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What to do if you start vomiting. Vomiting is the logical conclusion of nausea

Is there anything worse than vomiting? This is always an unpleasant phenomenon, be it pregnancy, food poisoning, stomach disease, intestinal disease, or even a hangover.

Besides the horror, vomiting can also cause other unpleasant symptoms such as fatigue and dehydration. In this condition, the stomach becomes very sensitive and weak, it is necessary to take certain measures so that the body can recover.

Simple steps

There are quite simple tips that will help you feel much better:

  • Eliminate any remaining vomiting by taking a warm bath.
  • clean the nasal cavity to avoid the development of infection.
  • rinse to remove the taste.
  • drink plenty of fluids.

What to do next?

  1. The first thing to do after vomiting is to remove any remaining fluid from the body. This will help reduce nausea and help the body recover.
  2. It is necessary to remove the remains of superficial vomit and clear the nasal sinuses, which may also be clogged with contents.
  3. Before leaving the bath, blow your nose well. The steam will clear your nose and it will be quite easy to do. To do this, keep the scarf quite close; if something goes wrong, you can always tear it out.
  4. Rinse your mouth to eliminate odor. You should avoid brushing your teeth right away because it may irritate your stomach.
  5. If the nausea is not intense, then take care of hydrating the body. Because vomiting causes the body to lose a lot of water and becomes easily dehydrated. To prevent nausea,... First, you should start with a tablespoon of water, and then increase the dose every half hour.
  6. Avoid strong odors, which can make you feel nauseous again. If you need to cook something, ask someone else to do it. Stay away from products with strong odors.

What can you eat?

If you have a desire to eat something, then there are some foods that are suitable for this condition. You need to start with small portions so as not to irritate your stomach.

Proven foods that prevent vomiting:

  • pasta without oil;
  • dry bread;
  • water;
  • white rice;
  • potato;
  • banana, only an hour after vomiting;
  • soups with light ingredients such as rice and boiled potatoes;
  • tinctures of chamomile or cumin.

After eating, you should remain seated or slightly reclined for at least an hour. This position will allow the stomach to digest food more easily.

If possible, you can go out into the fresh air. Also, it would be a good idea to watch TV or a movie, this can distract the brain from the urge to vomit.

Video: diet after poisoning

What to avoid

Since the stomach becomes quite sensitive after vomiting, it is recommended to avoid the following foods:

  • spicy products;
  • fried and fatty foods;
  • very salty food;
  • conservation;
  • dairy products;
  • caffeine;
  • alcohol;
  • raw fruits and vegetables.

These foods should be avoided until the person feels better. If you eat raw fruits and vegetables, repeated vomiting may occur because fiber can interfere with digestion and irritate the stomach.

Will it be difficult to sleep?

In cases where nausea is due to food poisoning, one of the recommendations is rest and sleep. In this case, there is no need to worry either.

However, if vomiting is frequent and caused by reflux, it is important to be aware of possible choking or airway blockage. In such cases, be sure to consult your doctor.

Dangers of the condition

When is vomiting dangerous? If your condition worsens, be sure to consult a doctor. You should seek medical help if:

  • vomits blood;
  • 3 times a day or more;
  • nausea within 48 hours;
  • feeling weak;
  • fever;
  • stomach pain;
  • unable to urinate for the last 8 hours or more;
  • incontinence of liquid or food in the stomach.

Vomit- this is a reflex eruption of the contents of the stomach (sometimes the duodenum) through the mouth (rarely through the nose).

Nausea- this is a painful feeling of discomfort in the upper abdomen, chest, oral cavity and pharynx, often precedes vomiting.

In order to draw any conclusions about the reasons that caused vomiting, it is advisable to examine the vomit after each occurrence. In this case, you need to pay attention to the following signs:

  • amount of vomit;
  • their consistency;
  • color;
  • smell;
  • the presence of food residues and their composition;

as well as for the presence of pathological impurities:

  • blood;
  • mucus;
  • pus;
  • worms;
  • large amounts of bile.

Depending on the nature of the vomit, the following types of vomit are distinguished:

  • freshly eaten food;
  • congestive vomiting (of food eaten long ago);
  • gall;
  • bloody;
  • feces;
  • purulent and others.

