Fact-checked by Grok 2 weeks ago

Vomiting

Vomiting, also known as emesis, is the forceful, involuntary expulsion of the stomach's contents through the mouth, often involving reverse peristalsis and coordinated contractions of the diaphragm and abdominal muscles.^[1] It is typically preceded by nausea, an unpleasant subjective sensation signaling the urge to vomit, and serves as a protective reflex to eliminate potentially harmful substances from the gastrointestinal tract or respond to systemic disturbances.^[1]^[2] This process distinguishes vomiting from simpler acts like regurgitation, as it requires active neural coordination and can occur in response to diverse stimuli ranging from peripheral to central origins.^[3] The physiology of vomiting is orchestrated by the vomiting center located in the medulla oblongata of the brainstem, which integrates emetic signals from multiple pathways.^[4] Key inputs include the chemoreceptor trigger zone (CTZ) in the area postrema, a circumventricular organ that lacks a blood-brain barrier and detects blood-borne toxins, drugs, or metabolic byproducts.^[4] Additional triggers arise from vagal afferents in the gastrointestinal tract sensing irritation or distension, the vestibular system during motion imbalance, and higher cerebral centers processing psychological or visual cues.^[3] Once activated, the response involves relaxation of the gastric fundus, closure of the pylorus, and forceful abdominal thrusting to propel contents upward, often accompanied by retching—ineffective expulsive efforts without emission.^[1] Vomiting arises from a broad spectrum of causes, including benign triggers like motion sickness, excessive alcohol intake, or viral gastroenteritis, as well as more serious conditions such as chemotherapy-induced effects, pregnancy (hyperemesis gravidarum), migraines, or obstructions in the digestive tract.^[5] In clinical contexts, it may signal underlying pathologies like appendicitis, meningitis, or metabolic derangements such as diabetic ketoacidosis.^[5] Management focuses on hydration to prevent dehydration, especially in vulnerable populations like children and the elderly, and pharmacological interventions with antiemetics targeting specific pathways—such as 5-HT3 antagonists like ondansetron for chemotherapy-related vomiting or dopamine antagonists like metoclopramide for postoperative cases.^[6] Prompt medical evaluation is essential if vomiting lasts more than 24-48 hours, contains blood or bile, or is accompanied by severe abdominal pain, confusion, or signs of dehydration like reduced urine output.^[7]

Basics and Pathophysiology

Definition

Vomiting, also known as emesis, is defined as the forceful, involuntary expulsion of the contents of the stomach through the mouth, typically resulting from coordinated contractions of the abdominal muscles and diaphragm.^[1] This process is mediated by the vomiting center located in the medulla oblongata of the brainstem, which integrates sensory inputs to trigger the reflex.^[8] Vomiting must be distinguished from related phenomena such as regurgitation, which involves the passive, nonforceful reflux of undigested gastric contents into the esophagus or mouth without associated retching or abdominal effort.^[1] In contrast, nausea represents the subjective, unpleasant sensation often preceding vomiting, serving as a prodromal warning but not always culminating in expulsion.^[9] Expectoration, meanwhile, refers to the coughing up of sputum or mucus from the respiratory tract, originating from the lungs or airways rather than the gastrointestinal system.^[10] Anatomically, vomiting involves the stomach, where gastric contents accumulate, the esophagus as the conduit for retrograde propulsion, and the diaphragm, which contracts to increase intra-abdominal pressure and facilitate expulsion.^[1] The lower esophageal sphincter relaxes to allow passage, while reverse peristalsis in the esophagus directs material upward toward the mouth. From an evolutionary standpoint, vomiting functions as a protective reflex to expel potentially harmful toxins or pathogens from the gastrointestinal tract before they can be absorbed into the bloodstream, a mechanism conserved across many species including fish, amphibians, reptiles, birds, and mammals.^[11] This adaptive response enhances survival by mitigating the effects of ingested poisons, as observed in various animal models where emetic reflexes prevent intoxication from tainted food sources.^[2]

