Nausea, its causes are familiar to almost every second person on our planet. This is for everyone, without exception, a very unpleasant sensation, extending into the chest cavity and into the oral cavity. As a rule, a rush of nausea is accompanied by chills, with an increase in temperature, excessive sweating, increased salivation, and even a decrease in blood pressure. All this occurs at the time of an attack of nausea.
1 discomfort
The causes of nausea can be different. And they are not always a link with a particular disease. Nausea and vomiting may be transient and rare, or a symptom of an illness. But, to determine for sure, especially in the early stages of the emetic state, it is very difficult.
Causes of persistent nausea:
- systematic overeating, that is, eating everything that has a high concentration of fat;
- as one of the side effects as a result of taking medications. Nausea and vomiting occur, usually due to the ingestion of a large amount of toxins contained in the preparations;
- as a result of psychogenic attacks on the subconscious in the form of fear, anxiety, fear and hysteria;
- if a person suffers from seasickness, it is also called kinetosis. It is its presence that is mainly the main cause of nausea and even vomiting;
- during pregnancy female body hormonally adjusted. In this state, a woman begins to sway in transport, she is haunted by a feeling of nausea from smells, from products, and so on. In this case, the manifestation of nausea in women, or, as they say, toxicosis, is provoked by pregnancy, which, as a rule, passes in the second half of the term;
- can feel sick from smoke, from burning, toxic evaporation of harmful substances;
- Nausea and vomiting can also be the result of sunstroke, overheating in the sun, that is, with hyperthermia.
If all the time there is constant nausea without vomiting, then after a while it disappears just as independently and imperceptibly as it appeared, and, accordingly, treatment is not required. Another thing is if the nausea and vomiting is more serious and is a sign of a serious illness. There are many diseases, the main symptom of which is nausea and vomiting. In addition, it may be the first sign of disease. So you can't leave it unattended.
2 Possible diseases
All diseases are different. All of them have their own symptoms, and each patient feels its course in his own way. Attacks of nausea can be associated with the digestive system, nervous system, reproductive system, cardiovascular system, endocrine system.
Nausea often appears along with diseases of the digestive system and can be associated with serious pathologies.
Serious diseases of surgery:
- pancreatitis;
- appendicitis;
- intestinal obstruction in acute form;
- stomach bleeding;
- cholecystitis.
Diseases of a chronic nature:
- hernia;
- gastritis;
- ulcers;
- colitis;
- chronic form of pancreatitis;
- enterocolitis;
- Crohn's disease;
- gallstone disease.
As well as defects in the form of stenosis, atresia, defects associated with the development of the pancreas.
Infections such as viruses of gastroenteritis, toxic infections, helminthiases.
Liver diseases - hepatitis, cirrhosis, individual intolerance to certain types of products.
In addition, nausea can often be a clear sign of diseases that are not associated with the intake and processing of food.
Nausea occurs with pathologies of the central nervous system which include the following events:
- tumors in the brain;
- brain infections;
- encephalitis;
- meningitis and meningococcal infection of the brain;
- intracranial pressure.
The unpleasant feeling of nausea in women and men can be caused by diseases of the cardiovascular system. This includes a number of diseases:
- hypertension;
- heart failure;
- heart attack.
Diseases associated with the ear are Meniere's disease, diseases of the labyrinth of the ear.
Also, an unpleasant sensation often accompanies patients with diabetes mellitus and its varieties, such as:
- ketoacidosis;
- thyrotoxicosis;
A kidney patient periodically feels nausea during attacks of urolithiasis or in renal failure.
In addition to all these diseases, severe nausea and vomiting accompanies cancer, and after chemotherapy or a radiation therapy procedure, nausea and vomiting can also occur. In this case, an imbalance of blood electrolytes and migraine play a major role in the appearance of a preemetic sensation.
3 Causes of mild nausea
There is mild nausea when a person has been poisoned, when diabetic ketoacidosis occurs or a hemorrhage occurs, and also with cardiovascular pathology, liver failure, and with sepsis.
It happens that nausea and vomiting does not appear by itself, but has whole line symptoms. At the same time, a frequent companion of nausea can be pain in the abdomen, belching with an unpleasant clayey odor, diarrhea, chills, trembling, skin rashes, yellowness of the skin, dizziness, severe fatigue, buckling of the legs, and so on.
Accompanying symptoms should be taken especially seriously. It could be:
- black feces;
- blood in the vomit;
- every day severe pain in the abdomen;
- lack of air;
- elevated temperature;
- drowsiness;
- headache every day;
- fainting;
- pulling muscles.