Reasons

Undigested food may indicate

  • complete absence of hydrochloric acid and enzymes in the gastric juice (gastric achylia),
  • violation of esophageal peristalsis or other lesions,
  • intestinal infection.

When vomiting pure gastric juice of high acidity, one can assume that there is damage to the pancreas, characterized by increased secretion of gastrin.

  • A putrid odor can be observed with decaying stomach cancer,
  • smell of alcohol - with alcohol poisoning,
  • the smell of acetone - about acetonemic vomiting (a symptom that develops as a result of metabolic failure in children; ketone bodies and acetone accumulate in the blood).

Bloody vomiting (hematemesis) always indicates bleeding in the gastrointestinal tract and requires emergency medical attention and identification of the causes.

The presence of slightly changed blood (liquid or in the form of loose clots) indicates a short stay of blood in the stomach (for example, during food bleeding), or achylia.

With a stomach or duodenal ulcer, vomit takes on the color and appearance of coffee grounds. Typically, such vomiting is accompanied by melena (black, semi-liquid stool with a characteristic unpleasant odor).

An abundance of bile in the vomit is observed

  • with narrowing of the duodenum,
  • reflux gastritis,
  • with biliary colic,
  • for complications after gastric surgery.

Laboratory diagnostics

If the cause of vomiting cannot be determined, then cytological, chemical examination and examination for the presence of intestinal infections are carried out.

A blood test can help identify many causes of nausea and vomiting, for example if inflammation of the appendicitis, cystitis of the liver and gallbladder, myocardial infarction, neuroborreliosis, food intolerance or metabolic disorders due to diabetes are suspected.

Urinalysis is indicated mainly for kidney diseases (such as renal failure, cystitis, renal colic).

A bowel examination is performed primarily when nausea and vomiting are associated with infectious diarrhea (eg, Salmonella infection).

(H2 breath test) can prove incompatibility with milk sugar (lactose), fructose (fructose).

The infection usually develops in two stages:

first manifests as flu-like symptoms and fever, headaches and muscle aches;

after a short-term improvement, fever, headache, nausea, vomiting and, possibly, paralysis and disturbances of consciousness reappear.

  • Neuroborreliosis: Lyme disease is a bacterial infection caused by Borrelia, which is transmitted by ticks. In five to ten percent of patients, the infection spreads to the nervous system months or years after the tick bite and signs of the disease are nausea and vomiting.
  • Brain contusion: If nausea and vomiting occur immediately after a head injury, but the patient remains fully conscious, a brain contusion is likely present. If vomiting persists, call an ambulance!
  • Concussion/traumatic brain injury: If nausea and vomiting occur immediately after a head injury and the patient then loses consciousness, the cause is a concussion (mild traumatic brain injury) or a higher level traumatic brain injury. You should call an emergency doctor immediately!
  • Brain tumor: Nausea and vomiting that cannot be explained by gastrointestinal illness, and most often in the early morning and on an empty stomach, may indicate a brain tumor. Another possible warning symptom is new headaches that get worse over time. They are especially noticeable at night and early in the morning, but can occur spontaneously during the day.
  • Motion sickness (travel sickness): On a ship, bus, car or train, it can disrupt the balance of the vestibular system, causing nausea and possibly vomiting.
  • Meniere's disease: Patients constantly experience attacks of sudden dizziness (nausea and vomiting), tinnitus and acute hearing loss.

Other reasons

  • Acute glaucoma: accompanied by nausea, vomiting, and intolerable, one-sided disease of the forehead and eyes. The affected eye becomes red and hard, and vision is blurred. Due to the risk of blindness, consult a doctor or the nearest eye clinic immediately!
  • For diabetes (diabetic ketoacidosis): warning signs include nausea, vomiting and cramping pain in the upper abdomen. Other symptoms of this dangerous metabolic disorder may include extreme thirst and fruity breath. Call an ambulance doctor immediately!
  • Nausea and vomiting during pregnancy: Nausea and/or morning vomiting, loss of appetite, and reluctance to eat certain foods appear in 70-90 percent of early pregnancy. Doctors talk about complications. Vomiting does not depend on food intake, does not occur at rest and is not associated with any other disease. It usually begins in the sixth to eighth week and lasts until the 12th week of pregnancy. Women lose a lot of fluid, electrolytes, and weight, so treatment is necessary.
  • Fear, anxiety, pain, disgust: some people react to these factors with nausea and perhaps even vomiting.
  • Side effects of medications: Nausea and vomiting can occur as an undesirable effect of various medications, such as pills, antibiotics.

