Vomiting

Episodes of vomiting of varying frequency and duration at least once in a lifetime overtook any person. As a result of exposure to some external or internal factors, a painful condition is formed, associated with nausea or without nausea, as a result of which the contents of the digestive tract are excreted through the esophagus, oral cavity and nasal passages. The etiology of the process is very diverse, since infections, nervous disorders, diseases of the digestive tract and body movements (traveling by car, plane, ship, riding a carousel) can provoke vomiting.

General characteristics of the symptom complex

In addition to an absolutely characteristic external manifestation, namely, the exit of the contents of the digestive tract through the mouth and nose, the process of vomiting has complex internal mechanisms and is a reflex act associated with the activity of the vomiting center of the brain. The excitation of the activity of the center can be provoked by internal changes in the body, or by the influence of the external environment.

The presence of a gag reflex in a person is due to the body’s defense system, which works to urgently remove the toxic and toxic substances present in it. However, vomiting is not always caused only by intoxication or poisoning. Excitation of the reflex is caused by dozens of different factors.

Vomiting of neurogenic origin can be the result of diseases and organic lesions of the membranes or tissues of the brain, disorders and disorders of the processes of cerebral circulation. It can also be observed with irritation or pathological changes in the organs of the vestibular apparatus (cerebellum, ear labyrinth). The psychogenic type of state is caused by psychosomatic diseases, emotional disorders.

The appearance of vomiting may be associated with an irritating effect on the mucous membranes and tissues of internal organs – the stomach, intestines, gallbladder, or with inflammation of the peritoneum and pelvic organs. Irritation of the root of the tongue, mucous membranes of the pharynx and pharynx is the most famous mechanical method to induce vomiting, which is used to remove the contents of the stomach.

Also, the vomiting center can be affected by toxins produced by bacteria, own toxic substances that are formed as a result of metabolic processes, and are not fully excreted in diseases of the kidneys, liver, and endocrine problems.

Vomiting must be distinguished from regurgitation (regurgitation) of gastric contents, which is not accompanied by nausea and strong contraction of the abdominal muscles. In the presence of impaired motility of the esophagus, characterized by impaired peristalsis and insufficient relaxation of the lower esophageal sphincter during swallowing (achalasia) or rumination syndrome or Zenker’s diverticulum, regurgitation of undigested food may occur without nausea.

There is no specific treatment for vomiting. Separately, vomiting is not considered as an independent disease – it is always considered a symptom of other health problems.

In most cases, the onset of the vomiting process is preceded by a state of nausea, increased salivation, deep and frequent breathing, and dizziness may occur. First, the diaphragm descends, then the glottis closes and the pyloric section of the stomach is sharply reduced. After that, the body of the organ and the esophageal sphincter (the valve that marks the place where the esophagus passes into the stomach) relax, and the phenomenon of antiperistalsis occurs. The sudden contraction of the diaphragm and the muscular structure of the abdominal press causes an increase in intra-abdominal and intra-gastric pressure, as a result of which the contents of the stomach are thrown into the esophagus and above, through the mouth and nasal passages.

At this time, there is also pallor of the skin, a sharp onset of weakness, increased heart rate, palpitations, and a decrease in blood pressure.

To diagnose and identify the etiology of vomiting, when taking an anamnesis, it is necessary to pay attention to the time when the condition occurred, whether it was preceded by nausea, or vomiting passed without nausea, as well as what volumes of vomit came out, their color and consistency.

Classification of the state of vomiting and vomit

To date, a large number of types of the state of vomiting are known. So, depending on the localization of the impact that caused the release of vomit, vomiting happens:

• gastric, if irritation of the mucous membranes of the stomach appears against the background, for example, medicines or chemicals, spoiled food;
• central origin: comes on suddenly, without nausea, and can last for a long time without bringing relief.

Vomiting provoked by factors of central origin is divided into:

• conditioned reflex;
• cerebral;
• toxic;
• medication.

The first type occurs due to mechanical irritation of the soft palate, the root of the tongue, the peritoneum, as well as in some diseases of the internal organs (appendicitis, cholecystitis, renal colic). Cerebral vomiting is the result of a pathological increase in intracranial pressure. With toxic vomiting, poisoning with toxic substances, toxins takes place. Medical vomiting is formed against the background of the action of drugs, for example, apomorphine, on the corresponding reflex center in the medulla oblongata.

Also distinguish vomiting in the morning (morning), evening, in a dream. Vomiting can be single or multiple.

The structure and characteristics of the vomit are of known diagnostic value, since any impurities in them indicate the causes of vomiting. Of course, it is impossible to make a diagnosis only on the basis of these data, but the attending physician must record information about the structure and nature of vomit in the medical history, and subsequently study it.

