Vomiting in children and adults: causes, symptoms and treatment

General practitioner (family doctor)

Gutorova

Natalia Konstantinovna

20 years of experience

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Vomiting, the spontaneous release of stomach or duodenal contents through the mouth, can have many causes. A single urge, as a rule, does not cause any particular concern and does not require close attention. However, if an adult or child vomits more than once, this is a reason to consult a doctor.

Causes of vomiting

Vomiting almost never happens without a reason: there is always something that provoked it, and there can be many options:

• food poisoning, medicines, drugs, alcohol intoxication;
• allergic reaction to a food product;
• excess food intake;
• infection;
• pregnancy (especially the first trimester);
• disease of the abdominal organs, for example, ulcer, colitis, gastritis, intestinal or stomach tumor, appendicitis, kidney failure, pancreatitis, etc.);
• intestinal obstruction;
• gallbladder pathologies (cholecystitis, hepatitis, dyskinesia, cholelithiasis);
• severe stress;
• disturbances in the functioning of the central nervous system (cerebral circulatory insufficiency, brain tumor, meningitis, mechanical head injury, migraine condition);
• problems with the vestibular apparatus;
• diabetes mellitus of any stage;
• AIDS.

With any of the above factors, standard vomiting may be observed, supplemented by other symptoms:

• abdominal pain;
• vomiting blood;
• vomiting and fever;
• vomiting bile;
• green vomit;
• vomiting, weakness;
• headache;
• heartburn;
• frequent urge to go to the toilet;
• disturbance of mental activity.

Diagnostics

The development of vomiting is most often caused by diseases of the gastrointestinal tract, so a comprehensive examination is carried out by a gastroenterologist. A diagnostic search involves studying the structural and functional features of the digestive system and excluding concomitant pathologies. The most informative for identifying the causes of vomiting:

• Endoscopy.
  Using the method of visualizing the mucous membrane of the upper gastrointestinal tract, a specialist can see inflammatory changes, foci of epithelial destruction, and voluminous neoplasms. If necessary, during endoscopy, a biopsy of individual sections of the mucosa is performed for subsequent cytomorphological diagnosis.
• X-ray methods
  . Radiography with contrast is highly informative for organic diseases, which are often manifested by vomiting. The images can reveal deformation of the contours of the esophagus or stomach, and pathological shadows. The speed of contrast advancement is used to judge the motor function of the digestive tract.
• Ultrasonography
  . A survey ultrasound of the abdominal cavity is prescribed to all patients with dyspeptic disorders as a screening method. Sonography allows you to identify nonspecific signs of the inflammatory process and changes in the organs of the hepatobiliary system. The method is used to diagnose gastrointestinal pathologies in pregnant women at any stage.
• Esophageal manometry
  . Measurement of esophageal pressure is performed to exclude dyskinesia and dysfunction of the muscle sphincters, as the main cause of vomiting. If hyperacid diseases of the stomach are suspected, daily pH measurements are prescribed. Intraesophageal pH determination is indicated for the verification of GERD.
• Lab tests
  . In the coprogram, characteristic changes can be detected: undigested food components, the presence of fecal elastase. Stool culture is recommended to exclude intestinal infections. Biochemical blood test indicators are also assessed: acute phase proteins, levels of bilirubin and liver enzymes.

In case of damage to the hepatobiliary system, duodenal intubation with microscopic examination of bile and targeted ultrasound of the liver and gallbladder are recommended. If vomiting is caused by an infectious process, serological tests are performed to determine the type of pathogen and the amount of specific antibodies. A gynecologist is required to examine pregnant women. Once all organic causes have been ruled out, autonomic nervous system testing may be necessary.

For profuse vomiting, give oral or parenteral rehydration

When does vomiting require immediate medical attention?

Very often, even vomiting without fever is a reason to call an ambulance as soon as possible. If the patient experiences symptoms such as vomiting blood or a previous injury to the head, spine or abdomen, or if the urge does not stop, call a doctor immediately.

JSC “Medicine” (academician Roitberg’s clinic) has its own emergency department, whose specialists are ready to come to your aid 24 hours a day, 7 days a week. You can call a car by phone.

general characteristics

At the time of vomiting, the patient experiences an uncontrolled contraction of the abdominal muscles and diaphragm, leading to a sharp release of gastric and, in some cases, intestinal contents.
The secreted masses may contain remnants of undigested food, mucous, bloody and bile inclusions, and other pathological impurities. Often the attack is preceded by nausea, profuse salivation, weakness, and sweating. Possible dizziness, unsteadiness of gait, rapid heartbeat. After an episode of vomiting, a sour, bitter, putrid taste or odor remains in the mouth and sometimes in the nasal passages. From the outside, the patient looks confused, pale, and beads of sweat are often visible on the forehead. The appearance of vomiting should always be regarded as a threatening condition that requires a medical examination. If the patient’s condition has improved after the vomit has passed, a visit to a general practitioner or family doctor may be scheduled. If indomitable vomiting occurs, blood, bile, mucus and feces are detected in it, the symptom is combined with hyperthermia, intense pain of any localization, diarrhea, stupor, disorientation and convulsions, you must call an ambulance.

