Vomiting
Vomiting is defined as a forceful expulsion of the stomach contents through the mouth. Retching is the laboured respiratory effort, which precedes vomiting. Vomiting is often related to or preceded by nausea, but both nausea-without-vomiting and vomiting-without-nausea are possible. Any nausea or vomiting symptom needs prompt professional medical investigation.
Regurgitation is the effortless appearance of gastric and esophageal contents in the mouth. Vomiting is a forceful action accomplished by a fierce, downward contraction of the diaphragm. At the same time, the abdominal muscles tighten suddenly against a relaxed upper stomach with an open sphincter. The contents of the stomach are propelled up and out.
In the medulla of the brain, there is a vomiting centre, which is activated by a cause from the digestive system, the ears and other regions of the body.
Vomiting is extremely common. Almost all children will vomit several times during their childhood. In most cases, it is due to a viral gastrointestinal infection.
There is a sudden rise of pressure within the abdomen secondary to vigorous movements of the diaphragm (which separates the thorax from the abdomen) as well as abdominal muscles. The stomach is shut off from the small intestine side. The sphincter between the stomach and esophagus relaxes, resulting in forward and upward movements of the stomach contents which is then thrown out of the mouth.
Vomiting is a complex, coordinated reflex orchestrated by the vomiting center of the brain. It responds to signals coming from:
- The mouth, stomach, and intestines
- The bloodstream, which may contain medicines or infections
- The balancing systems in the ear (motion sickness)
- The brain itself, including unsettling sights, smells, or thoughts
Causes of Vomiting
1. The digestive system e.g. Gastritis, infection of the gall bladder, liver cirrhosis, intestinal obstruction, infection of pancreas.
2. Poisons e.g. Food poisoning, alcoholism.
3. Central nervous system e.g. Brain tumor, infection of membranes of the brain, migraine.
4. Endocrine system e.g. Diabetic complication, thyrotoxicosis.
5. Heart diseases e.g. heart failure, heart attack.
6. Others e.g. Fever, pregnancy, ear diseases, motion sickness, unpleasant sights and smells, hysteria.
Management
1. If patient is conscious support him while he is vomiting.
2. If unconscious, turn the patient to one side and ensure his airway is clear.
3. Consult a doctor.
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