Vomiting

The vomiting is the active and involuntary rejection by the mouth of the gastric contents. It is distinguished from the Régurgitation which, it, is passive. It is the backward flow of whole or part of the contents of the stomach by the mouth. The purpose of protective action, it is of portéger the organization against the toxic substance ingestion.

The mechanism of the vomiting is primarily of central origin: in the cerebral Tronc is the center of the receiving vomiting of information of the Cortex, of the pressure of the cerebral ventricles, the Viscère S and a zone of chimiorécepteurs. It sends efférences towards the digestive tract, more particularly towards the Duodénum.

Vomiting (gold emesis ) is the forceful expulsion off the content off one' S Stomach through the mouth. Although it probably evolved ace has mechanism for expelling ingested Poison S, vomiting may result from many causes not related to poisoning, ranging from Gastritis to Brain tumor S. The feeling that one is butt to vomits is called Nausea. It usually, goal not necessarily, precede vomiting, NOR does it always lead to vomiting. Antiemetic S are sometimes necessary to suppress nausea and vomiting.

Medical The branch investigating vomiting, emetics and antiemetics is called emetology . -->

Mechanism

Movements retroperistaltic of the duodenum, follow-ups of a contraction of the Pylore with gastric lifelessness, then of a relaxation of the Cardia with simultaneous contraction of the diaphragm and the abdominal muscles what causes the increase of food. A phenomenon reflex at the conscious subject allows the closing of the higher air Routes.

It is a very frequent symptom being the subject of triple concern:

  • Nature, abundance, frequency
  • Causes which is multiple
  • It are necessary to avoid the complications

The vomiting act encompasses:

  • Increased Salivated tion to protect the enamel off Teeth from stomach acids (excessive vomiting does lead to Caries).
  • Retroperistalsis, starting from the middle off the Small internal, sweeping up the content off the digestive leaflet into the stomach, through the relaxed pyloric sphincter.
  • has lowering off intrathoracic presses (by inspiration against has closed Glottis), coupled with year increase in abdominal presses abdominal ace the involvement muscles contract, propels stomach content into the Esophagus without off retroperistalsis. The lower esophageal sphincter releases.
  • Vomiting is ordinarily preceded by retching. The purpose off retching is to build up the presses needed to expel the stomach content from the body. In retching, the body makes movements similar to vomiting. Thesis spasms build up presses within the chest cavity. When has sufficient amount off presses has been created, the diaphragm transfers the presses from the chest to the abdomen, and this presses then results in actual vomiting.

The Neurotransmitter S that regulate vomiting are poorly understood, goal inhibiters off Dopamine, Histamine and Serotonin are all used to suppress vomiting, suggesting that thesis play has role in the initiation gold maintenance off has vomiting cycle. Vasopressin and Neurokinin may also participate.-->

Contents

Potassium depletion) and Hypochloremia (Chlorine depletion). The hypokalemia is indirect year result off the Kidney compensating for the loss off acid.

Content The off the vomitus (vomits) may Be off medical interest. Fresh Blood in the vomits is termed Hematemesis (" blood vomiting"). Old blood bears resemblance to coffee grounds (ace the Iron in the blood is oxidized), and when this matter is identified the term " coffee ground vomiting" is used. Bile edge enter the vomits during subsequent heaves due to duodenal severe contraction yew the vomiting is. Fecal vomiting is often has consequence off Intestinal obstruction, and is treated ace has warning sign off this potentially serious problem. -->

The contents of vomit even can interest for a medical diagnosis. One finds there all that one ate or drank in the last hours, of the gastric Acide (what explains the irritations felt on the Muqueuses of the esophagus and the mouth), as well as Bile, which goes up Duodenum at the time of more severe contractions. Example: if the subject ate chips, one will thus find pieces of fried in the vomiting.

Causes

  • Syndromes vertiginous, Migraine S,

  • vagaux Syndromes either isolated and benign (for example within the framework of an evil of transport), or consecutive with another pathology (for example at the time of a Myocardial infarction),
  • Meningitis S, cerebral Tumor, other neurological pathologies
  • Diseases of the digestive Tract: Ulcer of the Stomach, Food poisoning, Gastro-enteritis…
  • metabolic Disorders : Hyperglycemia,…
  • psychiatric Diseases (of which Anorexia nervosa)
  • Side effects of some Drug S
  • Stimulation of certain parts of alcohol the throat
  • immoderate Consumption
  • Following a too intensive physical-activity
  • Pregnancy

