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Vomiting in a child without fever and diarrhea is quite common. Naturally, such a condition causes serious anxiety for parents, since often they cannot find an explanation for what is happening. Vomiting for no apparent reason can happen to both toddlers and older children.
It should be noted that such a condition does not always characterize any serious disease or disorder in the child’s body. However, only a doctor can determine this.
The absence of temperature in a child against the background of vomiting should not lull the vigilance of parents. After all, nausea and vomiting are not signs of health, and normally they do not occur. It is worth remembering that vomiting in itself is not a disease – it is always a symptom. Therefore, every adult should be guided in what can provoke a similar condition in a child.
Causes of vomiting without fever and diarrhea
Causes of vomiting without fever and diarrhea in a child may be as follows:
Gastroesophageal reflux. This condition is the backflow of gastric contents into the esophagus. In this case, the vomit will not be plentiful, often a sour smell comes from them. Vomiting will repeat after each meal. Reflux is accompanied by the following symptoms: the child is restless, poorly gaining weight, often hiccups, asthma attacks are possible. Also, children with gastroesophageal reflux are characterized by salivation and morning cough. If the pathology is not eliminated in time, then heartburn, belching, bouts of shortness of breath, night snoring, dysphagia will join in the future, tooth enamel will suffer.
Parents should remember that in children under three months old, reflux is a normal physiological phenomenon and is often accompanied by vomiting and regurgitation. This is due to the underdevelopment of the distal esophagus and the small volume of the stomach. Over time, regurgitation will occur less and less, and then it should stop altogether.
However, gastroesophageal reflux can cause serious pathologies, including: failure of the gastroesophageal junction, stomach diseases, inability of the esophagus to cleanse itself.
Pylorospasm or pyloric spasm. Pylorospasm is a disease that makes itself felt by spasm of the pyloric part of the stomach, which leads to problems with emptying it. As a result, the child periodically vomits. It is not abundant and is observed from the first days of life. It was found that girls are more likely to suffer from the disease. With pylorospasm, children gain weight worse, are more restless, and problems with stools are rare.
Pyloric stenosis. Pyloric stenosis is a condition that refers to congenital malformations of the muscular layer of the stomach and manifests itself in profuse vomiting. It occurs 20 minutes after feeding the baby. The vomit does not contain impurities and consists of undigested breast milk. Manifests a pathological condition as early as 2-3 days of a baby’s life. As with pylorospasm, female infants are more likely to suffer from pyloric stenosis. In addition to vomiting, there is a sinking of the fontanel and weight loss, which is very dangerous for infants.
Intestinal intussusception. Intestinal invagination is a variant of intestinal obstruction and consists in the introduction of a section of the intestine into the lumen of an adjacent segment. The disease occurs in 90% of cases in infants, it is detected mainly at 5-7 months, although it can also develop in older children. Most often, male infants suffer from intussusception of the intestine.
The causes of intestinal intussusception are past viral intestinal infections (most often rotavirus and adenovirus infection), hereditary predisposition, improper introduction of complementary foods, colitis, tumors, intestinal allergies, etc.
In addition to vomiting, this pathological condition is manifested by severe paroxysmal pain. Children tuck their legs up to their stomachs, crying and screaming. The skin turns pale, cold sweat appears. Babies refuse nipples and breasts. Attacks begin and end unexpectedly and last about five minutes.
As for the vomit, they contain impurities of bile. Vomiting occurs shortly after the pain attack. There is no diarrhea, but the stool may be streaked with blood and have the consistency of raspberry jelly.
Alimentary gastritis. Gastritis is an inflammation of the surface layer of the stomach. Children during an exacerbation of the disease experience severe pain in the epigastric region, nausea and vomiting, dry mouth. The tongue is covered with a white coating, salivation intensifies, belching and hiccups appear. Without vomiting and fever, it is alimentary gastritis that occurs in children. Its causes lie in nutrition that is inappropriate for the age of the child. Most often, the pathology develops when eating spicy, fried, fatty, very hot or coarse food. Overeating is dangerous. As a result, the food that has entered the stomach is not completely broken down and irritates the intestinal mucosa. The digestion process slows down, inflammation occurs, which provokes vomiting.
