Should You Give Liquid Medicine Again After Vomiting

Involuntary, forceful expulsion of stomach contents, typically via the mouth

"Emesis" redirects here. For the butterfly genus, run across Emesis (genus).

"Heaving" redirects hither. For the sailing term, see Heaving to. For the sailing term "heaving down", encounter Careening.

Medical condition

Airsickness
Other names	Emesis, puking, barfing, heaving, throwing upward, blowing chunks, upchucking, technicolor yawn, spewing, tossing your cookies, losing your tiffin
14th-century illustration of vomiting from the Casanatense Tacuinum Sanitatis
Specialty	Gastroenterology
Symptoms	Nausea
Complications	Aspiration, electrolyte and water loss, harm to the enamel of the teeth, tear of the esophageal mucosa
Adventure factors	History of migraine, history of PONV or motion sickness in a child'south parent or sibling, better ASA physical status, intense preoperative anxiety, sure ethnicities or surgery types, decreased perioperative fluids, crystalloid versus colloid administration

Vomiting (also known as emesis and throwing upwards)^[a] is the involuntary, forceful expulsion of the contents of one'south stomach through the mouth and sometimes the olfactory organ.^[ane] Projectile airsickness is an intense form of vomiting, sometimes seen in infants, that may include vomit exiting out the nostrils.

Vomiting tin can be the result of ailments like food poisoning, gastroenteritis, pregnancy, movement sickness, or hangover; or information technology can be an aftereffect of diseases such every bit encephalon tumors, elevated intracranial pressure level, or overexposure to ionizing radiation. The feeling that one is about to vomit is called nausea; it often precedes, but does not ever lead to vomiting. Impairment due to alcohol or anesthesia can cause inhalation of vomit, leading to suffocation. In astringent cases, where aridity develops, intravenous fluid may be required. Antiemetics are sometimes necessary to suppress nausea and airsickness. Self-induced vomiting can be a component of an eating disorder such as bulimia, and is itself at present classified equally an eating disorder on its own, purging disorder.^[2]

Vomiting is different from regurgitation, though the terms are often used interchangeably. Regurgitation is the return of undigested food back upward the esophagus to the rima oris, without the force and displeasure associated with vomiting. The causes of vomiting and regurgitation are generally different.

Complications

Aspiration

Vomiting is dangerous if gastric content enters the respiratory tract. Under normal circumstances the gag reflex and coughing foreclose this from occurring; however, these protective reflexes are compromised in persons who are nether the influence of certain substances (including alcohol) or even mildly anesthetized. The individual may choke and choke^[three] or suffer aspiration pneumonia.^[4]

Dehydration and electrolyte imbalance

Prolonged and excessive airsickness depletes the torso of water (aridity), and may alter the electrolyte status. Gastric vomiting leads to the loss of acrid (protons) and chloride directly. Combined with the resulting alkaline metal tide, this leads to hypochloremic metabolic alkalosis (low chloride levels together with high HCO ⁻
₃ and CO
₂ and increased blood pH) and frequently hypokalemia (potassium depletion). The hypokalemia is an indirect result of the kidney compensating for the loss of acrid. With the loss of intake of food the individual may eventually become cachectic. A less frequent occurrence results from a vomiting of intestinal contents, including bile acids and HCO ⁻
_iii , which can cause metabolic acidosis.^{[ citation needed ]}

Mallory–Weiss tear

Repeated or profuse vomiting may cause erosions to the esophagus or small-scale tears in the esophageal mucosa (Mallory–Weiss tear). This may become apparent if fresh reddish blood is mixed with vomit after several episodes.^{[ citation needed ]}

Dentistry

Recurrent vomiting, such as observed in bulimia nervosa, may lead to the destruction of the tooth enamel due to the acidity of the vomit. Digestive enzymes can also have a negative effect on oral health, by degrading the tissue of the gums.^{[ citation needed ]}

Pathophysiology

Receptors on the floor of the fourth ventricle of the brain stand for a chemoreceptor trigger zone, known as the expanse postrema, stimulation of which tin lead to vomiting. The expanse postrema is a circumventricular organ and every bit such lies exterior the blood–brain barrier; it tin therefore be stimulated by blood-borne drugs that can stimulate vomiting or inhibit it.^[5]

There are various sources of input to the airsickness middle:

• The chemoreceptor trigger zone at the base of the fourth ventricle has numerous dopamine D₂ receptors, serotonin 5-HT₃ receptors, opioid receptors, acetylcholine receptors, and receptors for substance P. Stimulation of different receptors are involved in different pathways leading to emesis, in the final common pathway substance P appears involved.^{[6] [seven]}
• The vestibular system, which sends information to the brain via cranial nerve Viii (vestibulocochlear nervus), plays a major role in motion sickness, and is rich in muscarinic receptors and histamine H_i receptors.^{[8] [9]}
• The cranial nerve X (vagus nerve) is activated when the pharynx is irritated, leading to a gag reflex.
• The vagal and enteric nervous system inputs transmit information regarding the country of the gastrointestinal organization. Irritation of the GI mucosa by chemotherapy, radiations, distention, or acute infectious gastroenteritis activates the 5-HT_iii receptors of these inputs.
• The CNS mediates vomiting that arises from psychiatric disorders and stress from higher brain centers.^[10]
• The medulla plays an important role for triggering the vomiting act.^[xi]

The airsickness act encompasses three types of outputs 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 acids.^[12] (Excessive vomiting leads to dental erosion.) This is role of the PNS output.
• The torso takes a deep breath to avoid aspirating vomit.^[12]
• Retroperistalsis starts from the center of the small intestine and sweeps upwardly digestive tract contents into the stomach, through the relaxed pyloric sphincter.^[12]
• Intrathoracic pressure lowers (by inspiration against a closed glottis), coupled with an increase in abdominal force per unit area as the abdominal muscles contract, propels stomach contents into the esophagus equally the lower esophageal sphincter relaxes.^[xiii] The tum itself does not contract in the process of vomiting^[xiv] except for at the athwart notch, nor is there any retroperistalsis in the esophagus.
• Vomiting is ordinarily preceded by retching.^[12]
• Airsickness too initiates an SNS response causing both sweating and increased heart rate.^[12]

Phases

The airsickness act has 2 phases. In the retching phase, the abdominal muscles undergo a few rounds of coordinated contractions together with the diaphragm and the muscles used in respiratory inspiration. For this reason, an individual may confuse this phase with an episode of violent hiccups. In this retching stage, nothing has yet been expelled. In the next phase, also termed the expulsive phase, intense pressure is formed in the stomach brought about past enormous shifts in both the diaphragm and the belly. These shifts are, in essence, vigorous contractions of these muscles that last for extended periods of fourth dimension—much longer than a normal period of muscular contraction. The pressure level is so all of a sudden released when the upper esophageal sphincter relaxes resulting in the expulsion of gastric contents. Individuals who practice not regularly exercise their intestinal muscles may experience pain in those muscles for a few days. The relief of pressure and the release of endorphins into the bloodstream subsequently the expulsion causes the vomiter to feel better.^[15]

Contents

Partially digested food, with human being-sized glove for scale

Gastric secretions and likewise vomit are highly acidic. Recent food intake appears in the gastric vomit. Irrespective of the content, vomit tends to exist malodorous.^{[ citation needed ]}

The content of the vomitus (vomit) may exist of medical interest. Fresh blood in the vomit is termed hematemesis ("blood vomiting"). Altered blood bears resemblance to coffee grounds (every bit the iron in the blood is oxidized) and, when this thing is identified, the term coffee-ground airsickness is used. Bile can enter the vomit during subsequent heaves due to duodenal wrinkle if the vomiting is astringent. Fecal vomiting is frequently a consequence of intestinal obstruction or a gastrocolic fistula and is treated as a warning sign of this potentially serious problem (signum republic of mali ominis).^{[ commendation needed ]}

If the vomiting reflex continues for an extended menstruation with no observable vomitus, the condition is known every bit non-productive emesis or "dry heaves", which can exist painful and debilitating.^{[ commendation needed ]}

Color of vomit^[16]

• Bright red in the vomit suggests haemorrhage from the esophagus
• Nighttime red vomit with liver-like clots suggests profuse haemorrhage in the stomach, such as from a perforated ulcer
• Coffee-ground-like vomit suggests less severe bleeding in the breadbasket because the gastric acid has had time to modify the composition of the blood
• Yellow vomit suggests bile, indicating that the pyloric valve is open and bile is flowing into the stomach from the duodenum (this is more common in older people)

Causes

Vomiting may exist due to a large number of causes, and protracted vomiting has a long differential diagnosis.^{[ commendation needed ]}

Digestive tract

Causes in the digestive tract

• Gastritis (inflammation of the gastric wall)^[17]
• Gastroenteritis
• Gastroesophageal reflux disease
• Celiac affliction^[18]
• Non-celiac gluten sensitivity^[19]
• Pyloric stenosis (in babies, this typically causes a very forceful "projectile vomiting" and is an indication for urgent surgery)
• Bowel obstruction
• Overeating (stomach likewise total)
• Astute abdomen and/or peritonitis
• Ileus
• Food allergies (oft in conjunction with hives or swelling)
• Cholecystitis, pancreatitis, appendicitis, hepatitis
• Food poisoning
• In children, it tin can be caused by an allergic reaction to cow's milk proteins (Milk allergy or lactose intolerance)