Nausea for no reason, and even nausea without vomiting - all this may indicate that a disease develops in the body, which can even end in death. With the appearance of at least one of these symptoms, it is necessary to see a doctor.
A qualified specialist, for starters, must carefully listen to the patient. If necessary, ask him those questions, the answer to which could establish a diagnosis. In For example, what did he eat and when, in what quantities, are there any diseases, did he hit his head, and so on.
If there is nothing that clearly indicates the cause of nausea, then the doctor prescribes examinations. The direction of diagnosis depends on the symptoms of nausea.
In addition, the doctor during the survey clarifies whether the patient took any medication or not. It should be borne in mind here that most drugs have a number of side effects, such as nausea, vomiting, diarrhea, rash, dizziness, etc.
5 Medications, side effects
Medications that can cause nausea without vomiting include:
- analgesics;
- cardiovascular drugs;
- hormonal drugs;
- antibiotics;
- anticancer drugs;
- drugs.
It is also worth knowing that if a patient, in case of any disease, took drugs, regardless of the dosage, in case of withdrawal, almost 99% out of 100 experience nausea, vomiting may occur.
Objectivity in the examination is the key to a successful diagnosis and treatment. If none of the options could help determine the cause of nausea, then the doctor prescribes a laboratory examination.
6 Laboratory examination of the patient
Laboratory research includes:
- General blood analysis.
- Fecal analysis.
- Study of the intestinal microflora.
With the help of this study, you can establish the presence of other diseases or discard their likelihood, prescribe treatment. Here, for example, according to the results of a general blood test, one can establish the presence of such a disease as anemia or leukocytosis, there is a stomach ulcer or a disease associated with the duodenum. The result of a study on the presence of electrolytes, urea and creatine is carried out to establish diseases of the kidneys. As for biochemical analysis, in this case it is possible to determine the level of protein, blood albumin and bilirubin. The glucose indicator shows the likelihood of developing diabetes. Investigated antibodies in the blood help to identify the work of the pancreas.
Feces are examined in case of suspected diseases of the digestive system. The intestinal microflora is examined in order to determine the presence of intestinal dysbiosis.
Further treatment is investigated and determined taking into account clinical picture and taking into account the age of the patient. A particularly thorough examination is carried out in cases where nausea has been present for quite a long time, especially in women who complain of vomiting attacks, are of childbearing age, the first study that the doctor prescribes is a pregnancy test. After all, it is pregnancy that can cause such discomfort associated with the restructuring of the body.
But sometimes the reasons other than pregnancy can be different.
In some cases, urinalysis, toxicology testing, and cultures are necessary. If nausea in women is associated with the work of the endocrine system, then consultation with an endocrinologist and a blood test for the presence of hormones is carried out first.
Once the cause is established, the doctor, if this is his profile, will prescribe the appropriate treatment. If the disease is not related to the qualifications of the doctor to whom the patient applied, the patient is referred to other specialists for an accurate diagnosis.
7 Treatment activities
Nausea goes away on its own. Another thing is if it is a sign of a disease. Then, along with the elimination of the cause of its appearance, its treatment occurs. The main thing is to ask for help in a timely manner.
You can help relieve nausea by:
- if the cause is the sun, the sea, food, then, first of all, the very action of the harmful factor is eliminated;
- if the patient suffers from seasickness, scopolamine in the form of a patch, which is attached to the surface of the skin 5 hours before going to sea, will help to cope with nausea and weakness;
- during pregnancy, all that can be used by a woman with nausea is meclozine. You can use this drug in the form of candles. In this case, its constituent components bypass the liver and enter through the blood veins in the rectum, directly into the blood.
Signs of nausea in everyone except pregnant women can be treated with old-fashioned methods.
Everything that's needed:
- Drink water with fresh lemon juice. To do this, every morning, on an empty stomach, you need to drink a glass warm water with the addition of a teaspoon of fresh lemon juice.
- Herbal green tea or dried ginger tea.
- An attack of nausea will weaken the juice from fresh potatoes, which should be drunk in a tablespoon three times a day.
- Brewed dill seeds per 1 glass of water 1 tsp. seeds that are brewed, infused for 2 hours, filtered and consumed in equal portions in 3 doses.
- Decoctions, infusions, prepared on the basis of traditional medicine recipes, will perfectly cope with surging nausea. Moreover, now there is a lot of information about the usefulness and harm of this or that remedy.
