Vomit

Synonyms

Vomiting, vomitus, vomiting, regurgitation, vomiting bile

Slang synonyms: surrender, spit, heron, etc.

definition

Declining (retrograde) Emptying of the gastrointestinal contents through the mouth as a result of involuntary contraction (contraction) of the diaphragm and the Abdominal muscles.

history

The Vomit had an important place in history as a therapeutic, that is, intentionally induced, vomiting. From many important doctors, i.a. also Hippocrates, it was considered to be an extremely effective remedy because, in their opinion, it served to cleanse the body.

control

To the Vomit it always occurs when the vomiting center (Area postrema) is stimulated to a sufficient degree. The area postrema lies in the elongated medulla (Medulla oblongata), the rearmost part of the brain.

In the event of mechanical or chemical influences (Noxa, toxins / drugs) and at Mucosal damage by Alcohol poisoning there is an activation of stretch and chemoreceptors in the gastrointestinal mucosa, which transmit their information through the Vagus nerve send to the crushing center. Ingested drugs and toxins can affect the vomiting center blood grasp, as there is no vomiting center Blood-brain barrier gives. In the case of kinetoses, the unusual constellation of stimuli from different sensors leads to excitation of the organ of equilibrium. This excitement is only at the Thalamus, then sent to the hypothalamus, both parts of the diencephalon. From here the excitation reaches the vomiting center again.

Symptoms

• nausea
• paleness
• Tremble
• dizziness
• Drop in blood pressure
• Tachycardia
• sweat
• Freeze
• Increased salivation to protect the Mouth and the esophagus before the Stomach acid

Most symptoms are caused by the loss of fluids and minerals during vomiting.

You can find more information on this here: Dehydration

Vomiting process

• Take a deep breath
• Closure of the glottis and the nasopharynx
• Transport movement of the meal in the opposite direction from Small intestine back into the stomach: the intestinal contents can also be vomited. In addition, it dilutes and buffers the acidic stomach contents through the alkaline secretion of the pancreas contained in the intestinal contents.
• Relaxation of the stomach muscles and the circular muscles of the esophagus
• Contraction (contraction) the arbitrarily controlled Musculature The esophagus: The stomach is pulled up so that the angle between the stomach and the esophagus is less narrow.
• jerky contraction of the abdominal muscles and diaphragm
• Pressure in the abdominal cavity increases
• Stomach contents are pressed upwards
• Retrograde emptying

diagnosis

The exact questioning (anamnese) of the sick person in the foreground. Above all, the appearance of the vomit, the time of vomiting, the accompanying symptoms, previous illnesses and medication intake are important.

With bloody vomit you have to between bright red and dark red Distinguish blood, where light red is a sign of fresh bleeding, for example bleeding from Varicose veins in the esophagus (Esophageal varices). Dark red blood ("coffee grounds-like" appearance), on the other hand, has already come into contact with the stomach acid, which leads to a "coffee grounds-like" appearance and in one person Gastric ulcer (Gastric ulcer) or some form of inflammation of the stomach (hemorrhagic gastritis) can occur. If the vomit looks yellow-greenish, then bile has been vomited; if it is clear-whitish, gastric juice has been vomited. If it's brown, let go of the manure (Miserere) close what a sign of a Intestinal obstruction (Ileus) is.

The smell of vomit can also help with the diagnosis. A sour smell suggests gastric juices, a putrid smell suggests spoiled food. The smell of acetone suggests the breakdown of fats, as happens in fasting people or diabetics. If you vomit in the morning, this speaks for pregnancy, increased intracranial pressure or excessive Alcohol consumption as the cause. If without prior nausea vomiting suggests a cause related to the central nervous system. If vomiting occurs in a surge, this is a sign of an obstacle to the passage in the stomach outlet (Gastric outlet obstruction).

The accompanying symptoms also suggest certain causes. Dizziness is a sign of a cause in the equilibrium system, fever is an infectious cause, diarrhea (Diarrhea) for a disease of the entire gastrointestinal system, a headache for migraines and Eye pain for an acute attack glaucoma (Glaucoma attack). Radiating pain in the area of ​​the Rib cage and abdomen can be a sign of a heart attack (myocardial infarction), belt-shaped pain suggests a Inflammation of the pancreas (Pancreatitis).

As a side effect of certain drugs such as cytostatics, Antibiotics or oral Contraceptives (Contraceptives) nausea and vomiting can occur. A physical exam will also be performed. The stomach is felt and listened to, as are heart and the lung bugged. In addition, gross neurological examinations are performed and the fundus is examined.

Further investigations such as Ultrasonic if suspected Gallstones, Gastroscopy (Gastroscopy) if a stomach ulcer is suspected or EKG if suspected Heart attack are carried out depending on the suspected diagnosis.

