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| Nausea and vomiting in adults |
The vomiting is a strong contraction of the stomach that propels its contents through the esophagus and expelled through the mouth. Vomiting empties the stomach and often relieves the feeling of nausea, at least temporarily. Vomiting is very uncomfortable and can be violent. Severe vomiting may throw the contents of the stomach a few meters away (jet vomiting). Vomiting is different from regurgitation , which is the reflux of stomach contents without strong abdominal contractions or nausea. For example, people with Zenbow achalasia or diverticulum ( Throat Disorders ) may regurgitate undigested foods without feeling nauseated.
The vomit material usually reflects newly ingested foods. It sometimes contains large pieces of food. When the person vomits blood, the vomit is usually red ( hematemesis ), but if the blood has been partially digested, the vomit looks like coffee grounds. In the presence of bile, the vomit is bitter and greenish-yellow in color.
Complications
In addition to being uncomfortable, vomiting can lead to complications:
Inhalation (aspiration) of vomit
Torn esophagus (Mallory-Weiss syndrome)
Dehydration and electrolyte abnormalities
Undernutrition and weight loss
Patients who are totally or partially unconscious can inhale their vomit. The acid contained in the vomit can then seriously irritate the lungs.
Vomiting significantly increases the pressure inside the esophagus, and severe vomiting can cause tears in the esophageal mucosa ( oesophageal dilatation (Mallory-Weiss syndrome) ). While a small tear causes pain and sometimes bleeding, a big tear can be fatal.
Because vomiting causes people to lose water and minerals (electrolytes), severe vomiting can cause dehydration and electrolyte abnormalities . Newborns and infants are particularly vulnerable to these complications.
Chronic vomiting can lead to undernutrition , weight loss and metabolic disorders.
causes
Nausea and vomiting occur when the cerebral center of vomiting is activated. The causes usually include digestive or brain disorders, or are related to ingested substances.
Frequent causes
The most common causes of nausea and vomiting are:
gastroenteritis (infection of the digestive system).
pharmaceuticals
toxins
It is common to experience nausea and vomiting with any dysfunction of the digestive tract, but these symptoms are particularly common in cases of gastroenteritis . A less common gastrointestinal disorder is intestinal obstruction, which causes vomiting as food and liquids move up into the stomach as a result of occlusion. Many other abdominal disorders that cause vomiting also cause severe abdominal pain . In this type of disorder (for example, appendicitis or pancreatitis), people most often come to see a doctor for pain rather than for vomiting.
Many medications, including alcohol, opioid analgesics (such as morphine ) and chemotherapy drugs, can cause nausea and vomiting. Toxins, such as lead or those found in certain foods and plants, can cause severe nausea and vomiting.
Less common causes
Less common causes of nausea and vomiting include
Brain or central nervous system disorders
Travel sickness
Metabolic changes or organic (systemic) condition
Psychological disorders
Cyclical vomiting syndrome
The center of vomiting may also be activated by certain disorders of the brain or central nervous system, including infections (meningitis and encephalitis), migraines and disorders that increase the pressure inside the skull (intracranial pressure). ). Disorders that increase intracranial pressure include brain tumors, cerebral hemorrhage and severe head trauma.
The organs of the inner ear that intervene on balance (vestibular apparatus) are connected to the center of the vomiting. This connection explains why the movements of a boat, car or plane and some inner ear disorders (such as labyrinthitis and positional vertigo) can cause nausea in some people.
Nausea and vomiting may also occur in the presence of metabolic changes in the body, such as early in pregnancy, or in poorly controlled diabetes or severe hepatic or renal impairment.
Psychological disorders can also be responsible for nausea and vomiting (called functional or psychogenic vomiting). These vomiting can be voluntary. For example, people who suffer from bulimia are throwing up to lose weight. They can also be involuntary. For example, children who are afraid of going to school will vomit in response to their psychological distress.
Cyclical vomiting syndrome is a rare disorder in people who have severe seizures (or sometimes only nausea) at varying intervals. People feel normal between crises. Although it usually begins during childhood, it sometimes lasts until adulthood. The cyclic vomiting that occurs in adulthood is often due to the use of marijuana.
Evaluation
All episodes of nausea and vomiting do not require an immediate medical examination. The following information can help people decide if a doctor's assessment is needed and help them know what to expect during the assessment.
Warning signs
Some symptoms and characteristics are of concern. These include
Signs of dehydration (such as feeling thirsty, dry mouth, infrequent or absent urination and feeling weak and tired)
Headache, stiff neck, confusion or decreased alertness
Constant abdominal pain
Abdominal sensitivity to the touch
Distention (swelling) of the abdomen
When to consult a doctor
People with warning signs should immediately seek medical attention, as well as those who have vomited blood or recently suffered a head injury.
People who have nausea and vomiting but no warning sign should consult a doctor if vomiting lasts longer than 24 to 48 hours or if they fail to keep more than a few sips of fluid. People with multiple episodes of vomiting (with or without diarrhea) who are able to keep at least some fluids should contact their doctor. Depending on the patient's age, other symptoms and known conditions (such as cancer or diabetes), the doctor may suggest a medical examination or stay at home and try simple remedies.
What does the doctor
Physicians first ask about people's symptoms and medical history. The doctor then performs a clinical examination. The observations made by the doctors during the history and the clinical examination often point them to the cause of the vomiting and the examinations to be carried out if necessary ( Some causes and characteristics of the nauseas and the vomiting ).
During the medical history, doctors ask the person if they are pregnant or in general if they have diabetes, migraines, liver or kidney disease, or cancer (including the date of initiation of any chemotherapy or radiotherapy ). All drugs and substances recently ingested are noted as some substances may be toxic up to several days after ingestion (such as acetaminophen and certain fungi).
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