What to do if you vomit?

If nausea and vomiting are accompanied by symptoms of a medical condition that requires treatment, you should consult a doctor.

But what should you do about nausea and vomiting in harmless cases, such as in the car, fever, stomach flu or during pregnancy? In such situations, you can take steps to alleviate the condition:

  • you should refrain from eating for at least one day or at least limit the amount;
  • drink sweet tea with a small amount of wheat crackers;
  • eliminate alcohol, caffeine, raw, fatty foods, and hot spices for a while.

If nausea is accompanied by vomiting, you need to drink plenty of fluids (at least two to three liters per day).

You can purchase special formulations at the pharmacy that will restore lost electrolytes and prevent fluid loss from the body.

  • For nausea during pregnancy It is best to have breakfast in bed in the morning.
  • Food should be light.
  • Eat small carbohydrate-rich meals throughout the day.
  • Avoid spicy and fatty foods, coffee, black tea, and carbonated drinks.

Nausea and vomiting represent two similar, often accompanying protective phenomena, which are provided by nature as reflexes that are not amenable to conscious control. Nausea and vomiting are designed to cleanse the digestive tract of substances that are harmful, according to the body, despite the fact that these substances may not enter the bloodstream from the intestines. So, for example, there are examples in medical practice that a person feels sick and vomits from certain specific smells, tastes and even colors. Nausea and vomiting can be symptoms of a variety of diseases.

Externally, vomiting is an uncontrolled eruption of stomach contents through the mouth, and in some cases through the nose. Absolutely all reflexes, which also include vomiting, are pathways that carry the command-impulse to the organs that execute it, such as the muscles of the diaphragm, stomach, and chest. Vomiting can be caused by irritation of any part of the reflex pathway. All components of the reflex pathway do not have to be involved. Understanding this fact is necessary to find out why the vomiting occurred.

The frequency of vomiting depends on many factors, such as age, gender, and individual characteristics of a person. For example, women suffer from vomiting more often than men, and children (especially in adolescence) more often than adults. Also, more often than in others, vomiting occurs in people with a tendency to “sickness,” as well as with increased nervous excitability.

Causes of vomiting

The causes of vomiting may be the following:
1. Gastrointestinal diseases:
acute surgical diseases: peritonitis, acute pancreatitis, acute intestinal obstruction, bleeding in the gastrointestinal tract, acute cholecystitis;
chronic diseases: gastritis, peptic ulcer of the stomach and duodenum, enterocolitis, duodenitis, cholelithiasis;
developmental anomalies of the gastrointestinal tract: narrowing of the pylorus (stenosis), fusion of a section of the gastrointestinal tract (atresia), defects in the development of the pancreas;
infections of the gastrointestinal tract: viral infections, food toxic infections, helminthiases,
foreign bodies of the stomach, esophagus, intestines,
functional disorders that are accompanied by impaired motor function of the intestines and stomach.
2. CNS diseases: brain tumors and injuries, brain infections (encephalitis, meningitis), increased intracranial pressure.
3. Diseases of the cardiovascular system: hypertension, heart failure, myocardial infarction.
4. Inner ear diseases: Meniere's disease, labyrinthitis.
5. Endocrine system diseases: in diabetes mellitus – ketoacidosis, thyrotoxicosis, adrenal insufficiency, phenylketonuria.
6. Side effects of drugs and penetration of toxic substances into the body.
7. Psychogenic reactions: fear and anxiety, hysteria, as an expression of some emotions - habitual vomiting.
8. Vomiting and nausea may be the result of motion sickness.
9. Vomiting often occurs in women in the first trimester of pregnancy, during toxicosis (gestosis).

Vomiting and nausea occur in many diseases. As a rule, nausea follows vomiting, and vomiting gives the patient a feeling of relief. But this does not always occur, so the presence or absence of nausea is one of the main criteria for diagnosis.