Causes of Vomiting

The causes for Diarrhea and Vomit As described, they are mostly due to an infection of the gastrointestinal tract, in newborns they may also be due to a malposition of the gastrointestinal tract. In addition, factors such as bacterial salmonella poisoning, consumption of poisonous mushrooms, or ingestion of chemicals can be the cause nausea and Vomit form.
Especially in the summer months there is a risk of Sunstroke and heatstrokewhich again diarrhea and induce vomiting. Usually a direct connection between cause and effect can be established, so that the reason for the complaint is relatively easy to identify. Diarrhea after a summer barbecue can lead to a Salmonella poisoning give.

Headache and vomiting after being at the lake may have been caused by sunstroke. The symptoms usually go away after a few hours to days. However, if no causal connection can be established or the symptoms persist, it is advisable to consult a doctor, as the problem can also be more serious.

Many more causes of vomiting can be found on our more extensive page: Causes of Vomiting

therapy

The focus is on treating the underlying disease. Serve for symptomatic treatment Antiemetics, the nausea and Vomit should suppress. These drugs are antagonists (Antagonists) of messenger substances (Transmitter) the pathway to the vomiting center. They prevent the transmission of a stimulus to the vomiting center. Depending on the cause of the vomiting, different antiemetics are prescribed: (The active ingredient is always mentioned first, then the trade name in brackets)

• With kinetoses: Scopalamin (e.g. Scopodermin TTS), Meclozin (e.g. Peremesin), Dimenhydrinate (e.g. Vomex A)
• In case of nausea and vomiting: Metoclopramide (e.g. Paspertin), Domperidone (e.g. Motilium), Phenothiazine (e.g. Atosil), Droperidol (e.g. Dehydrobenzperidol).
• In the event of postoperative vomiting: Dexamethasone (e.g. Dexa)
• For nausea as a result of chemotherapy: Dolastron (e.g. Anemet), Granisetron (e.g. Kevatril), Ondansetron (e.g. Zofran), Tropisetron (e.g. Navoban)

It may be necessary to balance the water and electrolyte balance.

Read more about this under Nausea medication and Anti-vomiting medication

rehabilitation

After this Vomit the physical condition improves through a Mouthwash or by applying cold water to the face and hands. Fresh air is also very helpful.
When building up food, attention should be paid to gradually building up food, with the main focus being on the intake of fluids. Grated apples, mashed bananas and rusks can be started as easily digestible foods. Basically, the food should be low in fat to build up the diet.

Consequences of chronic vomiting

• Malnutrition
• Loss of digestive juices or water leads to a lack of water in the body (dehydration)
• The consequence of dehydration is the dehydration of the body due to the decrease in body water (desiccosis)
• Loss of stomach acid, i.e. loss of H +-Ions (Alkalosis)
• loss of K +-Ions (Hypokalemia)
• lung infection by inhaling chyme (aspiration pneumonia)
• Physical injuries: tears in the Gastric mucosa (especially for alcoholics (Mallory-Weiss Syndrome) and the lining of the esophagus lead to blood in the vomit (Hematemesis); Broken ribs; Throat pain from vomiting
• Deterioration of the mental and moral condition (especially difficult for chemotherapy patients)
• At bulimia: Destruction of the tooth enamel and attack on the lining of the esophagus, since the stimulus is mechanical and unpredictable for the body. This means that the body does not have time to increase its saliva flow and the stomach acid cannot be buffered.

Vomiting and diarrhea

Vomiting and diarrhea occur when the body does not process the supplied liquid and food sensibly or cannot continue to work.
This can be both anatomical reasons such as the misalignment of the esophagus or intestines, but also temporary changes in intestinal function caused by viruses or bacteria.

Misalignments of the esophagus and intestines occur congenitally, i.e. with birth. The cause is a malformation during the child's embryonic development. A Esophageal atresia - i.e. a malformation of the esophagus - can occur in the form of a continuity interruption if the esophagus ends bluntly and is not connected to the stomach. In this way, ingested food is regurgitated and, in the worst case, can get into the lungs, where it causes pneumonia. But parts of the intestine or stomach can also be missing.
The different parts of the large and small intestines are important for the absorption of water and nutrients from the pulp. For example, the liquid is withdrawn from the food pulp in the large intestine in order to gain it for the body. A malfunction of the colon leads to diarrhea and dehydration.
In the small intestine, however, are iron, and vitamins added. These are essential for a child's growth. The substances mentioned above are only small examples of the diverse tasks and functions of the gastrointestinal tract. Any disturbance - whether anatomical or caused by bacteria and viruses - leads to malfunction and, in the long term, to malnutrition.

Bacteria and viruses attack the wall layers and transport mechanisms of the intestinal wall in a wide variety of ways and disrupt their function. The more maladjusted a bacterium or virus is, the more serious the effects on the human body. After all, it is in the pathogen's interest to live with the body in order to survive itself. So the intestinal wall is naturally made up of billions of Escheria Coli bacteria colonized, which are absolutely necessary for the functioning of the digestive tract, and - as long as they remain there - are in no way harmful to the body.
Rather, the small bacteria produce what is necessary for the human body to survive Vitamin K.