Vomiting with bile

In appearance it has a characteristic yellow or green color. In children, it can form after eating, especially due to overeating, if the child lies on his stomach in this state. Vomiting of bile is present in case of poisoning, against the background of appendicitis.

Vomiting of bile in the morning, which intensifies as food enters the digestive tract, is characteristic of pyloric stenosis, for a state of exacerbation of the chronic form of gastritis, biliary colic, cholelithiasis and other pathologies of the bile ducts. This type of vomiting is periodic, every 2-3 hours and does not bring relief. A similar type of vomiting accompanies intestinal obstruction, and some other diseases of the gastrointestinal tract.

In addition, bile begins to come out with vomit if vomiting is very intense and lasts more than a day. For example, if a person has developed severe poisoning after alcohol, he first vomits with what he has eaten and drunk, then with drunk water, and then with just bile, a liquid yellow or greenish mass. Bile contents are sometimes accompanied by morning vomiting with toxicosis.

Blood in vomit

Hematemesis is a very dangerous syndrome that signals intestinal or gastric bleeding and associated blood loss. The etiology of bleeding is established by clinicians – it can be a peptic ulcer of the intestine or stomach, damage to the walls of organs of any nature, cirrhosis of the liver. The color of the masses coming out with the blood at the same time acquires a shade of coffee grounds.

If the problem lies in the digestive tract, the patient is accompanied by a hard or liquid tar-like stool. The brown shade of the outgoing masses is also taken with infectious toxicosis.

The red color of bloody vomit indicates damage, possibly rupture of the walls and tissues of the stomach, intestines, esophagus, and pharynx. Sometimes the presence of blood and red color in the masses is caused by concomitant bleeding in the nasal passages or in the oral cavity.

Foam with blood in the vomit indicates pulmonary hemorrhage.

Vomit like curdled milk

It is observed in newborn children, and indicates that the product cannot overcome the stomach cavity and pass further. Such a pathology may be a sign of pylorospasm or pyloric stenosis. The outgoing masses acquire a sour smell.

Mucus in vomit

It is often present in the morning, before breakfast, and accompanies people with chronic forms of alcoholism, heavy smokers and patients with chronic bronchitis. It is especially characteristic of smokers to vomit mucus after bouts of morning coughing.

Infants during feeding can give out mucus during vomiting – this is considered a normal variant that occurs due to coughing up mucus from the bronchi. Especially high is the likelihood of vomiting mucus in children after taking certain products (jelly, milk).

In adults, mucus in masses indicates acute or chronic forms of gastritis, damage to the gastric mucosa, and may be present with rotavirus.

Why does fecal vomiting appear

The so-called vomiting of feces is a symptom of a fistula between the stomach and the transverse colon. Due to intestinal obstruction, vomit is very similar to feces in appearance and smell.

Vomiting in different age groups

The state of vomiting can be observed in adults and children, in women, in men of different ages, it can be one-time and systematic.

Vomiting in an adult, if it is episodic, is sometimes due to the result of motion sickness in transport, or a reaction to poisoning by food, drinks, excess alcohol, infectious diseases, such as enteroviruses. Such vomiting rarely lasts more than 2 days, it has quite understandable and visible reasons: infection, poisoning, mechanical effects on the body. Elementary measures, including taking detoxification drugs and drugs against the pathogen, rest, and after a day or two, vomiting stops. If this does not happen, you should seek medical attention.

Vomiting in women

The condition can be observed not only in diseases – it is often associated with pregnancy in women of reproductive age, sometimes with mental pathologies and conditions. Some women suffer from bouts of nausea and vomiting during menstruation.

The presence of vomiting in a woman of reproductive age without a cause may indicate the presence of pregnancy, so its likelihood should be assessed. Vomiting is one of the main signs of toxicosis that accompanies the first months of pregnancy. The state of toxicosis is associated with hormonal changes in the body during pregnancy, so a certain degree of malaise, of course, will be present.

Further, as the fetus develops and the uterus enlarges, the digestive tract organs are gradually compressed, food cannot move freely through the digestive tract, therefore, after eating, a woman may experience nausea followed by vomiting.

In addition, among women, more than among men, such mental illnesses as anorexia and bulimia are common – they are characterized by an eating disorder when a sick person for weight loss causes himself to vomit specifically to get rid of what he has eaten.

Given the peculiarities of the female psyche, it is the weak half of humanity that is more prone to the appearance of stress and nervous disorders. Against the background of strong emotional experiences, there is aversion and non-assimilation of food, when even after one sip of water a person vomits.

Vomiting in men

A similar condition is less commonly observed in the male half of the population, if there is no alcohol abuse. The problem with male vomiting is that usually men delay visiting a doctor until the last minute, and the more time passes, the more the disease or state of malaise can progress.