If frequent nausea and vomiting is not a disease, then it is quite easy to deal with. For this, there is no need to immediately start taking medicines.
Most often, when a person ate some kind of spoiled product, fried, or he was sick in transport, or he simply overate, a feeling of nausea may occur. In such situations, there is no need to sound the alarm and consult a doctor. Such a single attack of nausea, which occurs for obvious reasons for the patient, is not dangerous to health, so there is no reason to worry. But there are cases when you are constantly sick, and then it is best to contact a specialist who will diagnose and identify the sources of nausea. The causes of nausea can be very different. And among them are many diseases that are far from the simplest and require long-term treatment. In the event that the disease is in a neglected state, it will take even more time for a full recovery, as well as more financial costs.
Constant nausea can occur in the case of constant consumption of very fatty, smoked, salted foods. Improper nutrition, unhealthy and unhealthy foods usually become the main cause of diseases that are associated with an upset gastrointestinal tract, and as a result, against the background of their development, a constant feeling of nausea is considered a natural symptom, which can lead to vomiting.
Gallbladder diseases
If you constantly feel sick and discomfort in the stomach, then such symptoms may be a sign of the presence of gallbladder disease. If discomfort occurs already during a meal, this means that this may be due to problems with the gallbladder. There may also be pain under the ribs on the right side, heartburn appears, gases form, and the taste for food may also change: your favorite food may not seem so tasty, sweets are too sweet, and the like. Also, one of the signs of gallbladder disease is the taste of bitterness. In order to identify this disease, you need to take tests, mainly an ultrasound examination of the digestive system. After which, in confirmation of the disruption of the gallbladder, stones are found. If they are small, there is a chance that due to the right diet, as well as the prescribed medications, they can dissolve, or become smaller. But if the gallbladder is completely clogged with stones of considerable size, it will be possible to get rid of them only with the help of surgical intervention.
Pain in the abdomen in diseases of the gallbladder occurs on the right side and is very often accompanied by symptoms of nausea, which, in case of exacerbation of the disease, can lead to vomiting.
peptic ulcer
It is the feeling of nausea that is the first signs of gastritis, and it usually appears in the morning, but it can also appear on an empty stomach and after eating. Nausea and a constant unpleasant feeling in the stomach does not leave throughout the day, it can become either stronger or weaker. After a person eats, there is a burning sensation and fullness in the stomach, in addition to nausea. In order to identify a peptic ulcer, you need to undergo an ultrasound examination of the internal organs and take a blood test for biochemical diagnostics. Based on the results of a blood test, bacteria can be identified that affect the formation of peptic ulcers. During therapy, the doctor prescribes special medications. Also, in order for the recovery to be accelerated, you need to change your usual diet to a healthy diet food. Fatty, peppery, too salty foods must be excluded from your menu without fail.
pancreatitis
The main symptom is nausea, which is accompanied by bloating, bitterness in the mouth may appear. Constantly nauseous with pancreatitis? Then you should visit a doctor, because. further exacerbation of the disease can lead to the development of serious pathologies. Other signs of the disease may also appear, such as bitterness in the mouth, indigestion, and pain in the ribs on the right side of the abdomen. At the same time, a significant decrease in the weight of the patient is observed. Also characteristic symptom pancreatitis is considered a feeling of bitterness in the mouth, pain on the right side of the abdomen and in the region of the ribs on the right side. In order to make an accurate diagnosis, it is necessary to take a blood test for sugar, pass feces and undergo an ultrasound examination. The symptoms of pancreatitis are somewhat similar to those of diabetes. The specialist usually prescribes enzyme and drug therapy, and, of course, adherence to the right diet.
Appendicitis
Nausea is the first sign of an appendicitis attack. But very quickly it turns into vomiting, the temperature rises, the stomach hurts from below, on the right side, and intensifies in the evening. In such a situation, you should immediately consult a doctor by calling ambulance, since ignoring such an attack, everything can end in death. If an ambulance is called in time, the appendicitis is removed by surgery. Be very careful and if you have a feeling of constant nausea, be sure to immediately seek the help of a doctor.
