Vomiting , also known as emesis , throws , throws , throws Another term, is the forced eviction of the contents of one's stomach through the mouth and sometimes the nose.
Vomiting can be caused by various conditions; it may be present as a specific response to diseases such as gastritis or poisoning, or as a sequel to non-specific disorders ranging from brain tumors and high intracranial pressure to overexposure to ionizing radiation. The feeling that a person will vomit is called nausea, which often precedes, but does not always lead to, vomit. Antiemetics are sometimes necessary to suppress nausea and vomiting. In severe cases, where dehydration develops, intravenous fluids may be necessary. Self-induced vomiting can be a component of eating disorders, such as bulimia nervosa, and itself is now a self-feeding disorder, a disruption disorder.
Vomiting differs from regurgitation, although both terms are often used interchangeably. Regurgitation is the return of undigested food into the throat to the mouth, without the strength and discomfort associated with vomiting. The causes of vomiting and regurgitation are generally different.
Video Vomiting
Complications
Aspiration
Vomiting can be dangerous if the stomach contents enter the respiratory tract. Under normal circumstances the gag reflex and cough prevent this from happening; However, these protective reflexes are compromised on people under the influence of certain substances such as alcohol or anesthesia. Individuals may choke and suffocate or suffer from aspiration pneumonia.
Dehydration and electrolyte imbalance
Prolonged and excessive vomiting depletes the body of water (dehydration), and may alter electrolyte status. Gastric vomiting causes the loss of acid (proton) and chloride directly. Combined with the resulting base stream, this leads to a hypochloremic metabolic alkalosis (low chloride content together with HCO -
3 and CO
2 and increased blood pH) and often hypokalemia (potassium thinning). Hypokalemia is an indirect result of the kidneys that compensate for acid loss. With the loss of food intake, individuals can eventually become cachectic. The incidence is less frequent due to vomiting of intestinal contents, including bile acids and HCO - < in line: vertical-align: baseline "> 3 , which can cause metabolic acidosis. Mallory-Weiss
Excessive repetitive or vomiting can cause erosion to the esophagus or small tears in the esophageal mucosa (Mallory-Weiss rupture). It can become clear if fresh red blood mixes with vomit after several episodes.
Dentistry
Repeated vomiting, as observed in bulimia nervosa, can cause tooth enamel damage due to acidity of vomit. Digestive enzymes can also have a negative effect on oral health, by lowering gum tissue.
Maps Vomiting
Pathophysiology
The receptor on the fourth ventricle of the brain is a chemoreceptor trigger zone, known as the postrema area, a stimulation that can cause vomiting. Postrema region is a circumventricular organ and therefore lies outside the blood-brain barrier; because it can be stimulated by drugs containing blood that can stimulate vomiting or inhibit it.
There are various sources of feedback to the vomiting center:
- The chemoreceptor-trigger zone at the bottom of the fourth ventricle has many dopamine receptors D 2 , 5-HT 3 serotonin receptors, opioid receptors, acetylcholine receptors, and receptors for Substance P. Different receptor stimuli are involved in different pathways leading to emesis, on the substance of the final common path P seems to be involved.
- The vestibular system, which transmits information to the brain via the cranial nerve VIII (vestibulocochlear nerve), plays a major role in motion sickness, and is rich in muscarinic receptors and histamine H 1 receptors./li>
- The cranial nerve X (vagus nerve) is activated when the pharynx is disturbed, leading to a gag reflex.
- Vagal and enteric nervous system entries send information about the state of the gastrointestinal system. GI mucosal irritation by chemotherapy, radiation, distension, or acute infection gastroenteritis activates 5-HT recipe 3 of this input.
- CNS mediates vomiting arising from psychiatric disorders and stress from the higher brain centers.
The act of vomiting includes three types of output initiated by the chemoreceptor trigger zone: Motor, parasympathetic nervous system (PNS), and sympathetic nervous system (SNS). They are as follows:
- Increased salivation to protect tooth enamel from stomach acid. (Excessive vomiting causes tooth erosion). This is part of the PNS output.
- The body takes a deep breath to avoid vomiting aspirations.
- Retroperistalsis start from the middle of the small intestine and sweep the gastrointestinal contents into the stomach, through a relaxed pyloric sphincter.
- Intrathoracic pressure decreases (with inspiration to the closed glottis), coupled with an increase in abdominal pressure as the abdominal muscles contract, pushing the contents of the stomach into the esophagus as the lower esophageal sphincter relaxes. The abdomen itself does not contract in the vomiting process except on the curve of the angle, nor is there any retroperistalsis in the esophagus.
- Vomiting is usually preceded by vomiting.
- Vomiting also initiates an SNS response that causes sweating and increases heart rate.