Mechanisms and Phases

Vomiting is coordinated by a central vomiting center located in the medulla oblongata of the brainstem, specifically within the dorsal vagal complex, which integrates emetic signals and orchestrates the motor responses.^[3] This center receives inputs from multiple sources, including the chemoreceptor trigger zone (CTZ) in the area postrema, which lacks a blood-brain barrier and detects circulating emetic stimuli; vagal and splanchnic afferents from the gastrointestinal tract conveying visceral sensations; the vestibular system via cranial nerve VIII for balance-related signals; and higher brain centers such as the cerebral cortex and limbic system for cognitive or emotional inputs.^[12]^[3] The nucleus tractus solitarius within the dorsal vagal complex serves as the primary integration site for these afferent signals, relaying them to the dorsal motor nucleus of the vagus for efferent output to the viscera.^[3] A key component of this neural control is the central pattern generator (CPG), a network of neurons primarily in the medullary reticular formation, including the Bötzinger complex, that produces the rhythmic, coordinated motor patterns essential for vomiting without requiring ongoing external sensory input.^[13] This CPG synchronizes activity across respiratory, abdominal, and gastrointestinal muscles, involving neurotransmitters such as serotonin (via 5-HT3 receptors), substance P (via NK1 receptors), and dopamine (via D2/D3 receptors) to modulate the reflex.^[3] Key nerves involved include: the vagus nerve (cranial nerve X) transmits gastrointestinal afferent signals and efferent commands to the gut and lower esophageal sphincter, while the phrenic nerve innervates the diaphragm for its contractions; the glossopharyngeal nerve (IX) contributes to pharyngeal coordination, and the hypoglossal nerve (XII) aids in suprahyoid muscle movements.^[12]^[13] The vomiting process unfolds in three sequential phases: prodromal, retching, and expulsion, each marked by distinct physiological changes. The prodromal phase involves the onset of nausea accompanied by autonomic alterations, including increased salivation via the facial nerve (VII), sweating, and tachycardia, alongside gastrointestinal adjustments such as relaxation of the gastric fundus and lower esophageal sphincter, increased tone in the small intestine, and initiation of antiperistaltic waves in the proximal duodenum to propel contents upward.^[3]^[12] These changes, lasting throughout the episode, prepare the digestive tract by reversing normal motility patterns under vagal control.^[13] During the retching phase, rhythmic contractions of the diaphragm and abdominal muscles occur without expulsion of contents, driven by the CPG to generate intra-abdominal pressure. The glottis closes to protect the airway, the soft palate elevates, and the larynx rises, while antiperistaltic waves—manifesting as retrograde giant contractions propagating from the mid-jejunum to the gastric antrum at 10-15 cm/s—mix and move gastric contents into the esophagus without passage through the upper esophageal sphincter.^[13]^[12] This phase features alternating relaxation and contraction of diaphragmatic and cricopharyngeus muscles, coordinated by the vagus and phrenic nerves, resulting in spasmodic respiratory efforts against a closed glottis.^[13] The expulsion phase culminates in the forceful ejection of gastric contents through the mouth, involving a deep inspiration followed by closure of the glottis and elevation of the soft palate to isolate the airway. Coordinated contraction of the diaphragm (via the phrenic nerve) and abdominal muscles compresses the stomach, while relaxation of the cardia and pylorus, combined with longitudinal stretching of the esophagus, facilitates rapid bolus propulsion via sustained antiperistaltic waves and pharyngeal contractions mediated by cranial nerves IX, X, and XII.^[12]^[13] The upper esophageal sphincter briefly relaxes, allowing expulsion, after which swallowing clears residual material from the oral cavity.^[13]