Vomiting in children

In childhood, vomiting can be a reaction to many types of infections and nasopharyngeal diseases. This is due to the fact that the mechanisms of the occurrence and inhibition of gag reflexes in this age interval have not yet been fully formed. Vomiting in children can often be a consequence of negative emotional reactions. Vomiting in infants should not be confused with regurgitation of a small part of food after feeding, and vice versa: copious and frequent regurgitation after feeding must be distinguished from vomiting, which is associated with pathology of the intestines and stomach.

Vomiting in infectious diseases

In a group of diseases such as acute intestinal infections, vomiting in most cases is accompanied by symptoms of intoxication: weakness, fever, pain in joints and muscles. In many cases, vomiting precedes diarrhea or these symptoms occur at the same time. In such cases, vomiting brings a feeling of relief to the patient. Such diseases include: food poisoning, salmonellosis, cholera, yersiniosis. In addition, vomiting may be present with helminthic infestations.

In the group of acute general infections, almost every acute infectious disease includes signs of intoxication, often - especially when it comes to young children - accompanied by vomiting (in most cases one-time) and diarrhea.

As for infectious diseases of the brain and its membranes, it should be noted that when the membranes of the brain are damaged, severe vomiting, severe headache are added to the signs of general intoxication, and subsequently confusion and convulsions may be observed. A distinctive feature of such vomiting is that it is not preceded by nausea, and after it the patient does not feel relief.

Vomiting blood

An important factor in determining the causes of vomiting is contents of vomit. For example, if they constantly contain red blood, this indicates the presence of bleeding from the upper parts of the stomach (Malory-Weiss syndrome), esophagus or pharyngeal vessels. The blood that reacts with gastric juice will be colored brown (“coffee grounds”). If there is an admixture of such blood in the vomit, this indicates the presence of bleeding from the stomach or, in more rare cases, from the duodenum.

Vomiting blood may indicate bleeding from a stomach or duodenal ulcer; in patients diagnosed with liver cirrhosis, bleeding from dilated veins of the esophagus. If there is foam in the vomit with blood, this is in most cases a sign of pulmonary hemorrhage.

With erosive gastritis, vomiting with a slight admixture of blood is also possible.

Vomiting with bile

If the vomit is colored yellow or green and have a bitter taste, we can say that it is bile. The presence of bile in the vomit may indicate two facts: 1) either it was simply thrown into the stomach, 2) or we are talking about duodenal obstruction. Only in a small percentage of cases, vomiting can be mixed with helminths, pus (stomach phlegmon), and foreign bodies.

Time of vomiting

The cause of vomiting can also be judged by knowing the time of its (vomiting) appearance. Vomiting that occurs in the morning occurs in pregnant women, with alcoholic gastritis and brain diseases. If vomiting occurs in the afternoon, it may be associated with diseases accompanied by impaired evacuation of gastric contents. With peptic ulcers and gastritis, vomiting occurs after eating.

Smell of vomit

The smell of vomit can be used to judge not only the processes occurring in the gastrointestinal tract. For example, sour vomit smell may indicate a peptic ulcer or other processes with increased acid formation. If food stagnates in the stomach, there will be rotten smell of vomit. In case of intestinal obstruction, vomit is characterized by smell of feces. When consuming surrogates of alcohol or technical liquids, vomiting will have a characteristic smell of chemicals. Vomiting in renal failure smells like ammonia and for diabetes mellitus - acetone.

Examination of a patient with vomiting

If the diagnosis is based on the symptom of vomiting, it is necessary to use, in addition to the traditional detailed questioning of the patient, instrumental and laboratory research methods:
clinical blood test. It is needed in order to find out the nature of the disease (whether it is infectious or some other).
biochemical blood test. It will help assess the function of almost any organ, find out the level of glucose in the body, as well as the level of metabolic products.
fibrogastroduodenoscopy necessary to exclude diseases of the stomach, esophagus and duodenum.
radiography of the gastrointestinal tract with the use of radiopaque agents. Using this procedure, it is possible to identify diseases throughout the gastrointestinal tract.
additional diagnostic methods: computed tomography, ECG, ultrasound examinations.

