Topics Discussed: gastroenterology and hepatology; nausea and vomiting; vomiting.
Sections: Pathogenesis, Clinical Presentation, Differential Diagnosis, Complications, Treatment, Acknowledgment, References.
Excerpt:"Vomiting is the forceful retrograde
expulsion of gastric contents through the mouth consequent to the
coordinated contraction of diaphragm, abdominal, and respiratory
muscles. It is associated with a characteristic autonomic response,
including pallor, lethargy, hypersalivation, and tachycardia. This
differentiates vomiting from regurgitation,
which is an effortless involuntary
reflux of undigested gastric contents and is not associated with
abdominal/diaphragmatic contractions or autonomic responses. Nausea is the subjective unpleasant
sensation of impending vomiting that precedes but is not always associated
with vomiting. Emesis is a term that can be used to describe any
expulsion of gastric contents, and is useful to the physician when
describing symptoms that have not yet been fit into the more exact
categories of vomiting or regurgitation. Rumination is
voluntary reflux of gastric contents within the first hour after
eating and is associated with chewing and reswallowing of undigested
food. Retching or "dry heaves" is
the activated emetic reflux without vomiting, due to vomiting motion
against a closed glottis (Table 21). Vomiting should also
be differentiated from coughing or spitting of mucus from the lungs...."
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