Intestinal infection
The feeling of nausea appears with poisoning, which is caused by an intestinal infection. Signals of this disease are heaviness in the stomach, turning into emetic emissions of the stomach. In this case, an increase in temperature is possible. If the patient knows for sure that the cause of poisoning is expired or poor-quality food, then he needs to wash his stomach by giving an enema, and you need to constantly drink more liquid. You can also brew chamomile tea: it has an anti-inflammatory effect, flushes the stomach, and relieves a person of feelings of nausea and vomiting. In the event that vomiting turns into bile and does not stop, you need to quickly call an ambulance. Since poisoning can be very serious, for example, from bad mushrooms, one cannot do without the help of specialists. Nausea can also be a consequence of a disease such as salmonellosis.
The feeling of constant nausea with an intestinal infection is a very serious symptom that requires a mandatory examination by a specialist doctor. If you find such symptoms, which may be signs of a disease such as an intestinal infection, you should immediately seek the help of a specialist doctor.
Disorders of the vestibular apparatus
In case of violations of the vestibular apparatus, you constantly feel sick and vomit, other equally painful symptoms are observed. In addition to nausea, dizziness, loss of balance may occur, while signs of such a violation appear unexpectedly, and most often with sharp bends, or a change in position, for example, from sitting to standing. In order to start treatment, you need to seek help from a neurologist who will be able to diagnose and prescribe the correct method of treatment. Only an experienced doctor can prescribe a truly effective treatment for persistent nausea and vomiting in disorders of the human vestibular apparatus.
Heart attack with constant nausea
With such a disease, there is a feeling of nausea, which sometimes turns into vomiting. The patient becomes very pale and may have pain under the ribs. Also, in addition to pallor, a person feels a feeling of stuffiness, even though the room temperature may be normal. In this case, you should immediately call an ambulance, since only experienced specialists will help in the fight against such a disease.
Other reasons if you constantly feel sick
Other reasons why nausea is observed include pregnancy, in which this feeling is characteristic, as a manifestation of toxicosis, especially at the beginning of the second trimester. Another reason is an overdose of drugs.
If you constantly feel sick, regardless of whether the person has eaten or not (a feeling of heartburn and nausea, which leads to vomiting)?
If a person’s stool is normal, and the feeling of constant nausea does not leave him, regardless of whether he took food or not, then these symptoms can be signs of very serious diseases. For example, a feeling of constant nausea, which can go as far as vomiting, may be associated with disorders of some organs of the digestive tract or their entire system at once. Constant nausea and vomiting can be a sign of the development of diseases of the liver, pancreas, cholelithiasis, stomach ulcers, certain types of gastritis, etc.
Usually, the symptom of nausea, which can lead to vomiting, is one of the main symptoms of the onset of diseases of the digestive system, less often, persistent nausea occurs in people who suffer from neurological problems, endocrine diseases, etc.
Nausea that lasts for a long time can be a sign of high blood pressure. The main symptoms of such a pathology as constant high blood pressure are swelling of the face after a night, when it is of a characteristic red color, when it is very sick in the morning, when headaches are too frequent and sometimes lead to dizziness, when a person has increased body fatigue.
Mild nausea during the day is a symptom of numerous diseases, which should be treated at the first detection. But there are conditions that lead to an unpleasant symptom temporarily, and as soon as they pass, nausea immediately recedes.
Causes of prolonged nausea
Most of the reasons why a person periodically feels nauseated for several days or weeks are divided into several groups:
A description of the causes will help narrow the range of searches for pathological processes in the body. But an accurate diagnosis can only be made by a gastroenterologist or other doctor after examinations.
You need to see a doctor if nausea persists for more than 3-4 weeks.
If the symptoms are accompanied by high fever, vomiting and pain in the abdomen, you need to call an ambulance. This condition is typical for aggressive inflammatory processes, internal injuries and ruptures of cysts (neoplasms).
Organ diseases, infections and viruses
Among the most common diseases leading to such symptoms, gastrointestinal pathologies stand out. But damage to other organs can lead to mild nausea throughout the day:
- . Almost always, against the background of nausea, there are sensations such as a burning sensation before and after eating, bloating. After eating, the discomfort increases.
- concussion. In addition, double vision, dizziness appears. The stronger the concussion, the more symptoms appear.
- . Nausea starts when eating. Pain is located on the right side. It can be confused with gastritis, as flatulence, heartburn and belching persist.
- Inflammation of the pancreas. The symptom develops immediately after eating, often includes diarrhea.
- Appendicitis. Nausea develops along with fever and unbearable pain. The increase in symptoms is very fast, often there is vomiting.
- Heart failure. The symptom occurs as a result of lack of air, painful sensations are formed under the pit of the stomach (just below the solar plexus).