Vomiting and diarrhea are always a sign of a malfunction of the gastrointestinal tract. The causes can temporary, infectious in nature be, or chronic, and serious.

Vomiting in the child

Diarrhea and vomiting are of particular importance in children. The child's organism is up to its own 10th year of life not yet fully developed what that immune system concerned.
He therefore needs a lot of help and protection from pathogens. For this very reason, children are much more susceptible to bacterial or viral infections. The immune system has yet to learn and develop effective antidotes against the pathogens. On the other hand, children in kindergartens are exposed to a high level of pathogens every day, and as a result fall ill more often.
These are typical pathogens in childhood Norovirus, and the Rotavirus. Both viruses are transmitted through drinking water, food, and everyday items such as inadequately cleaned dishes.
Unfortunately, just a few viruses are enough to trigger an infection. It is not uncommon to hear in the news that all children in a kindergarten have been infected with a virus. The most frequent Gastrointestinal infection childhood is the one with rotaviruses.

The first symptoms appear 1-3 days after infection; after the symptoms have subsided, the children remain carriers for a good week because they continue to excrete viruses in their stool. So it happens that up to the third year of life is good 90% of the children are already infected with rotavirus. Just like rotavirus, norovirus is transmitted by mouth to mouth or mouth to object. Both viruses are very similar in the mode of transmission, the symptoms and the course of the disease. Also caused by the norovirus diarrhea and Vomit, however, these can occur after 6 to a maximum of 50 hours.
After the symptoms have subsided, the affected patients continue to be potential carriers for a good week, as they continue to excrete the virus in their stool. Children - especially when they are toddlers - need enough fluids to compensate for the water loss they suffer from vomiting and diarrhea. In addition, you can also Electrolyte solutions which are freely available in the pharmacy.

Please also read our topic: Diarrhea in toddlers

Since the body is barely able to absorb nutrients and energy from the intestines during infection, it is important to take in enough of them. Sweetened with honey tea, high-fat soup, and pretzel sticks are good nutritional strategies for diarrhea. In addition, it is important to calm down and take care of the child, as small children in particular do not yet understand that this is only a short-term condition that will soon be over. It is therefore important to ensure a familiar, quiet environment in which the child feels as comfortable as possible.

Vomiting during pregnancy

During pregnancy, the female body undergoes a multitude of hormonal and physical changes. Morning is especially important in the first trimester of pregnancy Vomit very often.
The reasons for this have not been fully clarified. One assumes a multifactorial event in which, on the one hand, the muscle tension in the gastric sphincter is reduced. On the other hand, increased sensitivity to smell and increased levels of the hormone also play a role hCG a role. Contrary to what was previously assumed, vomiting in the morning is not an unfavorable prognostic factor for the course of pregnancy. Studies have not found any connection between vomiting and the rate of miscarriages.

Vomiting can occur up to 5 times a day. In these cases, however, an intestinal infection should also be considered, since such a frequent number (called: Hyperemesis gravidarum) exceeds the normal level. A sufficient caloric and electrolyte-rich diet is also important for pregnant women. After all, not only your own body but also that of the child must be adequately cared for.
However, during pregnancy you should not take any Antiemetics ("Anti-emetic agents") must be clarified in advance with the attending physician, as many drugs have an embryotoxic effect and their use is therefore contraindicated. In fact, very few drugs are even approved for use during pregnancy!

You can read more information about this here: Anti-vomiting medication

Vomiting combined with a fever

In almost all food poisoning, it comes alongside nausea and Vomit also to fever. In addition to abdominal cramps and chills, fever is also to be expected, particularly in the case of salmonella poisoning. Fever is always an attempt by the body to kill the pathogens through elevated temperatures.
A few degrees of difference are often enough. So, in and of itself, a fever is a helpful way to get rid of an infection and shouldn't be artificially lowered if possible. Only when critical temperatures above 40 degrees are reached, or other factors make fever appear unfavorable, should an antipyretic ("antipyretic“) Funds can be used. Classic antipyretic agents are aspirin or ibuprofen. However, fever is the body's natural way to get rid of its pathogens. An artificial lowering to 37 degrees should therefore always be carefully considered.

Summary

Vomit has a protective function for the body against harmful substances or bulky objects. It can also be seen as a process of cleansing, especially in therapeutic vomiting. However, vomiting must not be intentionally induced in the case of poisoning with acid or alkali, with foam-forming substances, with organic solvents or with respiratory / circulatory disorders.

The process is extremely exhausting and uncomfortable. This is why nausea and vomiting are the main reasons for stopping chemotherapy. Need information on the subject Bad breath?