Treatment of vomiting

To get rid of vomiting, you first need to identify the cause that caused it. For the symptomatic treatment of vomiting, various groups of drugs are used:
for mild vomiting: antipsychotics (etaperazine, haloperidol), tranquilizers (phenozepam, diazepam);
for vomiting caused by diseases of the inner ear, antihistamines are used (dimenhydrinate, promethazine hydrochloride).

In symptomatic treatment, dopamine antagonists have the greatest effect (cerucal, metoclopramide). Similar to drugs in this group cisapride(stimulant of motor function of the gastrointestinal tract) has a great peripheral effect, in addition, it does not have some side effects metoclopramide.

For vomiting caused by chemotherapy for cancer, serotonin receptor antagonist drugs are used (granisetron, ondansetron, tropisetron).

To avoid dehydration and electrolyte imbalance with frequent vomiting, saline solutions are used: for internal use - rehydron, for intravenous administration – Ringer's solution.

Folk remedies for treating vomiting

It is recommended to treat vomiting using traditional medicine at home using herbal decoctions:
calming effect: lemon balm, valerian, mint,
calming and antispasmodic effect on the gastric mucosa: dill, chamomile.

Until the cause of vomiting is determined, you should refrain from eating. If a child starts vomiting, do not self-medicate, seek help from a doctor.

Minor ailments are not uncommon during pregnancy. Some of them are caused by a change in your condition, others may be caused by negative environmental influences.
Nausea and vomiting, which are caused by early toxicosis, accompany most pregnancies to one degree or another. These phenomena are unpleasant, but if they do not lead to malnutrition of the expectant mother, she does not lose weight, her body is not in danger of dehydration due to frequent vomiting, this condition does not require medical intervention.

Most experts consider morning nausea to be a completely normal phenomenon that accompanies the onset of pregnancy, since it is quite explainable by the restructuring that has begun in a woman’s body. Active production of hormones, increased load on the liver of the expectant mother - all this is the cause of morning sickness. As a rule, the condition of the expectant mother improves significantly by the 10-12th week of pregnancy, when the placenta begins to function.

Complications. Severe vomiting can lead to the development of dehydration and disturbances in electrolyte metabolism (usually hypokalemia and metabolic alkalosis), and is relatively rarely accompanied by ruptures of the esophagus - partial (Mallory-Weiss syndrome) or complete (Boerhaave syndrome). Long-term vomiting can lead to malnutrition, weight loss, and metabolic disorders.

Causes of nausea and vomiting

Nausea and vomiting occur when the vomiting center is irritated. Direct causes can affect the gastrointestinal tract or central nervous system or be observed as part of systemic diseases.

The most common reasons:

  • Gastroenteritis.
  • Impact of drugs.
  • Exposure to toxins.

Cyclic vomiting syndrome (CVS) is a relatively rare disorder characterized by severe, repeated attacks of vomiting or nausea alone that occur at varying intervals; however, in the period between attacks it is not possible to detect any structural changes. The disorder is most common in children (average age of onset is 5 years), with a tendency to go into remission as they get older. SCR in adults is often associated with long-term use of marijuana (hemp extract).

Nausea (nausea) and vomiting (vomitus) most often occur by neuroreflex with irritation of the stomach, especially the pyloric region, and the nearest organs - the beginning of the duodenum and jejunum, the lower segment of the esophagus, the pharynx in acute gastritis, esophagitis and pharyngitis (morning mucous vomiting of alcoholics ) etc. Impaired movement of food and chyme, stagnation and reverse peristalsis especially often lead to nausea and, to a certain extent, appropriate vomiting. Vomiting of pure gastric juice is characteristic of peptic ulcer disease, especially of duodenal ulcer, which brings relief and is often artificially induced by the patient himself; further vomiting occurs when the pylorus narrows, occurring rarely (as opposed to irritable vomiting with acute gastritis), usually once a day, and emptying the stomach of stagnant masses. Reflex vomiting is observed in diseases of a variety of organs, primarily the intestines and peritoneum with appendicitis, helminthic infestation, with colic - hepatic, renal, uterine, tubo-ovarian. Vomiting can also be of central nervous, including cortical, origin, with toxic irritation of the vomiting center (uremia, poisoning with alcohol, carbon monoxide, digitalis, sulfonamides, apomorphine, ipecac; however, with uremia, alcoholism, the effect of sulfonamides, the local stomach irritation), with increased intracranial pressure (tumors, meningitis, acute blood supply to the meninges), with damage to the semicircular canals. Cerebral vomiting is characterized by the absence of nausea, which is probably more closely associated with antiperistalsis of the stomach and intestines. Habitual nervous vomiting without anatomical changes can reach an indomitable level and lead to death from exhaustion and self-poisoning. Vomiting in pregnant women probably occurs with the participation of endocrine changes (the effect of the pituitary gland on the stomach) and nervous factors. Reflex and central nervous vomiting is more easily caused in women and children, especially with frequent repetition of vomiting. The practical diagnostic meaning of nausea and vomiting, as well as treatment methods, can be very different in each individual case.