First aid for vomiting

Despite the fact that medical manipulations should be carried out by a doctor, especially if brown vomiting, white foam vomiting or black vomiting is observed, it is not superfluous to know how to provide first aid to a victim with such a symptom.

• The sick person should be placed in a horizontal position, with a basin or other container placed nearby into which he could vomit if necessary.
• If severe vomiting is accompanied by weakness, then his head should be turned to the side in order to eliminate the possibility that the person will choke on the escaping masses.
• If this is vomiting due to poisoning or for any other reason, it is necessary to rinse your mouth with a disinfectant solution after the contents of the stomach are released.

These manipulations should be performed by calling a specialist.

Vomiting in children

Vomiting
occurs more often in children than in adults because the structures in their stomach and brain that prevent food from being expelled through the mouth are not fully developed. In a child, any infections, including ENT organs, fever, rotavirus infection, food poisoning can cause nausea and vomiting. In addition, children are more emotionally sensitive, so often a child’s vomiting can be associated with a dislike for a particular food that has unpleasant memories associated with it. In newborn babies, vomiting should not be confused with regurgitation. A healthy child normally regurgitates 5-10 ml of stomach contents several times a day; regurgitation is associated with food intake and can be a sign of overeating, and can also occur as a result of rapid feeding and swallowing air. However, if the child regurgitates too often and is accompanied by the expulsion of a large amount of stomach contents (vomiting), the baby is not gaining weight well - you should show the child to the doctor, as this may be a symptom of stenosis of the esophagus or pylorus. In older children, vomiting may occur as a result of acute appendicitis or gastroenteritis, in which case the child experiences vomiting and diarrhea with fever and severe abdominal pain. Vomiting, fussiness, a crying baby, no bowel movements, or jelly-like, raspberry-colored stools may indicate intussusception (intestinal obstruction), which is an emergency. Worms can be a common cause of periodic nausea and vomiting in children. In all cases of episodic nausea and vomiting, a child should have a stool test for parasite eggs and, if necessary, undergo treatment. Migraine in children can cause recurrent bouts of vomiting. It is important to note that, unlike adults, migraine in children does not always manifest itself as a headache and for a long time can only manifest itself as episodes of vomiting or dizziness. Nausea and vomiting can occur in girls during the period of menstruation.

Attention!

Call a doctor if:

• Nausea or vomiting occurs several times and you do not know what is causing these symptoms.
• If you suspect that the cause of nausea may be food poisoning, try to give your child a gastric lavage before the doctor arrives.
• If nausea and vomiting occur in a child after a fall or injury (especially head and abdominal injuries).
• Nausea and vomiting in a child is accompanied by one or more of the following symptoms: headache, drowsiness, agitation, diarrhea, loss of consciousness, progressive deterioration of the child’s condition.
• Nausea and vomiting periodically recur in a child for no apparent reason.

Treatment of vomiting in the clinic of JSC "Medicine" (clinic of academician Roitberg)

Often the symptom goes away on its own. However, if its appearance was dictated by the presence of a serious illness, a visit to a specialist is required. Depending on the cause of vomiting, the diagnosis may be carried out by a general practitioner, pediatrician, gastroenterologist, infectious disease specialist or gynecologist.

An experienced doctor will carry out the required diagnostics, make a diagnosis and draw up the most appropriate treatment plan, first of all prescribing anti-vomiting medication.

JSC “Medicine” (clinic of academician Roitberg) employs the best specialists of the capital and region, conducting diagnostics using the most modern equipment of proven world brands. All this together makes the treatment process quick and as convenient as possible for the patient.

You can make an appointment with a doctor by calling +7 24 hours a day or using the feedback form on the official website of the medical center. The clinic is located in the central district of Moscow at 2nd Tverskoy-Yamskaya lane, building 10, next to the metro stations “Belorusskaya”, “Mayakovskaya”, “Tverskaya”, “Novoslobodskaya”, “Chekhovskaya”.

Features of treatment with medications

First of all, you should understand how to stop vomiting. For this purpose, the doctor prescribes a special anti-vomiting remedy: it can be in the form of injections (if it is absolutely impossible to swallow anything), tablets, syrups.

Since the release of stomach contents can provoke pain, medications are also prescribed to anesthetize the mucous walls of the stomach and relieve spasms. If the symptom is accompanied by diarrhea, then medications that relieve it are prescribed as an additional measure.