Vomiting characteristic of children

Non-temperature episodes of vomiting in a child are considered a conditional norm for some age periods, and do not always indicate the presence of diseases. So, for example, regurgitation in infants, vomiting in infants during teething and during the introduction of complementary foods is considered normal. The presence of psychogenic vomiting is acceptable – of course, the child’s condition in this case cannot be called normal, but it does not require immediate intervention by doctors.

However, life-threatening conditions cannot be ruled out. For example, in children under one year of age, vomiting can develop against the background of the presence of pyloric stenosis – obstruction or narrowing of the junction between the stomach and intestines, or with intestinal intussusception, when a section of the intestine is introduced into the adjacent loop of the intestine, and all the contents of the intestinal cavity cannot move freely along along it to the rectum for defecation.

For children over the age of one year and up to 12-14 years, the presence of acetonemic syndrome is possible: a set of symptoms when the child has an increased blood content of ketone bodies – acetone, acetoacetic and beta-hydroxybutyric acids. Due to an increase in their concentration in the blood plasma, vomiting may develop. The level of acetone in children may increase due to stress, endogenous disorders, and poisoning. At the same time, girls suffer from acetone vomiting more often than boys. The condition acquires the character of repeated and indomitable, after each attack there comes only a short-term relief. To stop the crisis, it is necessary to conduct a course of intravenous injections of an antiemetic nature, as well as to administer drugs to restore water and electrolyte balance. Secondary acetonemic syndrome can develop against the background of ketosis and ketacidosis with fever, after removal of the tonsils, with some infectious diseases.

In children under 3 years of age, there is a possibility of a foreign body entering the esophagus, as evidenced by repeated vomiting with white foam, without diarrhea and fever.

In school-age children and adolescents, vomiting can be psychogenic due to stress and anxiety.

Symptoms of vomiting and typical manifestations

How to determine the approach of vomiting? Even if it is not preceded by nausea, there are some typical signs that usually develop 2-3 minutes before the onset of the process – this is an increase in breathing, increased salivation, the appearance of lacrimation, involuntary swallowing movements and spastic contractions of the abdominal muscles. Such manifestations result in the expansion of the esophagus and the release of vomit. However, quite often nausea and vomiting occur together.

Nausea and vomiting

Nausea is the first and most obvious sign of the body preparing to expel vomit, and it precedes the state of vomiting in a significant number of cases.

The sensation appears due to irritation of the celiac and vagus nerves. From them, the nerve impulse enters the vomiting center in the brain, from where it receives a signal to start the process of the release of vomit. It should be noted that nausea is not always a systemic symptom along with vomiting – there are conditions when it is an independent manifestation of a disorder not associated with vomiting, for example, some brain diseases.

Nausea and vomiting occur at the same time:

1. With intestinal infections: in such cases, they are also accompanied by fever, pain in the abdomen. Such conditions are typical for the defeat of rotavirus infection, salmonellosis, dysentery.
2. With food poisoning: nausea and vomiting attacks develop a few hours after eating.
3. If the mucous tissues of the stomach lining are damaged in case of peptic ulcer or other pathologies: gastric juice, which irritates and damages the mucous membrane at the wound site, provokes belching, sharp pains in the abdomen, nausea and vomiting.
4. Due to the use of certain medications, such as aspirin, due to smoking or excessive alcohol consumption.
5. With gastroesophageal reflux disease: in this case, partially digested food from the stomach enters the esophagus along with gastric juice and begins to irritate the mucous wall of the esophagus, causing nausea and vomiting.
6. With irritation of specific areas of the brain, effects on the vestibular apparatus, with labyrinthitis, with “seasickness”.
7. As a result of increased intracranial pressure due to infectious processes, malignant tumors or injuries.
8. With sun or heat stroke: against the background of nausea and vomiting following it, accompanied by disorientation in space, clouding or loss of consciousness, weakness.
9. During migraine attacks: often a severe headache is accompanied by nausea and vomiting, which is aggravated by loud and sharp sounds, bright lights.
10. With some other diseases: hepatitis and cirrhosis of the liver, pancreatitis, cancer, diabetes, mental disorders.

The reason for the appearance of the tandem “nausea-vomiting” may be the intake of certain medications, as well as medical procedures associated with chemotherapy and radiation therapy.

In pregnant women, this set of symptoms is a variation of the norm in the first trimester of pregnancy.

Vomiting without diarrhea

The condition manifests itself as a side effect of taking medications, or as a reaction of the body to overeating. In some cases, the problem is indigestion. In fact, these conditions are not dangerous for a person with a single vomiting without relapse and any concomitant and alarming symptoms. So, for example, when overeating, eating too quickly and rapidly, eating foods that promote gas formation, as well as during sports training or physical exertion after a short period of time after eating, even a healthy person can vomit – so the body urgently gets rid of excess food, which he is not able to digest and assimilate.