Composition of Vomit

Vomit primarily consists of gastric contents, which include partially digested food, hydrochloric acid (HCl), pepsin, and a high proportion of water (approximately 97-99%).^[14] These components arise from the stomach's secretory activity, where parietal cells produce HCl and chief cells secrete pepsinogen, which is activated to pepsin in the acidic environment.^[1] Mucus, secreted by goblet cells in the gastric mucosa, is also present, providing a protective layer but appearing in variable amounts depending on irritation or inflammation.^[14] In cases of duodenal reflux, vomit may incorporate bile from the small intestine, resulting in a yellow or green coloration due to the presence of bilirubin and bile salts.^[15] Bile, produced by the liver and stored in the gallbladder, contains water, bile acids, cholesterol, enzymes, and electrolytes, and its reflux into the stomach often occurs during prolonged vomiting or pyloric incompetence.^[16] Intestinal fluids, including those from the proximal duodenum, can contribute additional electrolytes and digestive residues if the retrograde propulsion extends beyond the stomach.^[12] The composition varies based on the timing relative to meals and the underlying cause. For instance, vomit shortly after eating may contain recognizable food particles, whereas prolonged fasting or obstruction leads to expulsion of more fluid gastric secretions without solid matter.^[1] In gastrointestinal obstructions, such as ileus, the material may develop a fecal odor from bacterial overgrowth and stagnant intestinal contents, though true fecal matter is rare.^[17] Blood can appear in vomit as hematemesis, presenting as bright red streaks if fresh or a coffee-ground consistency if partially digested by gastric acid, indicating upper gastrointestinal bleeding from sources like ulcers or varices.^[18] Vomit is characteristically acidic, with a pH typically ranging from 1 to 3, reflecting the dominance of gastric HCl (pH around 1.5-3.5).^[19] The volume per vomiting episode can reach 1 to 2 liters when the stomach is full, comprising stomach secretions rich in hydrogen, chloride, and sodium ions (up to 150 mEq/L each), though this can be influenced by hydration status, recent intake, and the extent of intestinal involvement.^[1] Dehydration may reduce output, while distended states increase it.^[1] These characteristics—odor, color, and consistency—offer diagnostic clues; for example, the coffee-ground appearance suggests slower upper GI hemorrhage, bilious tint points to distal obstruction or reflux, and fecal-like smell signals severe ileus or blockage, guiding further clinical evaluation without confirming etiology alone.^[18]^[20]

Causes

Gastrointestinal Causes

Gastrointestinal causes of vomiting primarily involve disruptions in the digestive tract's structure, motility, or inflammatory processes, leading to the accumulation of gastric contents and activation of emetic reflexes. These conditions often present with vomiting as a prominent symptom due to mechanical blockage, irritation, or impaired emptying of the stomach and intestines. Unlike systemic or neurological triggers, these originate directly from the gastrointestinal mucosa, lumen, or surrounding tissues.^[21] Mechanical obstructions in the gastrointestinal tract prevent the normal passage of contents, resulting in distension and forceful vomiting. In infants, hypertrophic pyloric stenosis is a leading cause, characterized by thickening of the pyloric muscle that obstructs gastric outlet, typically manifesting as non-bilious, projectile vomiting starting around 3-6 weeks of age.^[22] Intestinal blockages, such as volvulus—a twisting of the bowel—can lead to complete or partial obstruction, often producing bilious vomiting due to upstream accumulation of intestinal fluids and bile.^[23] These obstructions require prompt intervention to prevent complications like dehydration from ongoing fluid loss.^[24] Inflammatory and infectious conditions irritate the gastrointestinal lining, triggering vomiting through local inflammation and toxin release. Gastroenteritis, the most common such cause, is frequently viral (e.g., norovirus, the leading pathogen in developed countries) or bacterial (e.g., Salmonella species), causing acute nausea and vomiting alongside diarrhea.^[25] In children, vomiting occurs in approximately 70-90% of acute gastroenteritis cases, particularly with norovirus infections, which account for a significant portion of pediatric emergency visits for dehydration.^[26] Appendicitis involves inflammation of the appendix, often presenting with vomiting in up to 75% of cases, especially as pain migrates to the right lower quadrant.^[27] Peptic ulcers, erosions in the stomach or duodenal lining, can cause vomiting, sometimes with blood (hematemesis), due to irritation or partial obstruction from edema.^[28] Functional disorders impair gastric motility without structural blockage, leading to recurrent or persistent vomiting. Gastroparesis, a condition of delayed gastric emptying often linked to diabetes (affecting up to 50% of patients with long-standing type 1 diabetes and poor glycemic control) or idiopathic factors, commonly results in nausea and vomiting of undigested food.^[29] Cyclic vomiting syndrome involves episodic, intense vomiting attacks lasting hours to days, with no identifiable obstruction, and is more prevalent in children with a family history of migraines.^[30] Postoperative gastrointestinal issues, such as ileus or adhesions, commonly induce vomiting following abdominal surgery. Postoperative ileus, a temporary paralysis of bowel motility, affects nearly all patients after major procedures and manifests with nausea and vomiting due to gas and fluid accumulation, typically resolving within 2-5 days.^[24] Adhesions, scar tissues forming between organs, can cause chronic or acute small bowel obstruction, leading to bilious vomiting in recurrent episodes.^[31] These conditions highlight the role of surgical trauma in disrupting normal peristalsis.

