Vomiting Food : Causes, Symptoms, Diagnosis & Treatment

• Causes Of Food Vomiting
• Pyloric Stenosis
• Poisoning
• Gastritis
• Gastroduodenal Diseases
• Functional Dyspepsia
• Pathologies Of The Esophagus
• Survey
• Symptomatic Therapy

Vomiting food is a complex reflex act in which gastric juice with partially fermented food masses is released through the mouth as a result of increased pressure on the muscles of the gastrointestinal tract and diaphragm. The symptom is often combined with nausea, abdominal pain, stool instability. Vomiting occurs with organic and functional diseases of the upper digestive tract, but sometimes has a physiological origin. To identify the prerequisites for the violation, ultrasound, radiography, endoscopy, manometry, and laboratory tests are performed. To stop the symptom, prokinetics, sorbents are used.

Causes of food vomiting

In most cases, the appearance of a symptom is caused by various morphological or functional disorders of the digestive system. Physiological reasons include overeating, which is accompanied by stretching of the gastric wall and reflex excitation of the vomiting center in the medulla oblongata. The symptom is often provoked by the use of a large amount of heavy food with alcohol. Vomiting food is also one of the manifestations of toxicosis in the first half of pregnancy.

pyloric stenosis

Vomiting of food eaten is a common symptom of narrowing of the transition between the stomach and the duodenum, which can be both congenital and associated with organic lesions of the gastroduodenal zone. With pyloric stenosis, there is a long delay in the chyme in the stomach, which causes overstretching of the organ. Nerve impulses from receptors are transmitted mainly through the vagus nerve to a specific center of the brain, which triggers a sequential vomiting act.

The frequency of vomiting attacks depends on the severity of the stenosis. With a mild to moderate degree of narrowing of the pyloric sphincter, the manifestation is observed once every few days. With decompensated pyloric stenosis, antiperistaltic contractions occur after each meal. The vomit has a rotten smell. Characterized by constant heaviness and dull pain in the epigastrium, a feeling of fullness in the stomach, bloating. With a long course of the disease, exhaustion progresses up to complete cachexia.

poisoning

Dyspeptic disorders are the main symptoms of food poisoning provoked by the use of low-quality products contaminated with staphylococci, enterobacteria and other pathogens. An attack of vomiting occurs a couple of hours after eating and is combined with diarrhea, cramping abdominal pain, and signs of general intoxication. Excitation of the vomiting center is caused by a massive exposure to toxins, an important role is played by the direct irritating effect of microbes on the gastric mucosa.

Gastritis

The appearance of vomiting food is more typical for acute gastritis, which is accompanied by pronounced organic changes in the gastric mucosa. The symptom in most patients occurs immediately after eating due to irritation of the nerve endings. A combination of vomiting with sharp pains in the epigastric zone, constant nausea and belching with air is typical. Vomit may contain impurities of mucus and bile. There is also diarrhea up to 7-1 times a day, which sometimes leads to dehydration.

Gastroduodenal diseases

In diseases of the stomach and duodenum, vomiting is reflex in nature, it is preceded by nausea. The symptom is caused by excessive stimulation of the center of the medulla oblongata along the fibers of the vagus, phrenic nerves. Many patients note an improvement in well-being after the release of vomit, so sometimes they themselves induce vomiting. Complaints of abdominal pain, flatulence, diarrhea, constipation are typical. Vomiting of gastric chyme with food is manifested by:

• Gastroparesis . A decrease in the contractility of the gastric muscles predisposes to the appearance of antiperistaltic contractions, which cause vomiting with the release of a large amount of food. Patients complain of nausea after eating, a feeling of fullness in the epigastrium, belching with air or rotten. Repeated vomiting is noted in severe disorders, when the chyme stagnates in the stomach for several days.
• Acute dilatation of the stomach . The clinical picture of the disease develops acutely due to a violation of the innervation of the gastric wall. There are sharp pains in the epigastric region, which are combined with nausea, hiccups. There is indomitable vomiting with the release of gastric contents with food (up to 8 liters per day), then bile may appear in the vomit. Vomiting occurs without the application of volitional efforts, does not bring relief.
• Stenosis of the duodenum . Regurgitation of food eaten indicates a decompensated state, when the gastric muscles cannot cope with a large amount of chyme that has come as a result of duodeno-gastric reflux. Other dyspeptic disorders are likely: nausea after eating, belching rotten, sometimes patients complain of heartburn. Characterized by pain, a feeling of heaviness in the stomach.
• Adductor loop syndrome . In this variant of diseases of the operated stomach, partially digested chyme accumulates in the blind section of the intestine, the condition is aggravated by increased secretion of intestinal juice. With a significant expansion of the intestine, duodenostasis begins, which is complicated by jejunogastric reflux with profuse vomiting of food eaten. As a rule, the general condition is disturbed, intoxication increases.
• Neoplasms . Vomiting food often occurs when tumors are localized in the pyloric part, when they impede the passage of chyme into the underlying sections of the digestive tract. Benign formations develop oligosymptomatically, clinical signs appear only with large sizes of the polyp. In malignant tumors, vomit contains blood impurities; in severe situations, vomiting of "coffee grounds" begins.

functional dyspepsia

Inorganic disorders of the stomach are distinguished by the polymorphism of clinical signs, their rapid appearance and disappearance. Dyspeptic symptoms are usually preceded by errors in the diet, stressful situations. Habitual vomiting is typical, occurring suddenly and associated with the effects of higher nervous structures on the medulla oblongata. In addition to regurgitation of food, flatulence, heaviness in the epigastrium, and instability of the stool are possible. Against the background of dyspeptic symptoms, symptoms of vegetovascular dystonia often appear.

