Content

Introduction

Nausea and vomiting are very frequent complaints in adults and children: while nausea is the unpleasant feeling of malaise that often precedes it, vomiting is a violent reaction that causes the contents of the stomach to be expelled through the mouth.

Vomiting must be distinguished from regurgitation, an emission of stomach contents that is not associated with forced contractions of the abdominal muscles.

Vomiting in adults is usually not a sign of something serious. In most cases, when it occurs, it is not necessary the intervention of the doctor but it is enough to take care of yourself and stay at home until you feel an improvement.

Vomiting in adults

One of the most common causes of vomiting in adults is an "intestinal infection (gastroenteritis), which usually lasts a few days. However, sometimes vomiting can be a sign of a more serious problem and therefore require medical attention.

When To Seek A Doctor's Help

If you are affected by this annoying disorder, usually you do not need the intervention of your family doctor. If you feel an intense feeling of discomfort, however, it is advisable to consult your doctor without going to his office because if the vomiting was caused by an infection, it could very easily infect the people present.

In really serious cases it is advisable to call the emergency department by telephone.

It is advisable to call the family doctor when:

  • the episodes of vomiting have been repeated for more than 48 hours and there is no sign of improvement
  • you are unable to retain fluids in the stomach
  • you have severe signs of dehydration such as the emission of small amounts of urine of a deep yellow or amber color, presence of drowsiness, feeling of lightheadedness or dizziness, disorientation in the elderly
  • the vomit is green (this means it contains bile and could be a sign of an intestinal blockage)
  • body weight decreased since the disturbance began
  • episodes of vomiting occur frequently

When to call the emergency department

Vomiting can be a sign of a more serious problem and, in this case, should be treated as an "emergency. It is important to call the emergency number or be taken to the nearest emergency room if:

  • stomach pain is severe and sudden as it could be a sign of an appendicitis attack
  • you have severe pain in your chest
  • the vomitus contains blood or is the color of coffee grounds
  • vomiting is accompanied by pain or stiffness in the neck and high fever
  • you suddenly feel a severe headache, in a different form than the headaches from which one is usually affected
  • you are diabetic and you have repeated episodes of vomiting, particularly if you are treated with insulin to control diabetes

In addition, you will need to go to the emergency room immediately if you realize that you have ingested a toxic substance.

Take care of yourself at home

One of the first rules to follow in case of repeated episodes of vomiting is to avoid dehydration by drinking water in small sips. If water stimulates vomiting you can try lemon tea, which is generally better accepted. You can also eat small amounts of simple solid foods (salty crackers, plain rice) which help tolerate the introduction of liquids and contribute to restore lost salts.

Causes

The most common causes of nausea and vomiting in adults are:

  • an "intestinal infection (most likely when vomiting is accompanied by diarrhea)
  • pregnancy, especially during the first few weeks, women often suffer from nausea and vomiting
  • migraine, severe throbbing headache that can last from a few hours to days
  • labyrinthitis, inner ear disorder that also causes dizziness and dizziness
  • motion sickness, nausea and vomiting associated with travel by car, plane, ship etc.

Vomiting in adults can also be caused by other factors:

  • some medications, such as antibiotics and pain relievers, can cause vomiting as an undesirable effect
  • high intake of alcoholic beverages
  • kidney infections or kidney stones
  • intestinal obstruction
  • chemotherapy and radiotherapy, as they have vomiting as side effects
  • inflammation of the gallbladder (acute cholecystitis)

Vomiting in children

Vomiting is a very common complaint in infants and children. In most cases it is the sign of an intestinal infection, usually caused by viruses or bacteria, which also causes diarrhea. The ailments can be annoying but, generally, it is a malaise that disappears within a few days. However, if it lasts over time, vomiting in children can cause a state of dehydration that must be treated immediately. In rarer cases, it can be a sign of something more serious, such as meningitis.

What to do

At the first signs of vomiting, it is advisable to keep the baby under observation. It is a good idea not to get anxious and act according to your instincts as a parent. If you feel particularly worried and unsure of being able to manage the situation, it is preferable to call the pediatrician.

If intestinal discomfort causes vomiting, but the child shows no particular signs of suffering, plays and has an appetite, can eat as usual and must drink regularly.If, on the other hand, the child is very irritable, in pain, or less reactive, he could have a more serious disorder and should be consulted immediately.