Causes of vomiting without nausea:

  • Intracranial tumors.
  • The patient is asked if he suffers from headaches or double vision; check whether the gait is impaired.
  • Increased intracranial pressure.
  • Important signs: nystagmus, swelling of the optic nerve nipple, pathology of the cranial nerves.
  • Encephalitis.
  • Meningitis.
  • Migraine.
  • Periodic vomiting.
  • Vomiting usually recurs at intervals of 2-3 months and occurs in children, adolescents or young adults. It is often accompanied by migraine. With such vomiting, beta blockers sometimes help.

The vomiting center is localized in the medulla oblongata near the centers that control breathing and salivation (for this reason, vomiting is combined with hyperventilation and increased salivation). The center receives signals from the chemoreceptors of the trigger zone located in the bottom of the fourth ventricle, in the area postrema. The area postrema is supplied with blood from the posterior inferior cerebellar artery, and there is no blood-brain barrier here.

The trigger zone is the site of action of some drugs that cause vomiting; in addition, it receives information from the stomach, intestines, gallbladder, peritoneum and heart via afferent fibers:

  • The feeling of nausea appears to be formed by the passage of impulses along the same pathways responsible for the feeling of satiety, so nausea is usually accompanied by anorexia.
  • It is necessary to distinguish vomiting from belching (the latter occurs without effort, i.e. without the participation of muscles that provide gagging movements; it usually gives a sour or bitter sensation in the mouth and is not accompanied by nausea).

Medicines that cause nausea and vomiting

  • Opiates, digoxin, levodopa, ipecac, cytotoxic agents (act on the chemoreceptor trigger zone).
  • Antibiotics (tetracyclines, metronidazole, erythromycin). Sulfonamides (including mesalazine).
  • Acetylsalicylic acid, NSAIDs (damage the gastric mucosa and can stimulate the vomiting center through ascending afferent influences).
  • Alcohol (acts directly through the chemoreceptor trigger zone and due to its damaging effect on the gastric mucosa).

Symptoms and signs of nausea and vomiting

The following signs are especially important:

  • signs of hypovolemia;
  • headache;
  • signs of peritoneal irritation;
  • bloating, severe tympanitis. Interpretation of results. Many signs are characteristic of certain causes of vomiting.

If vomiting occurs shortly after taking a drug or toxic substance or sudden changes in body position, in the absence of significant changes in neurological examination and abdominal evaluation, vomiting can most likely be explained by these factors. The same applies to cases of pregnancy - in the absence of pathology according to the examination. With the acute development of vomiting and diarrhea in an initially practically healthy patient and the absence of significant changes according to examination data, the likelihood of infectious gastroenteritis is high; further examination can be delayed.

Vomiting that occurs when thinking about food or is not related in time to food intake suggests a psychogenic cause, as is indicated by a history of functional nausea and vomiting in the patient or his family members. You should ask the patient in more detail, because... he himself may not be aware of this connection or may not even admit that he was experiencing a state of stress.

Examination. All women of childbearing age should have a urinary pregnancy test. In case of severe vomiting, vomiting lasting more than 1 day, or the presence of signs of dehydration according to examination data, laboratory tests should be performed (in particular, assess the content of electrolytes, urea nitrogen, creatinine, serum glucose, perform a urine test, and in some cases, liver tests). If there are signs of alarm, the examination plan is based on the corresponding clinical manifestations.