Sensory organization and brain

Causes in the sensory system:^{[ citation needed ]}

• Movement leading to movement sickness (which is caused by overstimulation of the labyrinthine canals of the ear)^{[ citation needed ]}
• Ménière's illness
• Vertigo

Causes in the brain:^{[ citation needed ]}

• Concussion
• Cerebral hemorrhage
• Migraine
• Brain tumors, which can cause the chemoreceptors to malfunction
• Benign intracranial hypertension and hydrocephalus

Metabolic disturbances (these may irritate both the stomach and the parts of the encephalon that coordinate vomiting):^{[ citation needed ]}

• Hypercalcemia (high calcium levels)
• Uremia (urea accumulation, normally due to kidney failure)
• Adrenal insufficiency
• Hypoglycemia
• Hyperglycemia

Pregnancy:^[xx]

• Hyperemesis, forenoon sickness

Drug reaction (vomiting may occur every bit an astute somatic response to):^{[ citation needed ]}

• Alcohol, which can be partially oxidized into acetaldehyde that causes the symptoms of hangover, including nausea, vomiting, shortness of breath, and fast middle charge per unit.^[21]
• Opioids
• Selective serotonin reuptake inhibitors
• Many chemotherapy drugs
• Some entheogens (such as peyote or ayahuasca)

Affliction (sometimes colloquially known as "stomach influenza"—a broad name that refers to gastric inflammation caused by a range of viruses and bacteria):^{[ citation needed ]}

• Norovirus (formerly Norwalk virus or Norwalk agent)
• Swine flu

Psychiatric/behavioral:

• Bulimia nervosa
• Purging disorder

Emetics

An emetic, such as syrup of ipecac, is a substance that induces vomiting when administered orally or by injection. An emetic is used medically when a substance has been ingested and must exist expelled from the trunk immediately. (For this reason, many toxic and easily digestible products such every bit rat poison contain an emetic.^[22] This presents no problem for the effectiveness of the rodenticide every bit rodents are unable to vomit.)^[23] Inducing vomiting can remove the substance before it is captivated into the body. Emetics tin exist divided into two categories, those which produce their effect by acting on the airsickness center in the medulla, and those which human action directly on the stomach itself. Some emetics, such every bit ipecac, fall into both categories; they initially act direct on the stomach, while their further and more vigorous effect occurs by stimulation of the medullary heart.^[22]

Common salt water and mustard water, which human activity directly on the tummy, have been used since ancient times as emetics.^[24] Care must be taken with salt, every bit excessive intake can potentially be harmful.^{[25] [26]} Copper sulfate was as well used in the by every bit an emetic.^{[27] [28]} It is now considered too toxic for this utilize.^[29]

Hydrogen peroxide is used as an emetic in veterinarian exercise.^{[xxx] [31]}

Self-induced

• Eating disorders (anorexia nervosa or bulimia nervosa)
• To eliminate an ingested toxicant (some poisons should not be vomited as they may exist more toxic when inhaled or aspirated; information technology is better to ask for aid before inducing vomiting)
• Some people who engage in binge drinking induce airsickness to make room in their stomachs for more booze consumption.
• Participants of the Milk challenge typically end up airsickness most of the milk they eat, as proteins in the ingested milk (such every bit casein) rapidly denature and unravel on contact with gastric acid and protease enzymes, rapidly filling the stomach. Once the stomach becomes full, stretch receptors in the stomach wall trigger signals to vomit to expel any further liquid the participant ingests.^[32]
• People suffering from nausea may induce vomiting in hopes of feeling meliorate.

Miscellanea

• After surgery (postoperative nausea and vomiting)
• Disagreeable sights or disgust, smells, sounds or thoughts (such as decayed matter, others' vomit, thinking of airsickness), etc.
• Farthermost pain, such as an intense headache or myocardial infarction (middle attack)
• Extreme emotions
• Cyclic airsickness syndrome (a poorly understood condition with attacks of vomiting)
• Cannabinoid hyperemesis syndrome (similar to cyclic vomiting syndrome, but has cannabis employ every bit its underlying cause).
• High doses of ionizing radiation sometimes trigger a vomit reflex.
• Violent fits of cough, hiccups, or asthma
• Feet
• Depression
• Overexertion (doing likewise much strenuous exercise can lead to vomiting presently afterwards).
• Rumination syndrome, an underdiagnosed and poorly understood disorder that causes sufferers to regurgitate food shortly after ingestion.