When to request medical intervention

It is advisable to contact the pediatrician if:

  • the vomiting episodes are continuous and the baby is unable to retain fluids in the stomach
  • the child shows signs of dehydration. Signs of dehydration can include dry mouth, tearless crying, sleepiness, and reduced passing of urine: infants may not wet their diapers for more than three hours while children and adolescents may not urinate for eight hours or more.
  • the vomitus is green or contains blood
  • the episodes of vomiting have been repeated for more than a day

When to call the emergency department

You need to call the emergency number or go to the nearest emergency room immediately if:

  • vomiting is sudden and accompanied by severe stomach pains
  • the child is irritable or less reactive
  • in addition to vomiting there are also headaches, neck pain / stiffness, and skin rashes

Treat the baby at home

In most cases, there is no need to call the doctor or go to the hospital - taking care of the baby at home is the best thing to do. The most important rule to observe is to make him drink enough to avoid dehydration.

If a newborn is affected by vomiting, it is possible to continue breastfeeding or, alternatively, artificial feeding. If the child shows signs of dehydration, they will need to drink plenty of fluids. It is advisable to ask your doctor or pharmacist if it is appropriate to give him an oral rehydration solution. It is a powder containing sugar and mineral salts to be dissolved in water, which helps to replenish the liquids and substances lost with vomiting and diarrhea.If the child cannot keep the rehydration solution in the stomach, the pediatrician should be consulted.

Children who have had repeated bouts of vomiting should drink liquids, such as water or light broth, in small sips. Fruit juices and carbonated drinks should be avoided until signs of improvement are evident. If the child he is not in a state of dehydration and has an appetite, he will be able to eat as usual.

Children should not go to kindergarten or school until 48 hours after the last episode of diarrhea or vomiting.

Causes of vomiting in children

Gastroenteritis

Gastroenteritis is an "infection that affects the stomach and intestines. It is a common cause of vomiting in children and usually lasts a couple of days.

Food allergy

Food allergies can cause vomiting in children as well as cause other disorders (symptoms) including itching, rash (hives), swelling of the face, eye area, lips, tongue and palate.

In the suspicion that some foods may be responsible for the onset of vomiting, it is advisable to consult the family pediatrician for the necessary checks to ascertain (diagnose) a possible food allergy.

Other infections

Vomiting can sometimes be a disorder (symptom) that signals the presence of an infection other than gastroenteritis such as, for example, a urinary tract or middle ear infection (otitis), pneumonia or meningitis. If you suspect even just one of the aforementioned diseases, and other ailments such as fever and irritability are observed in addition to vomiting, it is advisable to contact your pediatrician.

Appendicitis

"Appendicitis is an" inflammation of a part of the intestine, the appendix, which causes severe stomach pain that worsens over time. Vomiting can be one of the symptoms that reveals this disorder that requires immediate intervention.

If a child has persistent stomach pain that worsens over time, you should contact the family pediatrician or the emergency department urgently.
In most cases, the appendix will need to be surgically removed as soon as possible.

Poisoning

The accidental ingestion of a poisonous substance can cause the child to vomit. If this happens, you should immediately intervene by calling your doctor or taking the child to the nearest emergency room.

Causes of vomiting in infants

There are many causes that cause the newborn to vomit, including:

  • gastroenteritis
  • food allergies or milk intolerance
  • gastroesophageal reflux, disorder caused by the ascent of the stomach contents into the esophagus and throat. In this case we speak of regurgitation rather than vomiting because the emission of the contents of the stomach is not associated with forced contractions of the abdominal muscles
  • congenital pyloric stenosis, a condition present at birth that causes difficulty in the passage of the contents from the stomach into the intestine. The vomiting in this case is typically "jet"
  • nipple hole of the bottle too large, in this situation the baby swallows more milk than he should
  • accidental ingestion of poisonous substances
  • strangulated hernia, in this case the child often vomits, cries and has severe pain, a situation that requires urgent medical / surgical intervention
  • intussusception, folding of a part of the intestine into another segment. It causes severe and sudden pain, the baby shows irritability, sudden crying attacks and vomiting. Also in this case an urgent medical / surgical intervention is essential

Bibliography

Manual of Gastroenterology, by the National Coordination of University Teachers of Gastroenterology. Edition 2016 - 2019. Rome: The Scientific Thought, 2016

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