Nausea and vomiting - causes, diseases, what to do, treatment

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

Nausea is a painful sensation of discomfort in the upper abdomen, chest, mouth and throat, often preceding vomiting.

What characteristics of vomit should you pay attention to?

In order to draw any conclusions about the reasons that caused vomiting, it is advisable to examine the vomit after each case of its 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.

Causes

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).

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

Bowel diseases with vomiting

• Food poisoning : Diarrhea, abdominal cramps, nausea and vomiting may indicate food poisoning. Triggers are toxins that are absorbed through food. Most often these are poisonous bacteria (for example, salmonella or staphylococcus), sometimes toxins of other organisms (for example, mushroom poisons) or chemical poisons (lead, copper, zinc, etc.).
• Other poisonings: Nausea and vomiting may also occur with other poisonings, such as poisoning from drugs, carbon monoxide, or pesticides. If you suspect poisoning, you should immediately call a doctor!
• Alcohol and Nicotine : Alcohol and nicotine are toxins to the body. In mild cases, with small doses, nausea, vomiting and nervousness occur. In case of severe alcohol or nicotine poisoning, convulsions and disturbances of consciousness (sometimes coma) are possible. In such cases, you should consult a doctor immediately!
• Caffeine: Large amounts of caffeine (coffee, caffeinated energy drinks, etc.) can cause nausea, vomiting, nervousness and sweating, as well as problems concentrating.
• Drugs: Drug overdose, as well as unavailability of drugs in the context of existing drug addiction, can cause nausea, vomiting, confusion, increased agitation, coma, and possibly severe anxiety and seizures. Call an emergency doctor immediately!
• Acute abdomen : This is a threatening complex of sudden onset symptoms - severe abdominal pain, abdominal wall tension, as well as autonomic symptoms such as nausea, vomiting, sweating, palpitations and a drop in blood pressure.
• A strangulated hernia: The first signs are sudden severe abdominal pain, nausea and vomiting. The hernia is hard, painful and can no longer be pushed back into the abdominal cavity. You should consult a doctor immediately!
• Peritonitis: develops, for example, with gastric rupture, appendicitis, mechanical intestinal obstruction and acute inflammation of the pancreas. Signs of acute abdominal syndrome appear: nausea, vomiting, rapidly increasing, sharp abdominal pain, acute abdomen, cold sweat and palpitations, often anxiety and fever. Contact your doctor immediately!
• Food intolerances : Nausea and vomiting after eating certain foods may indicate a food intolerance. For example, milk intolerance (lactose intolerance), fructose intolerance, cow's milk intolerance and celiac disease ( gluten intolerance ). Abdominal pain, diarrhea and/or bloating are common with these conditions.
• Stomach overload: After eating too much or too quickly, the body often reacts with a feeling of fullness, nausea and vomiting.
• Inflammation of the gastric mucosa (gastritis): a characteristic feature is the appearance of nausea after eating, often accompanied by vomiting, belching, as well as pain and/or a feeling of pressure in the stomach.
• Stomach/duodenal ulcer (peptic ulcer ): May cause nausea, vomiting, belching, loss of appetite, and pain and/or pressure in the stomach before eating.
• Stomach cancer (gastric carcinoma): manifests itself as an unpleasant odor, abdominal pain, aversion to certain foods (especially meat), nausea, a feeling of fullness, loss of appetite, and weight loss.
• Stomach rupture (gastric perforation): Both stomach ulcers and stomach cancer can cause the stomach wall to tear, resulting in a connection to the open abdominal cavity. Such perforation of the stomach is manifested by sudden pain, which often radiates to the left shoulder. The abdominal wall becomes hard, nausea and vomiting appear.
• Appendicitis : Appendicitis causes nausea, vomiting and rapidly increasing pain that extends from the navel to the lower right side of the abdomen. If you have severe pain or a hard abdomen (acute abdomen), you must call an ambulance! In addition, the patient should not eat or drink!
• Infectious diarrhea ( intestinal infections ): inflammation of the gastrointestinal tract can be caused by viruses or bacteria ( rarely parasites ), and nausea and vomiting, severe diarrhea, and abdominal pain develop.
• Intestinal obstruction (ileus): Causes nausea, vomiting, rapidly increasing, sharp abdominal pain and a sharp abdomen. You should call a doctor immediately!