Less often, vomiting without diarrhea is a concomitant sign of metabolic problems and endocrine pathologies, such as diabetes mellitus, or appears after consuming foods that are individual intolerant – it can be glucose, lactose, cereals.

In addition, the so-called cerebral vomiting passes without diarrhea, which can be a symptom of congenital pathologies, abnormalities in the functioning of the nervous system, trauma and infection of the brain. Psychogenic vomiting, that is, arising from stress factors, eating disorders, is usually not accompanied by diarrhea.

Other likely causes:

• a variety of inflammatory processes in the digestive organs, including colitis, gastritis, pancreatitis, cholecystitis;
• intestinal obstruction, most common for children under 1 year old;
• increased tone of the pylorus of the stomach – the valve that separates the stomach and intestines;
• pyloric stenosis: narrowing of the passage between the stomach and duodenum 12.

Vomiting accompanied by diarrhea

In both children and adults, a similar combination of symptoms can occur with:

• food poisoning, drug intoxication with antibiotics, cytostatics, laxatives, alcohol poisoning, spoiled food;
• irritation of the mucous tissues of the walls of the stomach with peptic ulcer and gastritis;
• inflammatory processes in the digestive organs: pancreatitis, cholecystitis, hepatitis;
• most intestinal infections;
• stress and neuroses.

It should be remembered that with vomiting and diarrhea, a person rapidly loses fluid from the body, he develops dehydration and electrolyte imbalance. If the symptoms last more than 2 days, and the stool has an unpleasant odor, impurities, black or too light color, you should definitely consult a doctor.

Vomiting without fever

A similar condition can be considered normal, for example, for babies who are teething, or when spitting up food debris. Regurgitation in babies is the result of overfeeding, improper positioning of the child during feeding. In addition, an infant may respond to complementary foods by vomiting if its digestive system is not yet ready for it.

Other causes in older children as well as adults include:

• violation of the patency of the digestive tract;
• CNS diseases;
• pathology of the endocrine system;
• psychogenic factor;
• weak intoxication against the background of poisoning, or the initial period of an acute reaction of the body to more severe poisoning;
• appendicitis in children is not always accompanied by fever.

Vomiting accompanied by fever

It is considered a particularly dangerous combination of symptoms for children under the age of one year, and is observed in some infectious diseases, for example, lesions of Staphylococcus aureus. However, most often, other manifestations of malaise join the high fever and vomiting.

Vomiting with fever and diarrhea

The combination is, in some way, classic for most human infectious diseases. When bacteria, viruses and protozoa enter the body, their active reproduction in target organs, toxic substances of their vital activity affect organs and systems. Such diseases, especially often affecting children, are also called “diseases of dirty hands” – these are dysentery, salmonellosis, giardiasis and some others.

In a small part of cases, a patient with such a combination of symptoms of malaise will not need medical assistance, for example, when infected with certain types of staphylococci, recovery occurs the very next day, provided that minimal assistance is provided at home.

However, most often with fever, diarrhea and vomiting, the patient needs medical attention. In addition to lesions and infection of the digestive organs, a complex of symptoms may occur due to an acute infectious condition of a different nature – pneumonia, otitis media, pharyngitis.

If a high temperature joins diarrhea and vomiting, then you should definitely seek medical help, since this “set” provokes dehydration, threatens the development of seizures, kidney failure and can be fatal.

Vomiting with pain and spasms

A condition characteristic of the development of the inflammatory process. If vomiting is accompanied by spasms and pain in the abdomen, this may indicate appendicitis, an acute attack of gastritis or cholecystitis, peptic ulcer.

In addition, the cause may be food poisoning, intestinal obstruction, which is especially likely with a combination of vomiting, constipation and paroxysmal pain.

The patient needs medical attention if he constantly has pain, spasms that turn into convulsions, as well as vomiting, with fever, palpitations, fever, loss of consciousness – such symptoms may indicate the development of peritonitis.

With vomiting and pain with spasms after a head injury in the abdomen, the victim should be immediately taken to a medical facility, as they may be manifestations of an injury to the internal organs of the abdominal cavity, or a concussion. Vomit with blood is a clinical sign of internal bleeding from damaged abdominal organs.

In rare cases, the problem may be of a psychogenic origin, for example, if the symptoms are observed in a child in the morning before going to kindergarten or school.

severe vomiting

The criterion for the intensity of episodes of vomiting is rather a subjective factor that makes it possible to assess a person’s individual response to a particular stimulus (infectious disease, poisoning). However, we must not forget about situations when it is severe vomiting that is an independent symptom of a pathological condition. For example, severe vomiting during pregnancy indicates its severe course.

