 year old man presents to you as his general practitioner at 9 am. He has had fluctuating nausea with four vomits and one loose stool overnight, associated with colicky central abdominal pain. No blood was present in the vomit or stool, and he reports that his girlfriend was recently diagnosed as having “viral gastro.” He is afebrile, intermittently uncomfortable, but otherwise well, with mild epigastric tenderness but no guarding or rebound. Clinically, you believe viral gastroenteritis is the most likely cause of his symptoms, and you consider his request for treatment that will help to stop his vomiting so that he can get to his evening shift at a factory.

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