Diseases of the liver, pancreas and kidneys

• Inflammation of the liver (hepatitis): nausea, loss of appetite, aversion to fat may indicate an acute hepatitis virus. Victims feel a feeling of pressure in the right upper abdomen, jaundice, dark urine, and discolored stool may occur.
• Acute liver failure: A sudden decrease in liver function without previously known liver disease may, for example, be a consequence of acute viral hepatitis or drug poisoning. Nausea, vomiting, and abdominal pain are common.
• Biliary colic: Biliary colic presents with nausea, vomiting and very severe stabbing pain in the right upper abdomen. Pain that may spread to the right shoulder, jaundice, dark urine, and itching may also occur. Biliary colic is caused by inflammation of the gallbladder or a stone that blocks the bile duct. Call an ambulance immediately!
• Acute pancreatitis: accompanied by nausea, vomiting and lumbar pain in the upper abdomen. Complaints often occur several hours after drinking alcohol or fatty foods. Fever and jaundice may develop. You should call a doctor immediately!
• Chronic pancreatitis of the pancreas: constantly recurring episodes of nausea, vomiting, and pain in the abdomen and back. Often complaints appear due to fatty foods and alcohol. In addition, steatorrhea and weight loss are possible.
• Pancreatic cancer (pancreatic carcinoma): the main symptoms include pain that radiates to the lower back, loss of appetite, nausea, vomiting, and decreased performance.
• Renal colic: This causes nausea, vomiting and very severe, stabbing pain in the side. The pain often spreads to the lateral iliac region, the labia or testicles, and the back. Blood may appear in the urine. You should call a doctor immediately!
• Pyelonephritis: nausea, vomiting, as well as pain in the upper abdomen and sides, fever, chills and pain when urinating.
• Urine poisoning (uremia) in renal failure: rapid or slow progressive decline in kidney function. They also talk about acute or chronic renal failure. In severe cases, substances accumulate in the body that can only be eliminated through the kidneys, causing poisoning of the body. It is characterized by nausea, vomiting, brownish-gray skin, and water retention in the tissues (edema).
• Addison's disease: In this dysfunction, the adrenal cortex produces little or no adrenal hormones. The main signs are abdominal pain, nausea, vomiting with weight loss and dehydration, weakness, low blood pressure, increased pigmentation of the skin and mucous membranes, depression and increased excitability.

Genitals

• Fallopian tube rupture during pregnancy (ectopic pregnancy): If a fertilized egg is in the fallopian tube and grows, it can eventually rupture the fallopian tube. The consequence is severe bleeding in the abdominal cavity with the formation of an acute abdomen (in particular, nausea and vomiting).
• Acute inflammation of the fallopian tubes and ovaries is accompanied by sharp pain in the lower abdomen (on one or both sides), fever, yellowish-green, foul-smelling discharge. If the inflammation spreads to the peritoneum (peritonitis), nausea and vomiting may occur.
• Ovarian cyst: a fluid-filled cavity that develops primarily as a result of hormonal changes shortly after puberty and also before menopause. Mostly they disappear on their own. Complications of ovarian cysts may be accompanied by nausea, vomiting, increased heart rate, sweat, and exhaustion.
• Testicular rotation: sudden, unilateral (sometimes bilateral) rotation of the testicle around its axis occurs mainly in infants up to the second year of life, as well as in adolescents aged 15 to 20 years. It causes sudden and very severe pain in the testicle, which can spread to the groin and abdominal cavity. Nausea and vomiting also often occur. After about six hours, the testicle will be permanently damaged, so surgery must be done quickly.

The cardiovascular system

• Acute heart failure: The development of heart failure within minutes to several hours is accompanied by acute weakness, malaise, nausea, rapidly increasing breathing, palpitations, very low blood pressure, and shock. You should call an emergency doctor immediately!
• Chronic heart failure: develops over months to years and may affect only half the heart or the entire heart. Right heart failure is characterized by, among other things, symptoms such as lack of appetite, nausea, flatulence and swelling.
• Heart attack (myocardial infarction): If you experience nausea, vomiting, severe pain or tightness in the chest, shortness of breath, cold sweats, and anxiety, a heart attack may be suspected. You should call an emergency doctor immediately!
• Angina: The same symptoms as a myocardial infarction may accompany angina pectoris (a temporary loss of blood supply to the heart muscle). Only a doctor can determine whether you have had a heart attack or angina.
• Hypertension: with a sudden increase in blood pressure to values ​​above 230/130, they speak of a crisis. Nausea, vomiting, headache, dizziness, visual disturbances, convulsions, paralysis, disturbances of consciousness and coma may also occur, which will indicate brain damage due to a sharp increase in blood pressure.
• Dizziness: Dizziness and nausea when looking down at high altitudes (such as from a suspension bridge) are a normal reaction of the body. But nausea and vomiting may occur.
• Heatstroke or sunstroke: Nausea, vomiting and headache after prolonged exposure to the sun or overheating usually indicate sunstroke or heatstroke. Other signs of this condition include hot, red skin, lack of sweating, dizziness and weakness. If there are problems with consciousness, you should immediately call an emergency doctor!

Brain

• Migraine: Often accompanied by nausea, vomiting, noise and light sensitivity, and possibly visual and speech disturbances, repeated, severe, most often throbbing and one-sided headaches.
• Brain hemorrhage: Sudden rupture of blood vessels in the brain (for example, due to hypertension, atherosclerosis or aneurysm) can cause severe and unbearable headaches, impaired consciousness, nausea and vomiting. Depending on the location of the brain hemorrhage, nerve damage is also possible, which can lead to impaired vision or speech, as well as paralysis of half the body. Call an ambulance immediately!
• Stroke due to bleeding in the brain (hemorrhagic stroke): About 20 percent of all strokes are based on bleeding in the brain. Sudden attacks of headache with nausea and vomiting are possible, as well as often paralysis, convulsions and disturbances of consciousness up to coma. You should call an emergency doctor immediately!
• At the beginning of summer, meningoencephalitis: this viral infection, transmitted by ticks, usually causes meningitis, sometimes additionally meningoencephalitis; Dangerous inflammation of the spinal cord (myelitis) occurs less frequently.

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.