- High pressure. Nausea mainly appears in the morning, accompanied by increased fatigue and weakness.
- Kidney inflammation. Nausea is the most pronounced, almost never goes away. With an exacerbation of the pathology, the temperature rises, the urinary function disappears.
- . Tumors of a benign and malignant type often lead to similar symptoms.
- Hypothyroidism. The disease occurs when the thyroid gland does not produce enough hormones. Slightly nauseated, the symptom is accompanied by severe weakness, lack of appetite.
- Meningitis. Nausea appears along with the temperature, unbearable pain in the back of the head. A specific symptom of the disease is sensitivity to bright light.
- Poisoning and intestinal infections.
Mild or severe nausea can occur in women and men as a result of other diseases of the stomach and intestines.
Almost all malignant tumors that have passed into the 3rd or 4th stage of development are accompanied by severe symptoms.
Some pathological reactions of the body occur to external influences. And they do not require any specific treatment. You can use folk methods to eliminate unpleasant feelings.
Causes that do not require specific treatment
The most common cause of nausea is severe stress characteristic of the majority of people living in major cities. You can treat the symptom with folk remedies. Another reason for nausea during the day is transport. A person can live 30 years without sensitivity to motion sickness, and then his vestibular apparatus will begin to change, and similar symptoms will appear.
The symptom often occurs against the background of the use of medicines (regardless of their pharmacological group).
The abuse of sweets can also cause an attack, especially if they are eaten on an empty stomach. Intensive diets and fasting are another point that leads to nausea.
In a woman, a common cause of an unpleasant symptom is pregnancy. But you need to be wary if nausea appears suddenly in the 2-3rd trimester. If the test is negative, then you need to continue the search for a possible factor in the pathology.
naughty female reasons
Nausea can occur during menstruation, as well as a few days before them. This is due to the hormonal background of a woman. Sometimes a symptom appears in women whose uterus has an incorrect location due to individual characteristics.
If the organ is lowered, then nausea is accompanied by unbearable pain and vomiting.
Remember that nausea physiological process- not a pathology. It can appear against the background of blood loss.
Treatment of nausea with folk remedies
You can get rid of mild nausea with a mint candy - The best way dealing with a symptom that occurs in transport. Sometimes an ordinary lemon also helps - it is cut in half and the sweet-sour aroma is inhaled for several minutes.
Minor ailments are not uncommon during pregnancy. Some of them are caused by a change in your condition, others may be negative impacts external environment.
Nausea and bouts of vomiting, which are caused by early toxicosis, accompany most pregnancies to one degree or another. These phenomena are unpleasant, but if they do not lead to malnutrition future mother, she does not lose weight, her body is not threatened by dehydration due to frequent vomiting, this condition does not require medical intervention.
Most experts consider morning nausea to be a completely normal phenomenon that accompanies the onset of pregnancy, since it is quite explainable by the restructuring that has begun in a woman's body. Active production of hormones, increased load on the liver of the expectant mother - all this is the cause of morning sickness. As a rule, the condition of the expectant mother improves significantly by the 10-12th week of pregnancy, when the placenta begins to function.
Complications. Severe vomiting can lead to the development of dehydration and electrolyte disturbances (usually hypokalemia and metabolic alkalosis), relatively rarely accompanied by ruptures of the esophagus - partial (Mallory-Weiss syndrome) or complete (Boerhaave syndrome). Long-term vomiting can lead to malnutrition, weight loss, and metabolic disorders.
Causes of nausea and vomiting
Nausea and vomiting occur in conditions of irritation of the center of vomiting. Immediate causes may affect the level of the gastrointestinal tract or the central nervous system, or be observed within the framework of systemic diseases.
The most common reasons:
- Gastroenteritis.
- The impact of drugs.
- Exposure to toxins.
Cyclic Vomiting Syndrome (CVS) is a relatively rare disorder characterized by severe repeated attacks of vomiting or nausea alone that occur at variable intervals; at the same time, it is not possible to detect any structural changes in the period between attacks. This disorder is most commonly seen in children (mean age of onset 5 years), with a tendency to go into remission as they get older. SCR in adults is often associated with long-term use of marijuana (cannabis extract).
