Nausea and Vomiting

Vomiting may be caused by severe irritation of the peritoneum resulting from the perforation of an abdominal organ; from obstruction of the bile duct, ureter, or intestine; or from toxins. Vomiting resulting from a perforation is rarely massive. Obstruction of the bile duct or other tube produces stretching of the muscular wall, resulting in episodic vomiting that occurs at the height of the pain. Intestinal obstruction prevents the intestinal contents from passing distally; consequently, vomiting may result in the expulsion of intestinal contents. Toxins generally cause persistent vomiting. Not all abdominal emergencies cause vomiting. Intraperitoneal bleeding may occur in the absence of vomiting. Vomiting is frequently also caused by inflammation of intra-abdominal structures, as well as by extra-abdominal conditions, including drug toxicity, central nervous system disorders, myocardial infarction, and pregnancy. Ask the following questions if a patient complains of nausea, vomiting, or both:

''How long have you had nausea or vomiting?'' ''What is the color of the vomit?'' ''Is there any unusually foul odor to the vomitus?'' ''How often do you vomit?''

''Is vomiting related to eating?'' If yes, ''How soon after eating do you vomit? Do you vomit only after eating certain foods?''

''Do you have nausea without vomiting?''

''Is the nausea or vomiting associated with abdominal pain? constipation? diarrhea? a loss of appetite? a change in the color of your stools? a change in the color of your urine? fever? chest pain?''

''Have you noticed a change in your hearing ability?'' ''Have you noticed ringing in your ears?''

If the patient is a woman, ask this question: ''When was your last period?''

The relationship of the pain to vomiting is important and may help in providing the diagnosis. In acute appendicitis, pain precedes the vomiting usually by a few hours. The character of the vomitus may aid in determining its cause. Acute gastritis causes the patient to vomit stomach contents. Biliary colic produces bilious, or greenish-yellow, vomitus. Intestinal obstruction often causes the patient to expel bilious vomitus, followed by feculent-smelling fluid. Feculent vomitus is usually caused by intestinal obstruction.

Nausea without vomiting is a common symptom in patients with hepatocellular disease, pregnancy, and metastatic disease. Nausea may be associated with a hearing loss and tinnitus in patients with Meniere's disease.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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