Another most dangerous form of gastritis that provokes severe vomiting with blood impurities is gastritis against the background of chemical burns (when swallowing acids, alkalis and other caustic, toxic substances). This condition requires emergency medical care, as it poses a direct threat to the life of the child.
Acute gastroduodenitis. Acute gastroduodenitis is an inflammation of the distal stomach and duodenum. Symptoms of the disease are similar to those of alimentary gastritis. But in addition to vomiting and nausea, bitter belching, headaches, and sleep disturbances are added. Body temperature usually remains normal. As for the stool, it is unstable – prolonged constipation will be replaced by diarrhea. In children with gastroduodenitis, appetite is noticeably worse, and therefore they lose weight. It has been established that duodenitis in childhood is often accompanied by vegetative-vascular dystonia.
Diseases of the pancreas. The most common disease of the pancreas in children, which provokes severe vomiting without fever and without diarrhea, is pancreatitis. The child has repeated vomiting, severe pain in the epigastric region, loss of appetite, flatulence (diarrhea does not always develop). As for body temperature, as a rule, it either remains within the normal range or rises to 37 ° C. The skin becomes paler than usual, a white coating appears on the tongue.
Separately, it should be said about the nature of vomiting in acute pancreatitis. If at first it consists of gastric contents, then later the contents of the duodenum (bile) appear in the vomit. The volume of vomiting is most often significant, which threatens to dehydrate the body.
The causes of pancreatitis in childhood are diverse. Acute inflammation of the pancreas can develop when there is a violation of the diet, when overeating, when carbonated drinks, fast food, spicy dishes, chips, etc. are included in the menu. Pancreatitis often develops against the background of a toxic-allergic reaction. An allergen can be not only food, but also medicines. Sometimes pancreatitis is a consequence of other diseases of the gastrointestinal tract and the body as a whole.
Diseases of the gallbladder. Biliary dyskinesia in children is the most common pathology of the gallbladder, leading to vomiting. In addition, diseases such as cholecystitis can provoke it. Parents should take into account that pathologies such as cholangitis and cholelithiasis are always accompanied by vomiting without diarrhea, but in the acute stage, the child’s body temperature will increase.
Biliary dyskinesia is characterized by symptoms such as: pain in the right hypochondrium, vomiting, bitterness in the mouth, nausea, loss of appetite, general weakness, headaches. Loose stools may occur, but severe diarrhea is usually absent.
Vomiting is an indispensable companion of a disease such as cholecystitis (inflammation of the gallbladder). In addition, the child complains of decreased appetite, abdominal pain and constipation. As for body temperature, it will stay at subfebrile levels for a long time. Provoke cholecystitis pathogenic microorganisms (various bacteria) and parasites. It is possible to develop inflammation against the background of existing diseases of the gastrointestinal tract (duodenitis, gastritis, appendicitis), against the background of appendicitis, scarlet fever, influenza, etc. Naturally, the child’s malnutrition affects the state of the gallbladder in a negative way.
Diseases of the central nervous system. Diseases that affect the central nervous system are often accompanied by persistent vomiting, which is not associated with food intake. As a rule, cerebral vomiting occurs at the peak of the headache and does not bring relief to the child.
The most common CNS diseases in infancy, accompanied by vomiting, are cerebral ischemia and hydrocephalus. In children older than a year, these are brain tumors and increased intracranial pressure. In pathologies of the central nervous system, vomiting is rarely the only symptom of the disease. Most often, there are signs such as: headaches, impaired coordination, visual disturbances, dizziness. Other neurological disorders that provoke vomiting include meningitis, encephalitis, and epilepsy.
The entry of a foreign body into the digestive tract. Swallowing a foreign body provokes vomiting a few minutes after the incident. The nature of the vomit depends on what is in the stomach of the child. If there is damage to the walls of the esophagus or the mucous membrane of the stomach itself, then blood will be present in the vomit. Other symptoms indicating that a foreign body has entered the digestive organs are: difficulty in breathing, excessive salivation, increased anxiety of the child, severe cough.
Food poisoning, indigestion. Vomiting with food poisoning is a fairly common occurrence. In this case, there is no increase in body temperature, but diarrhea is possible. Although mild intoxication often disappears with a single vomiting and without any changes in the stool. For example, when it comes to indigestion, overeating or taking the wrong medicine.