Strong, intense and sudden vomiting attacks accompany some brain diseases – intracranial hypertension, hydrocephalus, meningitis, encephalitis, tissue hemorrhages, tumor growth.

The category of “indomitable vomiting” is called severe vomiting attacks that are repeated 12-20 (or more) times a day. This condition can last for a long time if you do not provide the patient with medical care and contributes to the rapid onset of dehydration.

The indomitable type of vomiting accompanies some severe intoxications, Reye’s syndrome and other disorders that cause cerebral edema.

Characteristics of the state of vomiting in infectious diseases

Vomiting attacks are a sign that often accompanies the course of infectious diseases in both children and adults. In some cases, the attack is single at the beginning of the development of the disease, and sometimes pursues a person during the entire period of the disease.

Erysipelas

It is an acute infectious disease, which is accompanied by a state of general intoxication of the body with inflammatory skin lesions. The causative agent of the disease is environmentally stable streptococcus, insensitive to low temperatures and drying. The route of transmission is contact-household, while the disease does not have a high contagiousness. The incubation period after 3-5 days is replaced by an acute, abrupt onset of the disease, with pronounced signs of severe intoxication, possibly persistent and prolonged vomiting, preceded by nausea, headache, fever, chills and weakness. After 10-12 hours, a person has signs of skin damage – redness, swelling, burning sensation, hyperemia, pain at the site of inflammation.

Cholera

Acute infectious disease, which is accompanied by prolonged and persistent vomiting. Because of this symptom, dehydration can develop in the body, as the patient loses a lot of fluid and supplies of essential electrolytes. During infection, the small intestine is affected, with copious watery stools and frequent vomit. The causative agent V. cholerae, (serogroups 01 and 0139), is a short, curved, mobile, aerobic, Gram-negative bacillus that produces enterotoxins, proteins that cause hypersecretion of an isotonic electrolyte solution through the mucosa of the small intestine. Cholera is transmitted by drinking water, seafood, or other foods contaminated with the feces of people with symptomatic or asymptomatic infection. Domestic cholera patients are at high risk of infection, which is likely to occur through shared sources of contaminated food and water. Person-to-person transmission is less likely because it requires large amounts of pathogen material.

The incubation period for cholera is 1-3 days. Cholera can occur subclinically, as a mild and uncomplicated episode of diarrhea, or as a rapid and potentially fatal disease.

Abrupt, painless, watery diarrhea and vomiting usually represent the initial symptoms. Explicit nausea is usually absent. Stool volume in adults can exceed 1 L/hour, but is usually much less. Often, stools consist of white, liquid fecal material (rice-water-like stools).

Then profuse vomiting joins after a while, erupts in a fountain and occurs without nausea and without pain in the abdomen. It is this sequence of diarrhea, and then the eruption of vomit, that clearly characterizes cholera and makes it possible to differentiate it from other diseases.

May be fatal due to severe dehydration.

Acute gastroenteritis

In the presence of this infectious disease, the development of symptoms occurs on the contrary – at first, vomiting appears sharply with nausea and abdominal pain, then diarrhea joins. Severe forms of the course suggest the presence of weakness, fever, manifestations of general intoxication. A mild type of gastroenteritis resolves without fever. Food toxic infections proceed similarly: they begin with an acute malaise, accompanied by a feeling of pain and heaviness in the abdomen, nausea, and weakness. During vomiting, previously eaten food comes out with mucus. After some time, diarrhea joins. Severe cases occur with a temperature of 38-39 ° C, a decrease in blood pressure.

Hemorrhagic fever with renal syndrome

Has a viral nature, is not an intestinal infection. It is characterized by the presence of toxicosis, a state of fever, as well as hemorrhages and bleeding, kidney damage. The carriers of the pathogen are mouse-like rodents. Infection occurs by contact or alimentary means, upon contact with sick rodents and their secretions.

The incubation period lasts about two weeks, after which an acute period begins, with pronounced manifestations of intoxication. There is a severe headache, muscle pain and insomnia, pain in the eyeballs, and even a decrease in visual acuity. The high temperature lasts for about a week or a little longer. The feeling of excitement in the affected person is gradually replaced by a state of apathy, lethargy, in some cases clouding of consciousness. The skin on the face, neck, upper parts of the body is pronounced hyperemic. The mucous membranes in the mouth are reddened, the vessels of the sclera are dilated.