Neurotransmitters that regulate vomiting are not well understood, but dopamine, histamine and serotonin inhibitors are all used to suppress vomiting, suggesting that this plays a role in the initiation or maintenance of the vomiting cycle. Vasopressin and neurokinin can also participate.
Phase
The act of vomiting has two phases. In the retching phase, the abdominal muscles undergo several rounds of coordinated contractions along with the diaphragm and muscles used in respiratory inspiration. For this reason, one can disrupt this phase with harsh hiccup episodes. In this phase of vomiting, nothing has been released yet. In the next phase, also called the expulsive phase, a strong pressure is formed in the stomach brought about by a major shift in both the diaphragm and the stomach. This shift, in essence, is a strong contraction of these muscles that last for long periods of time - longer than the normal period of muscle contraction. The pressure is then suddenly released when the upper esophageal sphincter relaxes resulting in the expulsion of the contents of the stomach. Individuals who do not regularly train their abdominal muscles may experience pain in these muscles for several days. Relief of pressure and release of endorphins into the bloodstream after expulsion causes the vomiter to feel better.
Contents
Gastric secretions and also vomiting are very acidic. Food intake has recently appeared in gastric vomiting. Regardless of the content, vomiting tends to stink.
The content of vomit (vomit) may be of medical importance. Fresh blood in vomit is called hematemesis ("vomiting blood"). Changed blood has a resemblance to a coffee powder (like iron in oxidized blood) and, when this is identified, the term coffee-ground vomiting is used. Bile can enter the vomit during the next menstruation due to duodenal contractions if the vomiting is severe. Fecal vomiting is often a consequence of bowel obstruction or gastrocolic fistula and is treated as a warning sign for this potentially serious problem ( signum mali ominis ).
If the gag reflex continues for a long time without meaningful vomitus, this condition is known as non-productive emesis or "dry heaves", which can be painful and debilitating.
- Colors vomit
- The bright red in the vomiting shows bleeding from the esophagus
- Dark red vomiting with heart-like clots indicates abdominal bleeding, such as from a perforated ulcer
- Vomiting like coffee shows less severe bleeding in the abdomen, because stomach acid has time to change blood composition
- Yellow vomiting shows bile, indicating that the pyloric valve is open and bile flowing into the stomach from the duodenum (this is more common in the elderly)
Differential diagnosis
Vomiting can be caused by a large number of causes, and prolonged vomiting has a long differential diagnosis.
Digestive Tract
Causes in the digestive tract
- Gastritis (inflammation of the stomach wall)
- gastroenteritis
- Gastroesophageal reflux disease
- celiac disease
- Non-sheath gluten sensitivity
- Pyloric stenosis (in infants, this usually causes a very strong "vomiting projectile" and is an indication for urgent surgery)
- Bowel obstruction
- Excessive eating
- Acute stomach and/or peritonitis
- Ileus
- Food allergies (often associated with itching or swelling)
- Cholecystitis, pancreatitis, appendicitis, hepatitis
- Food poisoning
- In children, this can be caused by an allergic reaction to cow's milk protein (milk allergy or lactose intolerance)
Sensory system and brain
Causes in the sensory system:
- Movement: motion sickness (caused by overstimulation of the ear labyrinth canal)
- Disease MÃÆ' Â © niÃÆ'¨re
Causes in the brain:
- Konkusi
- Cerebral hemorrhage
- Migraine
- Brain tumors, which can cause chemoreceptors to become malfunctioning
- Benign intracranial hypertension and hydrocephalus
Metabolic disorders (this can irritate the stomach and parts of the brain that coordinate vomiting):
- Hypercalcemia (high calcium levels)
- Uremia (urea accumulation, usually due to renal failure)
- adrenal insufficiency
- Hypoglycemia
- Hyperglycemia
Pregnancy:
- Hyperemesis, morning sickness
Drug reactions (vomiting may occur in acute somatic responses):
- alcohol (got sick while drunk or sick the next morning, suffered from continued effects, ie drunk)
- opioid
- selective serotonin reuptake inhibitors
- many chemotherapy drugs
- some entheogens (like peyote or ayahuasca)
Illness (sometimes colloquially known as "stomach flu" - a broad name that refers to gastric inflammation caused by various viruses and bacteria):
- Norovirus (formerly Norwalk virus or Norwalk agent)
- Swine flu
Psychiatry/behavior
- Bulimia Nervosa
- An ugliness error
Emetics
An vomit , such as ipecac syrup, is a substance that causes vomiting when given orally or by injection. An emetic is used medically when a substance has been digested and must be removed from the body immediately (for this reason, many toxic and easily digestible products such as rat toxins contain emetic). Inducing vomiting can remove substance before it is absorbed into the body. Ipecac abuse can cause adverse health effects.