Nausea (nausea) and vomiting (vomitus) occur most often by neuroreflex when the stomach is irritated, especially the pyloric region, and the nearest organs - the beginning of the duodenum and jejunum, the lower esophagus, pharynx with acute gastritis, with esophagitis and pharyngitis (morning mucous vomiting of alcoholics ), etc. Violation of the movement of food and chyme, stagnation and reverse peristalsis especially often lead to nausea and, to a certain extent, expedient vomiting. Vomiting of pure gastric juice in peptic ulcer is characteristic, especially in duodenal ulcer, which brings relief and is often artificially caused by the patient himself; further vomiting during constriction of the pylorus, which occurs rarely (as opposed to irritable vomiting in acute gastritis), usually once a day, and empties the stomach from stagnant masses. Reflex vomiting is observed in diseases of various organs, primarily the intestines and peritoneum with appendicitis, helminthic invasion, with colic - hepatic, renal, uterine, tubal-ovarian. Vomiting can also be of central nervous, including cortical, origin, with toxic irritation of the vomiting center (uremia, alcohol poisoning, carbon monoxide, digitalis, sulfonamides, apomorphine, ipecac; however, with uremia, alcoholism, the action of sulfonamides, one cannot deny the local irritation of the stomach), with an increase in intracranial pressure (tumors, meningitis, acute blood filling of the meninges), with damage to the semicircular canals. Cerebral vomiting is characterized by the absence of nausea, probably more closely related to the antiperistalsis of the stomach and intestines. Habitual nervous vomiting without anatomical changes can reach a degree of indomitable and lead to death from exhaustion and self-poisoning. Vomiting of pregnant women probably occurs with the participation of endocrine changes (the effect of the pituitary gland on the stomach) and nervous factors. Reflex and central nervous vomiting is more easily caused in women and children, especially with frequent repetition of the vomiting act. The practical diagnostic value of nausea and vomiting, as well as methods of treatment, can be very different in each individual case.
Causes of vomiting without nausea:
- Intracranial tumors.
- The patient is asked if he suffers from headaches, double vision; check whether the gait is disturbed.
- Increased intracranial pressure.
- Important signs: nystagmus, swelling of the nipple of the optic nerve, pathology of the cranial nerves.
- Encephalitis.
- Meningitis.
- Migraine.
- Periodic vomiting.
- Vomiting usually recurs every 2 to 3 months and occurs in children, adolescents, or young adults. It often accompanies migraine. With such vomiting, beta-blockers sometimes help.
The vomiting center is located in medulla oblongata near the centers that control breathing and salivation (for this reason, vomiting is combined with hyperventilation and increased salivation). The center receives signals from the chemoreceptors of the trigger zone located in the area of the bottom of the IV ventricle, in the area postrema. The area postrema is supplied with blood from the posterior inferior cerebellar artery, and there is no blood-brain barrier.
The trigger zone is the site of application of the action of certain drugs that cause vomiting, in addition, it receives information from the stomach, intestines, gallbladder, peritoneum and heart through afferent fibers:
- The sensation of nausea appears to be generated by the passage of impulses along the same pathways responsible for the feeling of satiety, so nausea is usually accompanied by anorexia.
- It is necessary to distinguish between vomiting and belching (the latter occurs without effort, i.e. without the participation of the muscles that provide vomiting movements; it usually gives a sour or bitter sensation in the mouth and is not accompanied by nausea).
Medicines that cause nausea and vomiting
- Opiates, digoxin, levodopa, ipecac, cytotoxic agents (affect the chemoreceptor trigger zone).
- Antibiotics (tetracyclines, metronidazole, erythromycin). Sulfonamides (including mesalazine).
- Acetylsalicylic acid, NSAIDs (damage the gastric mucosa and can stimulate the vomiting center through ascending afferent influences).
- Alcohol (acts directly through the chemoreceptor trigger zone and through damaging effects on the gastric mucosa).
Symptoms and signs of nausea and vomiting
The following signs are of particular importance:
- signs of hypovolemia;
- headache;
- signs of irritation of the peritoneum;
- bloating, severe tympanitis. Interpretation of results. Many signs are characteristic of certain causes of vomiting.
If vomiting occurs shortly after ingestion of a drug or toxic substance, or sudden changes in body position, in the absence of significant changes on neurological examination and abdominal evaluation, vomiting is most likely to be explained by these factors. The same applies to cases of pregnancy - in the absence of pathology according to the examination. With the acute development of vomiting and diarrhea in an initially practically healthy patient and the absence of significant changes according to the examination, there is a high probability of infectious gastroenteritis; further examination can be delayed.
