Vomiting
Nausea is the feeling you get in your stomach before you vomit.
Vomiting is when you throw up your stomach contents through your mouth.
You can have nausea and vomiting together or separately.
Causes of Nausea and Vomiting
Nausea and vomiting are not diseases, but both are common symptoms of
many conditions, such as:
Gallbladder disease
Food poisoning
Infections (such as "stomach flu")
Ulcers
Bulimia or other psychological illnesses
Gastroparesis, or slow stomach emptying (a condition seen in people
with diabetes)
Nausea and vomiting can also result from:
Motion sickness or seasickness
Early stages of pregnancy (Nausea happens in 50%-90% of pregnancies;
vomiting in 25%-55 %.)
Ingesting something toxic
A reaction to medicines
Intense pain
Emotional stress (such as fear)
Drinking too much alcohol
Using illicit drugs
Overeating
Reactions to certain smells or odors
Vomiting in children
Children are more prone to vomiting than adults. Some common reasons
children vomit include:
A viral infection
Food poisoning
A milk allergy
Motion sickness
Overeating or over-feeding
Coughing
Other illnesses that give the child a high fever
Vomiting in adults
One common cause of vomiting in adults is gastroenteritis, a gut infection
caused by bacteria. It's often called "stomach flu," though it isn't a type of flu at
all. Other common causes are:
Pregnancy
Food poisoning
Migraines
Labyrinthitis, an inner ear infection that makes you feel dizzy
Motion sickness
Appendicitis
Other conditions
Sometimes, vomiting is a side effect of serious illnesses like:
Encephalitis
Meningitis
Some forms of cancer
Heart attack
Concussion or brain injury
Brain tumor
Bowel blockage (obstruction)
Appendicitis, an inflammation of the appendix
Mechanism of Vomiting:
1. Stimulation of the Vomiting Center:
The vomiting reflex is initiated by the vomiting center, a region in the
brainstem that receives signals from various sources, including the
gastrointestinal tract, the inner ear, and higher brain centers.
2. Chemoreceptor Trigger Zone (CTZ):
The CTZ, located in the brainstem, is sensitive to certain chemicals and
toxins, and its activation can trigger vomiting.
3. Neural Pathways:
Once the vomiting center is stimulated, signals are transmitted through
neural pathways to the muscles involved in vomiting, including the
diaphragm, abdominal muscles, and the muscles of the upper digestive tract.
4. Coordination of Vomiting:
Relaxation of the Lower Esophageal Sphincter: The lower esophageal
sphincter, which normally prevents stomach contents from flowing back into the
esophagus, relaxes.
Contraction of Abdominal Muscles: The abdominal muscles contract
forcefully, increasing pressure in the abdomen and forcing the stomach contents
upward.
Diaphragm Contraction: The diaphragm contracts, further aiding in the
expulsion of stomach contents.
5. Expulsion of Stomach Contents:The combined action of these muscles and
the relaxation of the lower esophageal sphincter leads to the forceful expulsion
of stomach contents through the mouth.
Investigations
1. Initial Assessment:
History:
The doctor will ask about the duration, severity, and pattern of vomiting, as well
as any other symptoms, medical history, and medications.
Physical Examination:
The doctor will assess hydration status, examine the abdomen, and check for
other signs of illness.
2. Diagnostic Tests:
Laboratory Tests:
Blood tests: To check for signs of infection, anemia, electrolyte imbalances, kidney
or liver problems, and nutritional status.
Urine tests: To screen for infections, irregularities, and other health conditions.
Pregnancy test: If a woman of childbearing age is experiencing vomiting.
Imaging Studies:
Upper GI endoscopy (EGD): A flexible tube with a camera is inserted to visualize
the esophagus, stomach, and duodenum.
CT scan: To check for blockages or other issues in the digestive system.
Ultrasound: To evaluate the gallbladder and other abdominal organs.
Abdominal X-ray: Can be used to assess for bowel obstruction.