Neurological and Sensory Causes

Vomiting can arise from central nervous system disorders that directly stimulate or irritate the vomiting center in the medulla oblongata. Increased intracranial pressure, often due to brain tumors or meningitis, elevates pressure within the cranial vault, leading to nausea and vomiting as prominent symptoms.^[32] In cases of brain tumors, particularly those in the posterior fossa, projectile vomiting occurs due to direct mechanical pressure on the vomiting center, distinguishing it from other forms of emesis by its forceful, unheralded nature.^[33]^[34] Strokes affecting the medulla, such as lateral medullary syndrome (Wallenberg syndrome), frequently manifest with acute vertigo, ataxia, and intractable vomiting resulting from ischemia in the brainstem's emetic pathways.^[35] Migraines, especially those with aura, commonly involve nausea and vomiting as accompanying features, affecting up to 90% of patients during attacks due to activation of central trigeminovascular pathways and associated autonomic responses.^[36] These symptoms often precede or coincide with headache and can persist even after pain resolution, highlighting the migraine's impact on brainstem emetic centers.^[37] Vestibular disorders contribute to vomiting through disruption of balance signals to the central nervous system. Motion sickness results from conflicting sensory inputs—such as visual and vestibular cues—to the chemoreceptor trigger zone, provoking nausea and vomiting in susceptible individuals during exposure to real or apparent motion.^[38]^[39] Labyrinthitis, an inflammation of the inner ear often viral in origin, causes severe vertigo accompanied by nausea and vomiting due to acute unilateral vestibular hypofunction.^[40] Similarly, Meniere's disease features recurrent episodes of vertigo with associated nausea and vomiting, stemming from endolymphatic hydrops that distorts vestibular function.^[41] Sensory-related causes include post-traumatic effects following head injury. Vomiting after concussion signals potential intracranial pathology, increasing the risk of skull fracture or more severe brain injury by up to fourfold, as it reflects irritation of central emetic pathways from trauma-induced pressure changes.^[42] Radiation therapy to the head or neck region induces nausea and vomiting in a significant proportion of patients, attributed to direct irradiation of brainstem structures like the area postrema, with incidence rates as high as 48% in affected cohorts.^[43]^[44] Distinguishing central from peripheral vertigo-associated vomiting is crucial for diagnosis; central causes, such as brainstem lesions, produce more severe, persistent vomiting with multidirectional nystagmus and additional neurological deficits, whereas peripheral etiologies like labyrinthitis yield episodic symptoms that improve with repositioning.^[45]^[46]

Metabolic, Drug-Induced, and Other Causes

Vomiting can arise from metabolic disturbances that disrupt systemic homeostasis, such as uremia in chronic kidney disease, where accumulated toxins stimulate the chemoreceptor trigger zone (CTZ) in the brainstem.^[47] In diabetic ketoacidosis (DKA), severe hyperglycemia and acidosis lead to frequent vomiting, often producing acidic vomit due to gastric acid and ketone accumulation, exacerbating dehydration and electrolyte imbalances.^[48] Hypercalcemia, commonly from hyperparathyroidism or malignancy, induces nausea and vomiting by altering gastrointestinal motility and central emetic pathways.^[47] Adrenal insufficiency, including Addison's disease, presents with intractable vomiting alongside fatigue and hypotension, resulting from cortisol deficiency that impairs stress response and fluid balance.^[49]^[50] Drug-induced vomiting is a frequent adverse effect of various medications, often mediated through the CTZ via serotonin 5-HT3 receptor activation. Emetogenic chemotherapy agents like cisplatin trigger acute and delayed vomiting by releasing serotonin from enterochromaffin cells in the gut, stimulating vagal afferents and the CTZ; cisplatin is classified as highly emetogenic, affecting up to 90% of untreated patients.^[6]^[51] Opioids, such as morphine, cause nausea and vomiting in 25-40% of patients by direct CTZ stimulation and delayed gastric emptying.^[52] Certain antibiotics, including erythromycin, can induce vomiting through its motilin receptor agonism, which promotes abnormal gastrointestinal contractions mimicking gastroparesis.^[53] GLP-1 receptor agonists, such as semaglutide and liraglutide, used for type 2 diabetes and weight management, cause vomiting in approximately 15-20% of patients through delayed gastric emptying and central emetic activation.^[54] Toxic exposures represent another key category, where ingested substances directly irritate the gut or activate central emetic centers. Food poisoning from botulism, caused by Clostridium botulinum toxin, often begins with nausea and vomiting before progressing to neurological symptoms like paralysis.^[55] Scombroid poisoning, resulting from histamine in spoiled fish, produces rapid-onset vomiting, flushing, and diarrhea due to mast cell degranulation.^[56] Alcohol intoxication induces vomiting through multiple mechanisms, including gastric irritation leading to gastritis and central effects on the CTZ, with blood alcohol concentrations of 0.2-0.4% commonly precipitating emesis.^[57] In pregnancy, hyperemesis gravidarum—a severe form of nausea and vomiting—affects 0.3-3.6% of pregnancies, causing significant weight loss and metabolic derangements like ketosis.^[58]^[59] Other causes encompass systemic conditions beyond primary metabolic or toxic origins. Cardiovascular events, particularly inferior myocardial infarction, are associated with vomiting in up to 50% of cases due to vagal stimulation from ischemic pain and Bezold-Jarisch reflex activation.^[60]^[61] Postoperative nausea and vomiting (PONV) occurs in 20-40% of patients after general anesthesia, driven by volatile anesthetics and opioids that sensitize emetic pathways.^[62]^[63] Psychogenic vomiting involves recurrent episodes without organic pathology, often linked to psychological stress, though detailed elsewhere. Evidence indicates COVID-19 can trigger vomiting as a metabolic disturbance via cytokine storm, where excessive inflammatory cytokines like IL-6 disrupt gastrointestinal and systemic homeostasis.^[64]^[65]