Vomiting that occurs at the thought of food or is not associated in time with eating suggests a psychogenic cause, as does the presence of functional nausea and vomiting in the anamnesis of the patient himself or his family members. You should ask the patient in more detail, because. he himself may not be aware of this connection or even admit that he was experiencing a state of stress.
Survey. All women of childbearing age should have a urinary pregnancy test. In case of severe vomiting, vomiting lasting more than 1 day, signs of dehydration, according to the examination, it is necessary to carry out laboratory research(in particular, to evaluate the content of electrolytes, urea nitrogen, creatinine, serum glucose, conduct a urinalysis, in some cases - liver tests). If there are signs of anxiety, the examination plan is based on the corresponding clinical manifestations.
Chronic vomiting usually requires these laboratory tests, as well as upper GI endoscopy, small bowel x-ray, gastric emptying, and antroduodenal motility studies.
Examination for nausea and vomiting
It is usually easy to decide on a list of blood tests, their set is based on anamnesis, as well as on the results of a previous examination:
- AT general analysis blood tests sometimes show anemia. The development of iron deficiency is possible with peptic ulcer or malignant tumors with ulceration, as well as with pathology of the small intestine, an increase in MCV is typical for situations with alcohol abuse, vitamin B 12 deficiency or folic acid.
- The concentration of urea and electrolytes can change both due to vomiting (at the same time, the content of K +, Na + decreases, hyperchloremic metabolic alkalosis develops), and due to the underlying primary kidney dysfunction - it is advisable to check the calcium concentration, as well as determine biochemical indicators liver functions. To rule out acute pancreatitis, immediately send blood to determine the activity of amylase.
- Diagnosis can be aided by upper GI endoscopic examination, especially if done to rule out peptic ulcer or other mucosal changes, bile reflux. Endoscopy provides little information for diagnosing functional disorders. In this regard, an x-ray contrast study is much more effective, with its help, stasis in the upper gastrointestinal tract and narrowing are detected.
Anamnesis. The history of the present illness helps clarify the frequency of episodes of vomiting and their duration; connection with possible precipitating factors, such as exposure to drugs or toxins, traumatic brain injury, body movements (travel by car, plane, ship, riding a carousel); the presence in the vomit of an admixture of bile (bitter taste, yellow-green color) or blood (red color, “coffee grounds”). Significant accompanying symptoms include abdominal pain and diarrhea. It is necessary to evaluate the time of the last bowel movement and gas discharge, the presence of headache and / or systemic dizziness (vertigo).
Assessment of the state of various systems is aimed at identifying signs of conditions that may be accompanied by vomiting, for example, amenorrhea and swelling of the mammary glands (during pregnancy), polyuria and polydipsia (during diabetes mellitus), hematuria and pain in the lateral abdomen (during urolithiasis).
Medical history helps to identify conditions that may be accompanied by vomiting, such as pregnancy, diabetes, migraine, liver or kidney disease, cancer (it is necessary to establish the timing of chemotherapy or radiation therapy), as well as previous surgery for abdominal cavity(which can cause adhesive obstruction). It is necessary to clarify what drugs and substances the patient has taken in recent times; certain substances may not be toxic for several days (eg, acetaminophen, mushroom poisons).
Consideration should be given to indications of recurrent vomiting in other family members.
Physical examination. When assessing vital signs, the presence of fever and signs of hypovolemia (tachycardia and / or hypotension) are noted.
On general examination, the presence of jaundice and skin rash should be noted.
When examining the abdomen, attention should be paid to bloating, scars after previous operations; assess the nature of peristaltic noises (normal, enhanced); conduct percussion to assess tympanitis; on palpation, assess pain, signs of peritoneal irritation (symptom of muscular protection, rigidity, the phenomenon of "rebound soreness" (Shchetkin-Blumberg symptom)), the presence of volumetric formations, an increase in the size of organs, hernias. Rectal examination and transvaginal examination (in women) reveal local tenderness, volumetric formations and blood discharge.
A neurological examination evaluates consciousness, the presence of nystagmus, signs of meningism (Kernig and Brudzinsky symptoms), ophthalmic symptoms characteristic of increased intracranial pressure or subarachnidal hemorrhage (retinal hemorrhage).
Make your life easier
First of all, find out which taste sensations and smells cause the most violent reaction in your body. Most expectant mothers react negatively to the smell of gasoline, cigarette smoke, various perfumes and detergents, as well as the smell of roasted coffee and the aroma of freshly brewed coffee. Avoid "meetings" with them, spend in a well-ventilated area, and perhaps nausea will not bother you during the day.