Other types

• Projectile airsickness is vomiting that ejects the gastric contents with great strength.^[33] Information technology is a archetype symptom of infantile hypertrophic pyloric stenosis, in which it typically follows feeding and tin can be so forceful that some material exits through the nose.^[34]

Handling

An antiemetic is a drug that is effective confronting vomiting and nausea. Antiemetics are typically used to treat motion sickness and the side furnishings of medications such as opioids and chemotherapy.^{[ citation needed ]}

Antiemetics deed by inhibiting the receptor sites associated with emesis. Hence, anticholinergics, antihistamines, dopamine antagonists, serotonin antagonists, and cannabinoids are used as antiemetics.^[35]

Show to support the use of antiemetics for nausea and vomiting amidst adults in the emergency department is poor.^[36] Information technology is unclear if any medication is better than some other or meliorate than no active treatment.^[36]

Epidemiology

Nausea and/or vomiting are the main complaints in ane.6% of visits to family physicians in Australia.^[37]

Society and civilisation

Herodotus, writing on the culture of the aboriginal Persians and highlighting the differences with those of the Greeks, notes that to vomit in the presence of others is prohibited amidst Persians.^{[38] [39]}

A drunk human being vomiting, while a young slave is property his forehead. Brygos Painter, 500–470 BC

It is quite mutual that, when one person vomits, others nearby become nauseated, particularly when smelling the vomit of others, and often to the betoken of vomiting themselves. It is believed that this is an evolved trait amongst primates. Many primates in the wild tend to browse for food in small groups. Should 1 member of the party react adversely to some ingested food, information technology may be advantageous (in a survival sense) for other members of the party to also vomit. This tendency in human populations has been observed at drinking parties, where excessive consumption of alcoholic beverages may crusade a number of party members to vomit nearly simultaneously, this beingness triggered past the initial vomiting of a single member of the party. This phenomenon has been touched on in popular civilisation: notorious instances appear in the films Monty Python'southward The Meaning of Life (1983) and Stand By Me (1986).^[40]

Intense airsickness in ayahuasca ceremonies is a mutual phenomenon. However, people who experience "la purga" afterward drinking ayahuasca, in general, regard the practise every bit both a physical and spiritual cleanse and ofttimes come to welcome it.^[41] Information technology has been suggested that the consistent emetic furnishings of ayahuasca—in improver to its many other therapeutic properties—was of medicinal benefit to ethnic peoples of the Amazon, in helping to clear parasites from the gastrointestinal arrangement.^[42]

There have also been documented cases of a single sick and vomiting individual inadvertently causing others to vomit, when they are especially fearful of besides condign sick, through a course of mass hysteria.^{[ commendation needed ]}

Special bags are often supplied on boats for ill passengers to vomit into.

Most people effort to comprise their vomit by vomiting into a sink, toilet, or trash can, every bit vomit is difficult and unpleasant to clean. On airplanes and boats, special bags are supplied for ill passengers to vomit into. A special disposable pocketbook (leakproof, puncture-resistant, odorless) containing absorptive material that solidifies the vomit quickly is too available, making it user-friendly and prophylactic to store until at that place is an opportunity to dispose of it conveniently.^{[ citation needed ]}

People who vomit chronically (east.thou., every bit office of an eating disorder such equally bulimia nervosa) may devise various ways to hide this disorder.^{[ citation needed ]}

An online report of people's responses to "horrible sounds" found vomiting "the most disgusting". Professor Trevor Cox of the University of Salford'due south Acoustic Research Middle said, "Nosotros are pre-programmed to be repulsed by horrible things such equally vomiting, as information technology is fundamental to staying live to avoid nasty stuff." It is thought that disgust is triggered by the audio of vomiting to protect those nearby from possibly diseased food.^[43]

Psychology

Emetophilia is sexual arousal from vomiting, or watching others vomit.^[44] Emetophobia is a phobia that causes overwhelming, intense feet pertaining to vomiting.

Run into also

• Bulimia nervosa
• Emetophilia
• Cancer and nausea
• Emetophobia
• Vasodilation
• Diarrhea
• Nose-bravado
• Belching

Notes

1. ^ informally known as (chiefly US) puking, barfing, and (chiefly Brit.) existence ill

References

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External links

Wikimedia Eatables has media related to Vomiting.

Wikiquote has quotations related to: Airsickness

Look up vomiting in Wiktionary, the free dictionary.

• Cyclical Vomiting Syndrome
• "Emetics". The American Cyclopædia. 1879.

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Source: https://en.wikipedia.org/wiki/Vomiting

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