Clinical Presentation and Diagnosis

Signs and Symptoms

Vomiting is characterized by the forceful expulsion of gastric contents through the mouth, typically preceded by nausea, an unpleasant queasy sensation in the stomach often accompanied by the urge to vomit.^[1] Retching, the labored and ineffectual attempt at vomiting without expulsion, frequently occurs alongside or prior to the act itself.^[66] Common associated symptoms include abdominal pain or cramping, diaphoresis (profuse sweating), pallor (pallor of the skin), and tachycardia (elevated heart rate), reflecting autonomic nervous system activation.^[1] In some instances, particularly with intense emetic stimuli, bradycardia (slowed heart rate) may arise due to vagal nerve stimulation.^[67] Prodromal signs often signal an impending episode, including yawning, increased salivation, dizziness, and a subjective feeling of discomfort or impending doom.^[1] Following the emetic event, individuals commonly experience relief from nausea but may feel profound exhaustion or fatigue.^[66] These features align briefly with the integrated phases of the vomiting reflex, where autonomic changes precede and accompany the expulsion.^[1] Vomiting patterns vary in frequency, distinguishing acute episodes (sudden onset lasting hours to days) from chronic recurrent forms (persisting or recurring over weeks to months).^[68] Volume can range from small amounts to large projectile ejections, with timing often postprandial (shortly after meals) or cyclical, sometimes linked to associated features like headache in migraine-related cases.^[68] In infants, vomiting manifests with fussiness, poor feeding, excessive crying, and signs of dehydration such as reduced urine output or a sunken fontanelle, potentially leading to failure to thrive if recurrent.^[69] Among the elderly, episodes frequently result in rapid dehydration, presenting with confusion, weakness, and altered mental status due to fluid and electrolyte shifts.^[70]