Vomiting after alcohol is a separate symptom. It is not stopped in any way, since the main goal is to rid the body of toxic substances. After this, it is necessary to restore the body’s water balance, and therefore it is recommended to drink as much plain water as possible.

Development mechanism

Vomiting is the result of a complex reflex reaction in which the uncontrolled contraction and relaxation of various muscle groups leads to the release of gastric chyme. The reflex is activated by influences on different links of the neural chain. Neuroreceptors that stimulate the vomiting center are located in the pharynx, stomach, intestines, bile ducts, peritoneum, coronary and mesenteric vessels, and a number of other organs. Their activation causes irritation of the mucous membranes with bacterial toxins, release of bioactive substances, pressure, vasospasm, and other visceral effects.

Impulses from peripheral receptors travel through vagal and sympathetic fibers to the vomiting center of the medulla oblongata. Neurons of the reticular formation can also be activated by the direct influence of toxic substances on the chemosensitive zone of the bottom of the fourth cerebral ventricle and by an increase in intracranial pressure. Less commonly, the gag reflex is triggered by impulses from the vestibular apparatus, exposure to mental stimuli, or intense pain of any origin.

The motor part of the reflex arc is represented by V, IX, X pairs of cranial nerves innervating the soft palate, larynx, pharynx, esophagus, stomach and diaphragm, spinal nerves providing contraction of the striated intercostal muscles and the muscles of the anterior abdominal wall. Since the vomiting center is located next to the cough, vasomotor, respiratory and other autonomic centers, their simultaneous activation causes hypersalivation, a drop in blood pressure, pallor and other parasympathetic reactions.

When efferent impulses arrive against the background of deep inspiration, the diaphragm lowers, the epiglottis closes the entrance to the respiratory tract, the larynx and palate rise, preventing the reflux of chyme into the trachea, bronchi and lungs. Tension of the diaphragmatic and abdominal muscles against the background of compression of the pylorus and relaxation of the cardia provides an increase in intra-abdominal and intragastric pressure, which ends in an attack of vomiting. In some conditions, antiperistaltic movements of the intestinal wall occur, causing intestinal contents to enter the stomach and then into the vomit.

Recovery after vomiting

Whatever the cause of the disease, after treatment it is necessary to undergo a recovery process. It includes the following items:

• the patient must remain in bed for some time;
• You should drink liquid often and little by little; for this it is better to alternate plain water, sweet tea and low-fat broth;
• temporarily stop consuming dairy products, as well as coffee, alcohol, citrus fruits, and aspirin-based medications;
• start eating food with light dietary foods: lean meat, bananas, rice, cereals;
• For 2-3 days, completely eliminate spicy, fried, smoked, and fatty foods.

Treating vomiting at home

While at home, you can also try to stop gagging using traditional medicine methods.

• Thus, tea based on mint leaves has an excellent calming effect. This is especially true for vomiting caused by a serious stressful situation. For the same purpose, you can drink 15 drops of mint tincture with water.
• A decoction of dill seeds, which can be purchased at any pharmacy, also has a beneficial effect on the treatment process.
• Lemon juice added to plain water is a great way to get rid of vomiting.
• If this is vomiting during pregnancy, then you should stick to fractional meals. Also an effective remedy during pregnancy is chewing a slice of lemon or simple crackers in the morning without getting out of bed, so it is better to prepare them in the evening.

Physiological features

Vomiting is a reflex action of the body, which is aimed at getting rid of the contents of the stomach. Muscle spasms are practically beyond conscious control. Uncontrollable vomiting can have various causes. In this case, the following happens. The diaphragm lowers and the stomach area contracts in the opposite direction. After this, the abdominal muscles contract, and the stomach muscles, on the contrary, relax. The entrance to the stomach opens, the esophagus expands, as a result of which the contents of the stomach enter the oral cavity.

Answers to the most common questions

• I am vomiting and have a fever, what should I do? You should not self-medicate; in this case, it is recommended to see a doctor as soon as possible.
• What does vomiting in the morning mean? It might be worth checking to see if you are pregnant. In all other cases, you should seek medical advice from a doctor.
• White vomit with mucus - what to do? Most likely, the person has recently consumed too much white bread, milk or rice. If there are no other signs of illness, then there is no need to panic.

Nausea and vomiting during pregnancy

Nausea and vomiting are possible signs of pregnancy. In pregnant women, nausea usually occurs in the morning and is accompanied by slight dizziness, weakness, and drowsiness. Nausea and vomiting in pregnant women are symptoms of early gestosis (toxicosis). The occurrence of nausea and vomiting in a pregnant woman may be a sign of worsened pancreatitis, gastritis, gastric ulcer, treatment with iron supplements, therefore, in all cases of nausea and vomiting in pregnant women, this problem should be discussed with doctor.