what are the causes of Nausea and vomiting?
vomiting is the expulsion of gastric content via the mouth. It is a highly integrated and complex reflex involving both autonomic and somatic neural pathways. Nausea may be defined as pronounced stomach discomfort and the sensation of wanting to vomit. The timing of vomiting can indicate the vomiting causes. The causes of vomiting and nausea are quite similar. There are many things that can bring up nausea and vomiting. When appearing shortly after a meal, it may be caused by food poisoning, Gastritis, an ulcer, or bulimia. Vomiting one to eight hours after a meal also indicates food poisoning.
It is different from regurgitation, although two terms are often used interchangeably. Regurgitation is the return of undigested food back up the esophagus to mouth, without force and displeasure associated with vomiting. In severe case when dehydration develops, intravenous fluid me required.
Mechanism of vomiting
Synchronous contraction of the diaphragm, intercostal muscle, and abdominal muscles
Increase intra-abdominal pressure and combined with the relaxation of the lower esophageal sphincter
Forcible ejection of gastric contents
Electrolyte imbalance after vomiting:
- Metabolic alkalosis
- Paradoxical aciduria
Fluid should be given: Normal saline.
The causes of both nausea and vomiting are quite similar which they can occur separately or they can occur together. The most common causes of nausea and vomiting are:
- Peptic ulcer disease
- Gastric cancer
- Gastric outlet obstructions(projectile Vomiting)
- Acute abdominal conditions: Appendicitis,cholecystitis, Pancreatitis, Intestinal obstructions.
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- Urinary tract infections(UTI).
3. CNS Disorder
- Raised ICP
- Vestibular disturbance(eg.motion sickness), migraine, meningitis.
- Uraemia. Hypercalcemia, Diabetic ketoacidosis
- NSAIDs(Nonsteriodal anti-inflamtory driugs)
- Bulmia Nervosa
8. Myocardial Infraction
Q. A patient has come to you with severe upper abdominal pain and vomiting.
a) What are the important differential diagnosis?
b) Mention the bad prognostic features of acute pancreatitis.
c) Write down the systemic complications of acute pancreatitis.
a) Important differential diagnoses:
- Peptic ulcer disease.
- Acute pancreatitis.
- Acute cholecystitis.
b) Bad prognostic features of acute pancreatitis
- PO2<8kPa (60mmHg).
- White blood cell count(WBC)>15*10^9/litre
- Serum calcium<2mmol/l (8mg/dl) (corrected)
- Gulcose>10mmol/l (45mg/dl)
- Urea>16mmol/l (45mg/dl) ) (after rehydration)
- Alanine aminotransferase (ALT).200U/l
- Lactate dehydrogenase(LDH),600U/l
C) systemic complications
- systematic inflammatory response syndrome(SIRS)
- Reduced serum albumin concentrations
Vomiting is a complex reflex which involves both autonomic and somatic neural pathways. nausea is the urge to vomit. Synchronous contraction of the diagram, intercostal muscles, and abdominal muscles raises intra-abdominal pressure and, combined with the relaxation of the lower oesophageal sphincter, in results in the forcible ejection of the gastric content.
The causes of nausea and vomiting are similar to each other which they can occur together or separately. it is important to distinguish true vomiting is acute or chronic (recurrent), as the underlying causes may differ. the major causes are enlisted above. if you have extreme vomiting please do visit to the doctor because you may suffer from dehydration and electrolytes imbalance.