In order to make the morning not so gloomy - and, as you know, bouts of nausea most often occur in the morning, on an empty stomach - follow a certain ritual of getting up. The best way to relieve your condition right now is a light breakfast in bed. Ask someone from your family to take care of you or take care of yourself - in the evening, put a plate of crackers or cornflakes on the nightstand next to the bed, put an apple. These products are usually well accepted by the stomach and do not cause nausea. Choose foods that you enjoy, such as a light fruit salad, yogurt, or boiled eggs.
Throughout the day, you should eat small meals 5 to 6 times a day. Drink plenty of fluids - acidic fruit juices diluted in half with water help many women, although you may prefer lightly salted tomato juice. Helps to relieve an attack of nausea and rinsing the mouth with mint decoction or water with a little lemon juice.
Look for your remedy - a small mint candy, a slice of lemon or a crust of rye bread can be a real salvation.
Increased load on the liver requires special attention to this organ. Now in your diet must be present animal proteins. Eat lean meats, cottage cheese, and mild cheese. Avoid broths, fried, fatty and spicy, canned foods.
Your doctor may recommend that you take vitamin B6 to alleviate your condition. Antioxidants such as vitamin E, ascorbic acid and betacarotene have proven themselves well (take only as directed by a doctor!). But you don’t need an additional intake of iron yet, moreover, iron-containing drugs can increase the manifestations of toxicosis.
At home, you can prepare infusions of herbs that have a beneficial effect on the mucous membrane of the digestive system and the functioning of the stomach, liver and biliary tract: valerian root, peppermint, calendula and chamomile flowers will help.
Aromatherapy can also help, for example, the beneficial effects of the smell of ginger on women have been proven.
Treatment for nausea and vomiting
Treatment of identified diseases and dehydration is carried out. Even in the absence of severe dehydration, intravenous infusion (1 L of 0.9% saline solution; in children at a dose of 20 ml / kg of body weight) should be carried out, which often helps to reduce symptoms. In adults, various antiemetic drugs are effective (Tables 7-6). The choice of one or another remedy depends on the underlying cause and severity of vomiting.
As a rule, apply:
- for motion sickness (motion sickness): antihistamines and / or scopolamine in the form of a patch;
- with mild to moderate symptoms: prochlorperazine or metoclopramide;
- in severe, refractory vomiting and vomiting during chemotherapy: 5-HT3 receptor antagonists.
With continued vomiting, it is necessary to prescribe drugs parenterally.
In psychogenic vomiting, establishing a trusting relationship with the patient involves understanding the discomfort that the patient is experiencing and working together to alleviate the symptoms, whatever their cause. Avoid remarks such as "you're fine" or "this is emotional problem". A short trial course of symptomatic antiemetic therapy can be done. With long-term observation of the patient, regular follow-up visits to the doctor contribute to the resolution of the underlying problem.
Causes of vomiting outside of pain syndrome
Infectious:
- Viral gastroenteritis.
- Food poisoning; possibly an HP-related infection. Other infections, including inflammatory diseases of the urinary tract and pneumonia in the elderly.
- Viral labyrinthitis.
Mechanical obstruction:
- Pyloric stenosis, duodenal obstruction in cancer of the stomach or pancreas. Esophageal carcinoma.
- Biliary reflux, especially if previous gastric surgery or gastroenterostomy has been performed.
Alcoholic gastritis:
- A common cause of belching in the early morning hours. Belching is usually mild, often with an admixture of blood.
Acute liver failure:
- For example, with an overdose of paracetamol (paracetamol poisoning), acute fatty degeneration of the liver of pregnant women
Metabolic causes:
- Addison's disease (if such a suspicion arises, efforts are directed to the search for postural hypotension, pigmentation of the mucous membranes).
- Elevated or normal content of K is especially great importance, since during vomiting, in a typical case, the concentration of potassium in the blood decreases.
- The possibility of hypercalcemia, uremia and hyperthyroidism must be considered.
- Up to 30% of patients with diabetes occasionally experience episodes of nausea and vomiting.
Many medications are prescribed for nausea and vomiting. They should be used with caution, bearing in mind that they all give side effects.
Basic provisions
- In many cases, the causes of vomiting are obvious, when examining the patient, significant deviations are not detected; only symptomatic treatment is sufficient.
- It is necessary to be vigilant about the possibility of having an acute abdomen syndrome and a dangerous craniocerebral pathology.
- Patients of childbearing age should be evaluated for possible pregnancy.