Salt water and mustard water have been used since ancient times as emetic. Treatment should be done with salt, because excessive intake is potentially harmful.
Copper sulfate is also used in the past as an emetic. It is now considered too toxic to use.
Hydrogen peroxide is used as emetic in veterinary practice.
Social cues
It is common that, when one person vomits, another person nearby becomes nauseous, especially when kissing another person's vomit, often to his own vomit. It is believed that this is an evolving trait among primates. Many primates in the wild tend to find food in small groups. If one party member reacts negatively to the digested food, it may be beneficial (in the sense of survival) for other members of the party to also vomit. This tendency in the human population has been observed at binge drinking, where excessive consumption of alcoholic beverages can cause a number of members of the vomiting party almost simultaneously, this is triggered by the initial vomiting of a party member. This phenomenon has been alluded to in popular culture: notable examples appear in Monty Python's The Meaning of Life (1983) and Stand By Me (1986).
The intense vomiting in the ayahuasca ceremony is a common phenomenon. However, people who experience "la purga" after drinking ayahuasca, in general, regard the practice as physical and spiritual cleansing and often come to greet it. It has been suggested that the consistent emetic effect of ayahuasca - in addition to many other therapeutic properties - is a drug benefit to indigenous Amazon communities, in helping to clear parasites from the gastrointestinal system.
There are also documented cases of an individual who is sick and vomiting inadvertently causing others to vomit, when they are especially afraid of getting sick, through the form of mass hysteria.
Most people try to hold their vomit with vomit to the sink, toilet, or dumpster, because vomiting is difficult and unpleasant to clean. On airplanes and boats, special bags are provided for sick passengers to vomit. Disposable special bags (anti-leaks, puncture-resistant, odorless) that contain absorbent materials that rapidly condense vomit are also available, making them comfortable and safe to store until there is a chance to dispose of them comfortably.
Chronic vomiting (for example, as part of an eating disorder such as bulimia nervosa) can devise ways to conceal this disorder.
An online study of people's responses to "terrible sounds" is found spewing out the "most disgusting". Professor Trevor Cox from the Salford University Acoustic Research Center said that "We've been programmed to be driven back by horrible things like vomiting, because it's important to stay alive to avoid the bad stuff." It is thought that the disgust triggered by the sound of vomit to protect the people closest to the food that may be diseased.
Miscellanea
- Induced by yourself
- Feeding disorders (anorexia nervosa or bulimia nervosa)
- To get rid of toxins swallowed (some toxins should not be vomited as they may be more toxic when inhaled or aspirated; better ask for help before inducing vomiting)
- Some people involved in binge drink induce vomiting to make room in their stomach for more alcohol consumption.
- People suffering from nausea can cause vomiting in the hope of feeling better.
- After surgery (postoperative nausea and vomiting)
- Unpleasant scenes or disgust, smells or thoughts (such as rotting matter, vomit of others, thinking of vomiting), etc.
- Severe pain, such as severe headache or myocardial infarction (heart attack)
- Fierce emotion
- Cyclic vomiting syndrome (a condition not understood with vomiting attacks)
- High-dose ionizing radiation sometimes triggers a gag reflex.
- Severe violence such as cough, hiccup, or asthma
- Anxiety
- Depression
- Excessive fatigue (doing too much exercise can cause vomiting shortly afterwards).
- The ruminating syndrome, undiagnosed and poorly understood disorders that cause the sufferer to vomit the food shortly after consumption.
Other types
- projectile vomiting refers to vomiting that secretes gastric contents with great strength. This is a classic symptom of infantile hypertrophic pyloric stenosis, which usually occurs after a meal and can be so strong that some of the material exits through the nose.
Treatment
Antiemetics are an effective remedy against vomiting and nausea. Antiemetics are commonly used to treat motion sickness and drug side effects such as opioids and chemotherapy.
Antiemetics act by inhibiting the receptor sites associated with emesis. Therefore, anticholinergics, antihistamines, dopamine antagonists, serotonin antagonists, and cannabinoids are used as antiemetics.
Evidence to support the use of antiemetics for nausea and vomiting among adults in poor emergency departments. It is not clear whether any medication is better than others or better than no active treatment.
Epidemiology
Nausea and/or vomiting is a major complaint in 1.6% of visits to family doctors in Australia.
Social and cultural aspects
Herodotus, writing about ancient Persian culture and highlighting differences with the Greeks, notes that to vomit before others is forbidden among the Persians.
See also
- Bulimia nervosa
- Emetophilia
- Cancer and nausea
- Emetophobia
References
External links
- Winding Vomiting Syndrome
- Ã, "Emetics". The CyclopÃÆ'Â|dia America . 1879.
Source of the article : Wikipedia
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