Approximately 3-4 days after the onset of a sharp course, the condition worsens, intoxication increases and constant vomiting appears. The skin in the armpits and on the shoulder girdle is affected by a hemorrhagic rash with single or multiple small hemorrhages. In addition, the patient has bleeding, mainly from the nose, severe tachycardia, shortness of breath, congestion in the lungs. Due to retroperitoneal hemorrhages, he has pain in the abdomen, the liver and spleen periodically increase. When tapping, sharp pains in the abdomen with a transition to the lumbar zone are characteristic. The amount of urine excreted decreases, it becomes cloudy, as it contains a large amount of protein and blood.

Meningococcal lesions

Vomiting often accompanies meningitis of meningococcal origin. The onset is acute, with chills, fever, a state of excitement, motor and nervous restlessness. Without previous nausea, vomiting attacks, headache, increased auditory, visual and skin sensitivity appear.

Typical meningeal symptoms develop at the end of the first day – this is stiff neck, symptoms of Kernig and Brudzinsky. There is confusion, delirium, convulsions and agitation. After 2-5 days, an abundant rash of a hemorrhagic nature appears, in some cases, pinpoint hemorrhages of a stellate shape.

Encephalitis

If during meningitis inflammation affects only the membranes of the brain, then with the development of encephalitis, the lesion extends to its internal tissues. Encephalitis can be primary or secondary and is usually more severe than meningitis.

The primary type is tick-borne encephalitis, which is carried by ixodid ticks. These insects can infect humans directly. The incubation period lasts from 8 days to 3 weeks. The disease is accompanied by a high temperature up to 39-40 ° C, a sharp headache, redness of the conjunctiva, pharynx, neck and upper chest appear, the condition is accompanied by very intense vomiting, sometimes loss of consciousness and convulsions. Weakness passes quickly. The febrile form has a benign course, passes without vomiting, with headache, nausea, fever for about 3-6 days.

The meningeal form lasts about a month, accompanied by a state of general intoxication, including vomiting.

With meningoencephalitis, brain damage can be irreversible, and in 25% of cases death occurs. Vomiting is not always present. The patient has drowsiness, confusion, delirium, hallucinations, convulsions.

Secondary encephalitis develops as a result of local purulent inflammation of the brain tissue with the formation of an abscess. A brain abscess is usually accompanied by headaches, nausea, weakness, and fever. Periods of drowsiness are replaced by periods of excitement. The progression of the lesion is accompanied by hallucinations, delirium, depression of consciousness, as well as uncontrollable cerebral vomiting, attacks of paralysis, and, finally, the onset of coma.

Vomiting in acute surgical pathologies of the gastrointestinal tract

This symptom very often accompanies various types of acute surgical conditions, injuries of the digestive organs (acute abdomen condition). In this case, vomiting is usually combined with other, more characteristic signs. An acute abdomen accompanies acute surgical diseases of the abdominal organs, as well as lesions of extraperitoneal localization, for example, diseases of the stomach and duodenum, thrombosis of the mesenteric vessels, acute diseases of the gallbladder and pancreas, strangulated hernia, closed abdominal injuries, some gynecological diseases in women.

An acute abdomen typically manifests itself as a combination of sharply advancing pain in the abdominal cavity, vomiting, muscle tension in the anterior abdominal wall, sometimes intestinal obstruction is added to the combination of these symptoms.

Acute appendicitis

It is an inflammatory process in the process of the caecum. Against the background of diffuse pain in the abdomen, apathy and weakness appear, the temperature may rise. After some time, the pain descends to the right lower abdomen, gradually increases, intensifies with coughing, movement, deep inspiration.

Further, signs of intoxication join – nausea, vomiting, loosening of the stool.

Appendicular abscess

It develops as a limited purulent inflammation in the tissues of the peritoneum, which is formed due to inflammatory processes in the appendix, and, in fact, is a complication of acute appendicitis. Localized in the right iliac fossa or in the cavity of the small pelvis, in the space of Douglas.

Against the background of severe pain, vomiting appears. At the location of the abscess, a painful infiltrate is formed, tight and elastic on palpation. The condition is accompanied by an increase in temperature and a violation of the defecation process. With a limited lesion, an abscess can be localized in the intestinal lumen with subsequent self-healing. If pus enters the abdominal cavity, a person develops diffuse peritonitis, and if it enters the retroperitoneal space, phlegmon develops.

Peritonitis

Complicated surgical disease of the abdominal cavity, accompanied by a condition of an acute abdomen. It is an inflammatory process in the peritoneum, which is also characterized by a pronounced general reaction of the body to the entry of microbes into the sterile abdominal cavity and the resulting purulent intoxication. Most often, the condition develops a second time, as a complication in violation of the integrity of the hollow internal organs in the abdominal cavity, including:

• intestines;
• appendix;
• stomach;
• gallbladder.

Peritonitis is considered cryptogenic if its cause cannot be found even at autopsy.

It should be noted that the lesion is secondary, so its symptoms are often superimposed on the manifestations of the primary disease.