Craniocerebral injury. Most often, vomiting is accompanied by concussion and bruising. In addition, amnesia, headaches, weakness, sweating, sleep disturbances are possible.
acetone crisis. The acetone crisis is a whole complex of symptoms, which is caused by the accumulation of ketone bodies in the child’s blood. Vomiting during a crisis is indomitable, repeated. It occurs as a reaction to an attempt to water or feed a child. Against the background of vomiting, symptoms of poisoning and dehydration rapidly increase. The skin becomes pale, a blush appears on the baby’s cheeks, and muscle weakness increases. The causes of the crisis are varied, they can be hidden in the child’s malnutrition (the predominance of dishes rich in ketogenic amino acids and fatty acids in the menu), in liver enzymatic insufficiency, and in metabolic features.
Psychogenic vomiting. Psychogenic vomiting occurs in a child after the age of three years. Provoking factors are: severe anxiety, fear, overexcitation and other emotional upheavals. Sometimes psychogenic vomiting is a way to attract attention, which is typical for children deprived of parental care.
Feeding introduction. Vomiting on the introduction of complementary foods is most often single. It may be accompanied by bloating and rumbling in the abdomen, flatulence. Sometimes diarrhea develops.
Acute appendicitis. Vomiting often occurs with acute appendicitis, as the initial symptom of this pathology. In parallel, there are pains in the abdomen (their localization is different), the pulse quickens. After a few hours, the body temperature will rise, other dyspeptic disorders will occur.
Vomiting without fever and diarrhea: what to do?
If a child has vomiting, which is not accompanied by fever and diarrhea, then parents should be alert and show maximum attention to their baby. In the event that vomiting recurs, and its cause cannot be determined, qualified medical assistance is needed.
Parents themselves can take the following steps:
Provide the child with rest and bed rest. It is important to ensure that his head remains elevated and is on a hill. This will prevent vomit from entering the respiratory system.
Do not try to feed your baby if he is vomiting.
When vomiting occurs during a meal, you need to stop this process and hold the child in an upright position for some time.
If the attacks have stopped, then liquid food can be offered no earlier than two hours later.
After the end of vomiting, you need to remove all food debris from the mouth. If the child is an adult, then he can rinse his mouth on his own.
To prevent dehydration, it is necessary to offer the child to drink water in small sips. It can be alternated with drugs for rehydration (Regidron).
You should not give your child any antiemetics on their own. You should immediately call an ambulance if there are streaks of blood in the vomit, or they are brown. Also, the arrival of specialists is mandatory when the child has an increase in body temperature, with abdominal pain or constipation, with loss of consciousness.
How to treat vomiting in a child without fever?
Treating vomiting in a child without fever should be based on the cause that provoked this symptom:
Treatment of gastroesophageal reflux. If the parent believes that the child is spitting up more than expected, or this continues for a long time, then the attention of the pediatrician and pediatric gastroenterologist should definitely be paid to this fact. Most often, it is possible to get rid of the problem by switching to a thicker food, adjusting the frequency and volume of feeding.
If the problem lies deeper, then a medical correction of gastroesophageal reflux is prescribed with the use of drugs that block the production of hydrochloric acid. It is possible to take antacids, adsorbents, as drugs that suppress gastric secretion. To stimulate the motor-evacuation function of the digestive tract, it is recommended to take prokinetics.
Treatment of pyloric spasm. Spasm of the pylorus is corrected by prescribing a special diet to the child (alkaline drink, thick cereals) and antispasmodic drugs. The amount of food that the child receives should correspond to his age, it is recommended to offer children alkaline mineral water before feeding. After feeding, do not put the child to bed, you need to keep him in an upright position for at least an hour.
Physiotherapeutic treatment is effective, which includes electrophoresis with novocaine on the epigastric region, applications of ozokerite and paraffin. The prognosis for recovery is most often favorable, and vomiting stops from the first days of treatment. In severe cases, surgical intervention is indicated.
Treatment of gastritis in children. A gastroenterologist is involved in the detection and treatment of gastritis. Children in the acute period are shown bed rest, refusal of food for up to 12 hours. If necessary, perform gastric lavage. The child should drink plenty of fluids, but in small portions, so as not to provoke vomiting.
