Nausea and Vomiting

What is Nausea and Vomiting

Nausea is the unpleasant feeling of wanting to vomit and throw up. Nausea is often followed by Vomiting

Vomiting is the act of bringing up gastric contents in a forceful manner. Vomiting involves a combination of abdominal muscle contraction and gastric muscle contraction in a synchronised fashion

Vomiting is often confused with Regurgitation which is a gradual and gentle welling up of gastric contents without any forceful expelling of contents. Regurgitation usually ends up with the contents in the mouth for which the person usually spits it out.

What causes Nausea and Vomiting

Nausea and Vomiting are natural body responses to any noxious or unpleasant stimuli. Due to the wide variety of stimuli, Nausea and Vomiting are fairly non-specific symptoms and can be associated with a variety of conditions.

Nausea and Vomiting are often discussed together as the underlying causes are similar. The causes are more easily understood by dividing into Digestive system and Non-Digestive system causes.

Gastritis and Peptic Ulcer

Gastritis is inflammation of the lining of the stomach and is often referred to as ‘gastric’. The common symptoms include nausea and vomiting and upper abdominal pain.

Peptic ulcer refers to ulcers developing in the stomach is an extension of worsening gastritis. The symptoms are similar to Gastritis with the addition of possible black stools due to ulcer bleeding.

Gallstones

Gallstones refers to the presence of stones in the gallbladder. Gallstones can be asymptomatic. However, when symptomatic, nausea and vomiting are common symptoms together with upper central and right sided abdominal pain. Fever and Yellowing of the skin and eyes can be associated with the symptoms

Acute appendicitis

Appendicitis refers to the inflammation and infection of the appendix. The appendix is a vestigial organ attached to the right side of the colon known as the caecum. Acute appendicitis often starts off with nausea and a vague central abdominal pain. This is followed by loss of appetite, vomiting, fever and a sharp right sided lower abdominal pain

Gastroenteritis (Food Poisoning)

Gastroenteritis, also known as Food Poisoning refers to infection of the digestive system and gastrointestinal system by either bacteria or viruses. The common symptoms include nausea and vomiting and diarrhea together with generalised crampy abdominal pain.

A variant of Food Poisoning is Gastric Flu. Gastric flu is actually a viral infection causing gastritis. It can be caused by a variety of viruses, the commonest being the cold and flu viruses.

Headaches and Migrane

Headaches and Migranes are often associated with nausea and vomiting. Other associated symptoms include visual blurring, flashing lights and fear of bright lights.

It is important to realise that headaches can be a sign of serious underlying issue in the brain such as a brain tumour or arterial aneurysm or arterio-venous aneurysm (AVM)

Urinary Tract Infection (UTI)

Urinary Tract Infection (UTI) refers to an infection of the urinary system. With a UTI, nausea and vomiting are common symptoms. This is in addition to pain on urination and back pain.

Medications and Chemotherapy

Many common medications have nausea and vomiting as a common side effect. This can sometimes be managed by taking the medications before sleeping, taking a smaller meal or by taking some anti-nausea medications.

Chemotherapy drugs are known to cause nausea and vomiting. This will often require intra-venous anti-nausea drugs

When do I seek Medical help?

As nausea and vomiting can be associated with a whole variety of medical conditions, it is important to seek medical help early if there is persistent vomiting. Vomiting can lead to dehydration which in turn can lead to kidney failure. 

The investigations can be very varied, ranging from blood tests to ultrasound to CT scans and also Endoscopy. In addition, it is important to keep an open mind to causes that are outside the digestive tract.

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