Pathologies of the esophagus

In the pathogenesis of esophageal vomiting, disorders in the coordination of contractions of the sphincters and the smooth muscle layer, as well as mechanical obstacles that impede the movement of food, are of great importance. Distinguish between early vomiting occurring directly during eating and caused by mechanical obstruction, and late as a manifestation of functional changes in the work of muscle sphincters. The symptom is combined with dysphagia, chest pain. The most common causes of vomiting are:

• Esophageal stenosis . In the case of congenital stenosis, symptoms in the form of regurgitation of uncured milk are detected already in the first days of life. With acquired constriction, the first sign is dysphagia, first of solid food, and then of semi-liquid and liquid. The delay of the food bolus over the site of stenosis and the expansion of the organ provokes vomiting. Inhalation of particles predisposes to coughing, shortness of breath, suffocation.
• Diverticula of the esophagus . The formation of a saccular protrusion of the wall occurs more often in older people, who often suffer from other pathologies of the gastrointestinal tract. Food accumulates in the formation, which is then excreted during vomiting. For a diverticulum, the presence of retrosternal pain, bad breath, and belching is pathognomonic. Due to the improvement in the condition after vomiting, many patients cause it artificially.
• Dyskinesia . Regurgitation of just eaten food is possible with any violation of the contractile activity of the esophageal muscles. The symptom often occurs with hypomotor dyskinesia with a long delay in food masses at the entrance to the stomach. In addition to vomiting, swallowing disorders are determined, and with functional disorders, patients have difficulty swallowing liquids, and solid food passes without problems.
• Achalasia cardia . In case of violations of the innervation of the lower esophageal sections, the cardiac sphincter closes reflexively, which makes it difficult for food to pass into the stomach. The esophagus expands, stagnation of food masses develops. This leads to regurgitation due to contraction of the esophageal muscles and is manifested by profuse "mouthful" regurgitation. Patients have dysphagia when taking both liquid and solid foods.
• Ulcerative defect . For lesions of the esophageal mucosa, the appearance of sharp retrosternal pain, heartburn immediately after eating is pathognomonic. At the height of the pain, vomiting begins, which brings relief. In the allocated masses, in addition to the food eaten, blood impurities are detected, indicating bleeding from the ulcer. With a prolonged course of the disease, there is a significant loss of body weight up to cachexia.

Survey

Vomiting food is often a sign of the presence of functional or organic diseases of the digestive system, so the diagnosis is carried out by a gastroenterologist, and research is aimed at a comprehensive study of the state of the gastrointestinal tract. The use of instrumental examination methods allows you to establish the root cause of vomiting, laboratory tests are prescribed to confirm the diagnosis. In diagnostic terms, the most valuable are:

• Endoscopy . With the help of EGDS, the state of the esophageal, gastric and duodenal mucosa is visualized. The method allows to identify volumetric neoplasms, strictures and cicatricial deformities of the digestive canal. In doubtful cases, a biopsy of pathological foci for further histological examination is additionally recommended.
• Radiography . Highly informative is the method of X-ray imaging using an oral contrast agent - it helps to assess the nature, coherence of the work of the gastric and esophageal sphincters, to determine the speed of food movement through the gastrointestinal tract. Radiography is also needed to detect organic lesions.
• Ultrasound . Ultrasound of the abdominal cavity belongs to the group of rapid non-invasive methods that are prescribed for screening examination of gastroenterological patients and the choice of further tactics. According to the indications, after a survey sonography, a targeted ultrasound of individual organs is performed to detect pathological changes.
• Esophageal manometry. With a possible esophageal origin of vomiting, the pressure in different parts of the organ must be measured. Usually, a study is made of the contractions of the upper and lower smooth muscle sphincters, as well as an assessment of the pressure in the body of the esophagus. If necessary, the study is supplemented with antroduodenal manometry.
• Bacteriological Research . Dyspeptic symptoms are possible with various intestinal infections. In order to exclude this group of diseases, it is necessary to sow feces and vomit on nutrient media, which makes it possible to identify the main pathogens. When confirming the infectious etiology of the process, the blood is additionally examined for antibodies.

With a possible connection between vomiting of food eaten and violations of the acid-producing function of the stomach, it is advisable to measure the acidity of gastric juice and the amount of free hydrochloric acid. A biochemical blood test is shown to determine the level of amylase, lipase, concentration of gastrin, pepsinogen. In the absence of organic lesions of the digestive organs, a neurological examination is prescribed to rule out functional disorders.

Esophagogastroduodenoscopy

Symptomatic therapy

If vomiting occurs one-time or episodically and is provoked by overeating, it does not require specific treatment. To reduce the load on the digestive system after heavy feasts, it is advisable to consume easily digestible low-calorie foods for several days, refrain from taking fatty meat dishes, smoked meats. If you suspect food poisoning, you should rinse the stomach, take sorbents. With pathologies of the gastrointestinal tract, complex therapy of the underlying disease is necessary.

Before an accurate diagnosis is made, medications can be used to reduce unpleasant symptoms: prokinetics, anticholinergics. Do not take strong antiemetics on your own, as this can be dangerous to health. Repeated vomiting of food, which is accompanied by a violation of the general condition, an increase in body temperature, the appearance of pathological impurities of blood or bile in liquid vomit, is an indication for immediate medical attention.