Peritonitis itself is characterized by abdominal pain, nausea, shortness of breath and weakness, increased thirst. Vomiting is accompanied by regurgitation and belching, is continuous and indomitable.

An external examination of the patient shows a sharpening of facial features, a change in the color of the skin of the face to an earthy-gray tint, and sunken eyes. He has a chest type of breathing, he subconsciously strives to immobilize the abdominal wall, and there is also bloating. Inhibition of reactions to external stimuli is noted while maintaining consciousness. Mucous tissues are dry, dry tongue is coated with a dense coating.

With palpation of the abdomen, it is possible to determine the source of peritonitis, since in this place the pain is most pronounced. The abdominal wall is painful and tense.

Sepsis

Blood poisoning is one of the most serious complications of surgical diseases and surgical intervention. Occurs under the condition of reduced general immunity, characterized by the progressive spread of any type of infection throughout the body.

As a complication of surgical pathologies, it is usually the result of a breakthrough of pus from a festering wound, as well as from a purulent boil or purulent thrombophlebitis.

Due to the massive and extensive intoxication of the body, the patient develops vomiting, which occurs after nausea, has a long character, but does not bring him relief. As a result of poisoning of the nervous system caused by the ingress of toxic waste products and the decay of pathogenic microorganisms, a person is tormented by headaches, insomnia, confusion, he has depression of nervous reactions, in severe cases – loss of consciousness.

The high temperature is not stable, fluctuates at different times of the day and reaches a maximum of 39-40 ° C, accompanied by chills and intense sweating. Due to constant vomiting and severe toxic damage, body weight decreases, deterioration in well-being progresses sharply even with treatment.

Vascular disorders in this state are sometimes manifested by a hemorrhagic rash over the body, more often by a sharp increase in heart rate, low blood pressure, a decrease in pulse filling, depression of cardiac activity, the formation of bedsores, thrombosis, edema, thrombophlebitis.

The functioning of parenchymal organs worsens, the excretory and detoxifying functions of the kidneys and liver decrease, jaundice, manifestations of hepatitis and splenomegaly may develop. The patient loses his appetite, and the tongue becomes dry and furred. All this happens against the background of constant and continuous septic diarrhea.

Local manifestations of sepsis are determined in the immediate wound foci, with characteristic symptoms of the development of a purulent process.

Rupture of the esophagus

Very often it occurs in the presence of vomiting, in most cases it leads to death, if medical attention is not provided immediately. Perforation occurs as a result of tumor and inflammatory processes, as well as due to the ingress of sharp foreign objects in food (fish bones, pieces of glass or plastic, which are sometimes found in purchased food products).

Without nausea, a person is tormented by persistent vomiting, as well as intense pain behind the sternum, in the lower third of the neck – the sensation intensifies when swallowing. Body temperature rises, subcutaneous emphysema is formed, tachycardia is accompanied by a sharp drop in blood pressure.

If the thoracic esophagus is damaged, the patient develops signs of purulent inflammation of the mediastinal tissue, or purulent pleurisy.

Bowel obstruction

Occurs against the background of invagination of intestinal loops. In addition, mechanical obstruction can be the result of intestinal volvulus, adhesive disease, incarcerated hernia, foreign bodies, or stagnation of feces that make their evacuation difficult. Worms or tumor formations can also interfere with the passage of intestinal contents.

Dynamic obstruction, as a rule, is caused by paresis of the motor function of the intestine and impaired peristalsis.

Vomiting with mechanical obstruction is accompanied by a characteristic fecal odor, and vomit is similar in shape and consistency to feces. The condition is accompanied by bloating, spastic pain, lack of feces from the rectum. Gradually, the signs of dehydration and intoxication with the products of one’s own vital activity increase.

Symptoms of dynamic obstruction are similar in manifestation and intensity, the difference is only in the cause of the appearance.

First aid for vomiting: how to alleviate the patient’s condition

First of all, the patient should, if possible, take a sitting position. When vomiting in an unconscious state, it is necessary to lay the patient in such a way as to avoid choking with vomit.

If necessary, support the shoulders and head of a person, substitute a container for vomit, wipe the mouth, and clean the nasal passages. Nearby should be clean water for rinsing the mouth.

If the victim cannot be seated, he is placed on a flat surface, his head is turned to the side to prevent vomit from entering the respiratory tract. A tray or basin for vomiting is attached to the corner of the mouth, or a towel can be placed. The mouth is wiped with a towel after attacks, and the oral cavity is cleaned with a gauze swab, or any clean cloth.