After 12 hours, the child is offered nutrition appropriate for age, most often low-fat broths, jelly, mucous porridges. Gradually, the menu is expanded, the table becomes ordinary, but fried, spicy, smoked dishes, as well as coarse food, are banned. It is important that a child with a history of gastritis be registered with a pediatric gastroenterologist for at least 3 years. With adequate and timely treatment, the prognosis for recovery is favorable.
Treatment of gastroduodenitis. The basic treatment of gastroduodenitis in childhood is diet. Meals should be fractional, the number of meals per day – at least five. Food is either boiled or steamed. Meat and strong vegetable broths, fatty fish dishes, mushrooms, as well as all canned and smoked foods are strictly prohibited. During an exacerbation of the disease, the child is shown bed rest with complete physical and psychological rest.
Treatment of acute pancreatitis. During the acute phase of the disease, the child must be in a medical facility. He is shown strict bed rest and fasting for 12 hours. At this time, a glucose solution is injected parenterally and alkaline mineral water is given. Depending on the patient’s condition, it is possible to introduce proteolytic enzymes, rheopolyglucin, plasma. Also, the child is prescribed painkillers and antispasmodics, pancreatic enzyme preparations, antisecretory drugs. After the elimination of the acute phase of the disease, the child is offered food according to a special dietary scheme.
Treatment of diseases of the gallbladder. Biliary dyskinesia is treated with a diet that restricts fatty, fried, sweet, spicy foods. Fractional nutrition is shown, the inclusion of fermented milk drinks in the diet. Depending on the cause of the disease, cholespasmolytics, sedatives, and choleretic drugs may be prescribed. Such physiotherapeutic methods as Bernard currents, galvanization, electrophoresis are effective.
Treatment of CNS diseases. Treatment of pathologies of the central nervous system is a very difficult task. As a rule, therapy is in the competence of a neurologist. It, depending on the cause, is carried out either in a hospital or at home. A drug correction is prescribed with the use of drugs that improve cerebral circulation, nootropics, etc. Brain tumors and severe hydrocephalus are treated with surgical intervention.
Ingestion of a foreign body. Ingestion of a foreign body by a child requires immediate assistance from adults. Expectant tactics can be taken only if it is reliably known what exactly the child swallowed, if this object is small and will not harm him. However, it is important to track the exit of a foreign body through the intestines. In all other cases, you must call an ambulance. It is possible that surgery will be required. It should be noted that no matter how safe the situation with swallowing a foreign body may seem to parents, consultation with a specialist is required.
Treatment of traumatic brain injury. After a child has received a traumatic brain injury, an examination by a specialist should be immediate. Assessment of the child’s condition, even if he did not lose consciousness, should be carried out only by a doctor. With a mild traumatic brain injury, which includes only a concussion, the patient is shown bed rest, psycho-emotional rest, applying cold to the head, oxygen inhalation. For the prevention of cerebral edema, diuretics, sedatives, nootropics and vitamins are prescribed.
Indigestion and poisoning. With mild indigestion or food poisoning, it is necessary to provide the child with plenty of fluids. Reception of enterosorbents (smecta, activated carbon). Refrain from food for 6-12 hours. If vomiting stops, then for the first few days the child is recommended a sparing diet (sour-milk products, mucous soups, crackers, etc.).
If vomiting becomes persistent and diarrhea joins, then it is necessary to seek medical help, prescribe drugs for rehydration, polyenzymes. As for antimicrobial therapy, it is carried out under strict medical supervision.
Treatment of acetonemic syndrome. Treatment of acetone crisis is carried out in a hospital. The child is shown a strict diet with a maximum restriction of fats, with plenty of portioned drinking. Enemas with sodium bicarbonate solution, oral rehydration with alkaline mineral water are prescribed. With persistent vomiting, antiemetics, antispasmodics, and sedatives are administered. Children with acetonemic syndrome are registered with a pediatric endocrinologist.
If a child has psychogenic vomiting, then he needs the help of a psychotherapist, who must find out the causes of its occurrence.
When vomiting occurs in response to the introduction of a new product, then it should be abandoned for a while. Perhaps, after a few months, the same product will no longer cause such a reaction, since the child’s digestive system will become more perfect.
Treatment of pyloric stenosis, intussusception of the intestine, acute appendicitis and congenital diverticulum of the esophagus is only surgical.