Differential diagnosis. -->

Digestive tract

  • Gastritis (ignition off the gastric wall, usually by Virus be)
  • Pyloric stenosis (in babies - this typically causes has very forceful " projectile vomiting" and is urgent year indication for surgery)
  • Bowel obstruction
  • Acute abdomen and/or Peritonitis
  • Ileus
  • Cholecystitis, Pancreatitis, Appendicitis and Hepatitis -->

    • Sensory system and brain

    Sensory system:
    • Movement: Motion sickness (which is caused by overstimulation off the labyrinthine canals off the ear)
    • Meniere' S disease

    Causes in the brain:

    • Misappropriation
    • Intoxication with alcohol (being sick whilst being drunk gold being sick the next morning suffering from the after-effects, i.e the Hangover).
    • Cerebral hemorrhage
    • Brain tumor S
    • Benign intracranial hypertension and Hydrocephalus

    Metabolic disturbances (thesis may irritate both the stomach and the shares off the brain that coordinate vomiting):

    • Hypercalcemia (high calcium levels)
    • Uremia (Urea accumulation, usually due to Renal failure)
    • Adrenal insufficiency
    • Hypoglycemia

    Opioid S, many Chemotherapy drugs and has host off other drugs may causes nausea and vomiting. -->

    Complications

    • Disorders hydroelectrolytic

    • mechanical complications: Ulceration, Syndrome of Mallory-Weiss,…
    • respiratory complications (pneumopathy of inhalation, being able to go to a respiratory table of distress: Syndrome of Mendelson)

    Others

    • Eating disorder S (Anorexia nervosa gold Bulimia), Emetophilia
    • To remove has poison in box such has been ingested (nap poisons should not Be vomited ace they may Be more toxic when inhaled gold aspirated; it is generally considered better to ask for help before inducing vomiting)
  • After Surgery (Postoperative nausea and vomiting)
  • The sight gold smell off decayed food, but others' vomits
  • Extreme bread, Myocardial infarction (heart attack)
  • Pregnancy (Morning sickness, Hyperemesis gravidarum)
  • Violent emotions
  • Cyclic vomiting syndrome (poorly understood condition with attacks off vomiting has)-->

    • Drugs related to the vomiting

    Emetics

    emetic , such ace Syrup off Ipecac, has substance that induces vomiting when administered orally gold by injection. Year emetic is used medically where has substance (typically Poison) has been ingested and must Be expelled from the body immediately. Inducing vomiting edge remove the substance before it is absorbed into the body. -->

    Antiemetics

    Drug that is effective against vomiting and Nausea. Antiemetics are typically used to treat Motion sickness and the Side effect S off nap Opioid Analgesic S and Chemotherapy directed against Cancer. -->

    1) ANTAGONISTS OF THE DOPAMINE

    • Phénothiazines : Chlorpromazine (Largactil), Métopimazine (Vogalene), Thiethylperazine (Torecan)

    • substituted Benzamides: Metoclopramide (Primperan) +++, Alizapride (Plitican), Domperidone (Motilium); Haloperidol (Haldol) +++

    Attention with the early risks of dyskinésies nerve sedatives (spasmodic trismus, stiff necks, crises oculogyres…) under Primpéran in the young adults

    2) CORTICOIDS

    • Dexamethasone (Soludecadron)

    • Methylpredsinolone (Solumedrol)
    primarily in the vomiting induced by chemotherapy

    3) The ANTAGONISTS 5HT3 OF SEROTONIN

    Reserved for the vomiting induced by chemotherapy

    • Ondansetron (Zophren)

    • Granisetron (Kytril)

    4) INHIBITERS OF RECEIVERS NK1 OF THE SUBSTANCE P

    • Aprepitant (Emend)

    in partnership with Dexamethasone and Ondansetron, indicated in the treatment of nauseas and acute and delayed vomiting anti-cancer chemotherapy.

    Social implications

    Context

    In the language

    “Vomit” generally indicates the ejected gastric contents. It can be indicated by other more familiar turnings (“dégueuli”, “sheaf”, “quiche”, “fox”, “tax controller”…).

    In the other animals

    Terminology

    • a Régurgitation is a simple increase of the gastric contents towards the back of the throat.

    • the effort of vomiting is called a nausea .
    • a Drug making vomit is called an emetic . One speaks in the same way about effect émétisant .
    • a drug fighting against the vomiting is called a Anti-émétique .

    See too

    External bonds

    • Emetophobia FAQ
    • Cyclical Vomiting Syndrome

    Simple: vomits

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