Depending on whether the cause of the development of the ailment is known, and what it is, further assistance actions will differ. Affected by harmful chemicals, people with poor-quality food poisoning and alcohol need to wash the stomach. For patients with vomiting attacks of reflex or central origin, help will be to put the person in a calm position, and give him drugs to stop the attack, for example, validol or mint drops, if the doctor prescribes – antipsychotic medications.

Bloody vomiting is a very dangerous condition for the victim. It is necessary to lay him on his side, take all necessary measures to immobilize and transport the person to the nearest medical facility. A cold compress or ice pack is applied to the epigastric area of ​​the abdomen. It is strictly forbidden in this case to give the patient to drink, eat or take any medicine.

If vomiting is caused by unknown causes, or if the cause is known and is chemical poisoning, or if the vomit has an atypical color and structure, they are collected in a sealed container for transfer to the doctor for examination. You need to store them in a dark, cool place until handed over to the doctor.

In case of poisoning with poor-quality food or alcohol, vomiting cannot be stopped, since in this way the body gets rid of toxins. Treatment in this case consists in following a diet, restoring the lost fluid.

Is it possible to eat during and immediately after vomiting? Despite a significant loss of strength and nutrients, it is not recommended to eat with vomiting, as well as in the first few hours after it stops. If possible, it is better to refuse food, and use only water, absorbent drugs (Enterosgel, Smecta), and means to restore water and electrolyte balance.

You need to drink a lot and often, in small doses. Mineral water without gas, low-fat vegetable broth or sweet, weak tea, always warm, are suitable for drinking.

It is forbidden to drink caffeine-containing foods, milk, milk and sour-milk drinks, alcohol, juices, take drugs with aspirin and ibuprofen.

If the attacks and the urge to vomit are over, and did not resume during the night, you can start eating the next morning. The following products are allowed:

• cereal porridge on the water;
• vegetables and fruits stewed or baked;
• boiled lean meat;
• white bread crumbs;
• zoological cookies.

In order not to provoke new attacks, you need to give up fried, fatty foods, canned food, pickled snacks, raw vegetables and fruits for the first two to three days after vomiting has passed.

How to treat vomiting at home? There are various recipes for folk remedies to normalize a person’s condition. It should be noted that the very cause of vomiting may not always be amenable to unqualified home treatment, but it can be removed or somewhat alleviated by various home recipes.

Peppermint infusion or peppermint tea is a well-known remedy for vomiting. Peppermint has a calming effect and is effective for psychogenic vomiting. To prepare the product, a teaspoon of dried or fresh mint is poured into a glass of boiling water and left to infuse for 30 minutes. The drink is drunk 3 times a day, in small sips. Mint tincture, which is brewed for 6 hours, is taken 1 tablespoon 3 times a day. The tool has a restoring and soothing effect on the walls of the gastric mucosa.

Peppermint drops are taken for stress and accompanying vomiting – just add 15 drops to 1 tablespoon of clean water, let the patient drink the liquid and take him to fresh air.

For treatment, dill seeds are also used – 1 teaspoon is poured into a glass of boiling water, left to brew, and after the infusion has cooled, they drink it like tea.

Dried maple leaves are used to prepare an antiemetic decoction that helps to normalize the digestive tract. To do this, pour 1 tablespoon of crushed dried leaves with boiling water and prepare a decoction, keep in a water bath for half an hour, without boiling. The cooled and filtered broth is taken 50 milliliters 3 times a day.

Potato juice has a known anti-inflammatory effect on the mucous walls of the digestive organs, promotes the healing of ulcers and reduces attacks of acute gastritis. To obtain it, raw peeled potatoes are grated, the resulting cake is squeezed, and the juice is poured into a glass container. Half a tablespoon of potato juice is drunk before meals three times a day.

Dried asparagus powder is sold in pharmacies and is also used as an antiemetic. To reduce the intensity of vomiting, as well as to calm the walls of the stomach, 1 gram of the powder is dissolved in a glass of warm water and drunk immediately after stirring.

Vomiting is an unpleasant condition associated with a violation of the normal process of digestion, when the food bolus, the contents of the stomach or gall bladder enter the esophagus and exit through the oral cavity and nasal passages.

It cannot be considered as an independent disease, but only as a symptom of other problems, which has a certain diagnostic value. The root cause of the appearance can be a variety of factors, including diseases of the brain, pathologies of the digestive organs, a psychosomatic element, so the treatment of vomiting is possible only after determining the etiology of the condition.

In psychogenic vomiting, establishing a trusting relationship with the patient implies an understanding of the uncomfortable sensations that he experiences, and a joint effort to alleviate the symptoms, whatever their cause. Comments such as “you’re fine” or “it’s an emotional problem” should be avoided. A short trial course of symptomatic antiemetic therapy can be done. With long-term observation of the patient, regular follow-up visits to the doctor contribute to the resolution of the underlying problem.

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