Chronic vomiting typically requires these laboratory tests, as well as upper gastrointestinal endoscopy, small bowel X-ray, gastric emptying, and anthroduodenal motility studies.

Examination for nausea and vomiting

Deciding on the list of blood tests is usually simple; their set is based on the medical history, as well as on the results of the examination carried out before:

  • A general blood test sometimes reveals anemia. The development of iron deficiency is possible with peptic ulcer disease or malignant tumors with ulceration, as well as with pathology of the small intestine, an increase in MCV is typical for situations with alcohol abuse, deficiency of vitamin B 12 or folic acid.
  • The concentration of urea and electrolytes can change both due to vomiting (at the same time the content of K +, Na + decreases, hyperchloremic metabolic alkalosis develops), and due to the underlying primary kidney dysfunction - it is advisable to check the calcium concentration, as well as determine biochemical indicators of liver function. To rule out acute pancreatitis, blood is immediately sent to determine amylase activity.
  • Diagnosis can be aided by endoscopic examination of the upper gastrointestinal tract, especially if it is performed to exclude peptic ulcers or other changes in the mucous membrane, bile reflux. Endoscopy provides little information for diagnosing functional disorders. In this regard, X-ray contrast examination is much more effective; it helps to detect stasis in the upper gastrointestinal tract and narrowing.

Anamnesis. History of present illness helps clarify the frequency of vomiting episodes and their duration; association with possible precipitating factors, such as exposure to drugs or toxins, traumatic brain injury, body movements (traveling by car, plane, ship, riding a merry-go-round); the presence in the vomit of bile (bitter taste, yellow-green color) or blood (red color, “coffee grounds”). Important accompanying symptoms include abdominal pain and diarrhea. It is necessary to evaluate the time of the last bowel movement and passing of gas, the presence of headache and/or systemic dizziness (vertigo).

Assessment of the state of various systems is aimed at identifying signs of conditions that may be accompanied by vomiting, for example, amenorrhea and swelling of the mammary glands (during pregnancy), polyuria and polydipsia (with diabetes), hematuria and pain in the lateral abdomen (with urolithiasis).

A medical history can help identify conditions that may be accompanied by vomiting, such as pregnancy, diabetes, migraines, liver or kidney disease, cancer (the timing of chemotherapy or radiation therapy should be established), and previous abdominal surgery (which may cause of adhesive obstruction). It is necessary to clarify what medications and substances the patient has taken recently; certain substances may not show toxic effects for several days (eg, acetaminophen, mushroom poisons).

Indications of recurrent vomiting in other family members should be taken into account.

Physical examination. When assessing vital signs, note the presence of fever and signs of hypovolemia (tachycardia and/or hypotension).

On general examination, the presence of jaundice and skin rash should be noted.

When examining the abdomen, you need to pay attention to bloating and scars after previous operations; assess the nature of peristaltic noises (normal, increased); perform percussion to assess tympanitis; upon palpation, evaluate pain, signs of irritation of the peritoneum (symptom of muscle protection, rigidity, the phenomenon of “rebound pain” (Shchetkin-Blumberg symptom)), the presence of space-occupying formations, an increase in the size of organs, hernias. Rectal examination and transvaginal examination (in women) reveal local tenderness, mass formations and bleeding.

A neurological examination evaluates consciousness, the presence of nystagmus, signs of meningism (Kernig and Brudzinski's symptoms), ophthalmological symptoms characteristic of increased intracranial pressure or subarachnidal hemorrhage (retinal hemorrhage).

Make your life easier

First of all, find out which tastes and smells cause the strongest reaction in your body. Most expectant mothers react negatively to the smell of gasoline, cigarette smoke, various perfumes and detergent flavors, as well as the smell of fried food and the aroma of freshly brewed coffee. Avoid “meetings” with them, spend time in a well-ventilated area, and perhaps nausea will not bother you during the day.

In order to make the morning less gloomy - and, as you know, attacks of nausea most often occur in the morning, on an empty stomach - follow a certain ritual of getting up. The best way to alleviate your condition now is to have a light breakfast in bed. Ask someone from your family to look after you or take care of yourself - in the evening, put a plate of crackers or cornflakes and an apple on the nightstand next to your bed. These foods are usually well accepted by the stomach and do not cause nausea. Choose those foods that are pleasant to you: it could be a light fruit salad, yogurt or boiled eggs.

Throughout the day you should eat small meals 5 to 6 times. Drink more fluids - many women benefit from sour fruit juices diluted half and half with water, although you may prefer slightly salted tomato juice. It helps to relieve nausea by rinsing your mouth with mint infusion or water with a small amount of lemon juice.

Look for your remedy - a small mint candy, a slice of lemon or a crust of rye bread can be a real salvation.

The increased load on the liver requires special attention to this organ. Nowadays, animal proteins must be present in your diet. Eat lean meat, cottage cheese and mild cheese. Avoid broths, fried, fatty and spicy foods, and canned foods.

To alleviate your condition, your doctor may recommend that you take vitamin B6. Antioxidants such as vitamin E, ascorbic acid and beta-carotene have proven themselves well (take only as directed by a doctor!). But you don’t need additional iron intake yet; moreover, iron-containing drugs can increase the manifestations of toxicosis.

At home, you can prepare infusions of herbs that have a beneficial effect on the mucous membrane of the digestive system and the functioning of the stomach, liver and bile ducts: valerian root, peppermint, calendula and chamomile flowers will help.

Aromatherapy can also help, for example, the beneficial effects of the smell of ginger on women have been proven.

Treatment for nausea and vomiting

Identified diseases and dehydration are treated. Even in the absence of severe dehydration, intravenous infusion (1 liter of 0.9% saline solution; in children - at a dose of 20 ml/kg body weight) should be administered, which often helps to reduce symptoms. In adults, various antiemetic drugs are effective (Table 7-6). The choice of one or another remedy depends on the underlying cause and severity of vomiting.

Typically used:

  • for seasickness (motion sickness): antihistamines and/or scopolamine in the form of a patch;
  • for mild to moderate symptoms: prochlorperazine or metoclopramide;
  • for severe, refractory vomiting and vomiting during chemotherapy: 5-HT3 receptor antagonists.

If vomiting continues, it is necessary to prescribe drugs parenterally.

In psychogenic vomiting, establishing a trusting relationship with the patient involves understanding the discomfort they are experiencing and working together to relieve the symptoms, whatever their cause. Remarks like “you’re fine” or “it’s an emotional problem” should be avoided. A short trial of symptomatic therapy with antiemetics may be given. During long-term follow-up of the patient, regular follow-up visits to the doctor help resolve the underlying problem.

Causes of vomiting not related to pain

Infectious:

  • Viral gastroenteritis.
  • Food poisoning; Possibly HP related infection. Infections of other localizations, including inflammatory diseases of the urinary tract and pneumonia in older people.
  • Viral labyrinthitis.

Mechanical obstruction:

  • Pyloric stenosis, duodenal obstruction due to stomach or pancreatic cancer. Esophageal cancer.
  • Biliary reflux, especially if you have had previous gastric surgery or gastroenterostomy.

Alcoholic gastritis:

  • A common cause of belching in the early morning hours. The belching is usually not profuse, often mixed with blood.

Acute liver failure:

  • For example, with an overdose of paracetamol (paracetamol poisoning), acute fatty liver in pregnant women

Metabolic reasons:

  • Addison's disease (if such a suspicion arises, efforts are directed to the search for postural hypotension, pigmentation of the mucous membranes).
  • An increased or normal K content is especially important, since vomiting typically reduces the concentration of potassium in the blood.
  • The possibility of hypercalcemia, uremia and hyperthyroidism must be considered.
  • Up to 30% of people with diabetes experience occasional episodes of nausea and vomiting.

Many medications are prescribed for nausea and vomiting. They must be used with caution, keeping in mind that they all have side effects.

Basic provisions

  • In many cases, the causes of vomiting are obvious; examination of the patient does not reveal significant abnormalities; Only symptomatic treatment is sufficient.
  • It is necessary to be alert to the possibility of acute abdominal syndrome and dangerous cranial pathology.
  • Patients of childbearing potential should be assessed for possible pregnancy.