Diagnostic Approaches

The diagnostic evaluation of vomiting commences with a detailed medical history and physical examination to ascertain the onset, pattern, and potential precipitants of symptoms, as well as to identify alarm features warranting urgent investigation. Key historical elements include the temporal profile (acute versus chronic), frequency and volume of emetic episodes, associated manifestations such as abdominal pain, diarrhea, headache, or vertigo, and exacerbating factors like specific foods, medications, or motion. Red flags in the history encompass unintentional weight loss exceeding 5% of body weight, progressive dysphagia, recurrent vomiting after meals suggesting obstruction, or neurological symptoms including severe headache, focal deficits, or altered sensorium, which may indicate central nervous system pathology.^[71]^[72] The physical examination complements the history by assessing for dehydration through indicators like dry oral mucosa, sunken eyes, reduced skin turgor, and orthostatic hypotension, alongside evaluation of abdominal distension, tenderness, or masses that could signal peritonitis or obstruction. Neurological assessment is critical to detect deficits such as nystagmus, ataxia, or meningismus, while vital signs may reveal tachycardia or fever pointing to systemic involvement. Presence of jaundice, pallor, or feculent odor in vomitus further heightens concern for hepatobiliary or proximal gastrointestinal complications.^[71]^[72] Laboratory investigations form the cornerstone of initial diagnostic testing, tailored to the clinical context. Serum electrolytes and renal function tests are routinely obtained to identify hypokalemic hypochloremic metabolic alkalosis from gastric losses or prerenal azotemia from volume depletion. A urine pregnancy test is mandatory in females of reproductive age to exclude hyperemesis gravidarum, while a toxicology screen is indicated if ingestion of toxins or substances is suspected. Additional tests, such as complete blood count for anemia or leukocytosis, liver enzymes for hepatobiliary involvement, and serum amylase or lipase for pancreatic pathology, are pursued based on suggestive history or examination findings.^[72]^[71] Radiographic and advanced imaging modalities are selected to investigate structural or neurological etiologies. Plain abdominal radiography can reveal air-fluid levels or dilated bowel loops indicative of obstruction, while abdominal ultrasound evaluates for gallstones, appendicitis, or renal colic. Computed tomography (CT) of the abdomen is reserved for suspected perforation, ischemia, or malignancy in refractory cases, and CT of the head is essential for patients with neurological red flags to rule out intracranial hemorrhage, mass lesions, or infection. Upper gastrointestinal endoscopy allows direct visualization and biopsy for suspected mucosal lesions, bleeding sources, or eosinophilic esophagitis in chronic presentations.^[71]^[72] Specialized physiologic studies are employed for suspected functional disorders. Scintigraphy-based gastric emptying studies quantify delayed emptying in gastroparesis, with delayed retention of more than 60% at 2 hours or 10% at 4 hours confirming the diagnosis. Esophageal manometry or antroduodenal manometry assesses motility abnormalities in cases of suspected achalasia or pseudo-obstruction, measuring parameters like lower esophageal sphincter pressure or duodenal contraction waves.^[72] In acute settings, particularly emergency departments, point-of-care ultrasound (POCUS) enhances rapid assessment of dehydration severity by evaluating inferior vena cava (IVC) dimensions and respiratory variability. A subcostal view showing IVC diameter less than 2.1 cm with greater than 50% collapsibility during inspiration correlates with low right atrial pressure and intravascular volume depletion, guiding rehydration strategies; however, interpretation requires caution in patients with cardiac arrhythmias, pulmonary hypertension, or mechanical ventilation, where accuracy diminishes.^[73]

Management

Initial Treatment

The initial management of acute vomiting prioritizes stabilization by addressing dehydration, electrolyte imbalances, and symptom control to prevent complications such as hypovolemia. Oral rehydration therapy is the cornerstone for mild to moderate cases, utilizing World Health Organization-recommended low-osmolarity oral rehydration solutions containing glucose 13.5 g/L, sodium chloride 2.6 g/L, potassium chloride 1.5 g/L, and trisodium citrate dihydrate 2.9 g/L to facilitate sodium and water absorption in the intestines.^[74] In severe cases with significant fluid loss or inability to tolerate oral intake, intravenous isotonic fluids like 0.9% normal saline are administered at rates adjusted to the degree of dehydration, typically 20 mL/kg bolus initially followed by maintenance.^[71] Antiemetic therapy is initiated promptly to interrupt the vomiting cycle. Ondansetron, a selective 5-HT3 receptor antagonist, serves as a first-line agent with a typical adult dose of 4-8 mg intravenously, effective for various etiologies including postoperative and chemotherapy-induced vomiting.^[75] For vomiting linked to gastroparesis, metoclopramide is preferred at 10 mg intravenously or orally to enhance gastric motility and reduce nausea, though its use is limited to short-term due to potential extrapyramidal side effects.^[76] Supportive measures include placing the patient on nil per os (NPO) status to allow gastrointestinal rest, implementing aspiration precautions such as lateral positioning during episodes, and continuous monitoring of vital signs, urine output, and mental status to gauge hydration status and response to treatment.^[77] In specific scenarios like pregnancy, the combination of vitamin B6 (pyridoxine 10-25 mg) and doxylamine (12.5-25 mg) is recommended as a first-line antiemetic, taken orally up to three times daily, due to its established safety profile in reducing nausea without adverse fetal effects.^[78] Electrolyte correction is essential, particularly for hypokalemia resulting from gastric losses, with intravenous potassium chloride replacement at 10-20 mEq per hour in monitored settings, titrated to maintain serum levels above 3.5 mEq/L while avoiding overcorrection.^[79] Post-2020 guidelines endorse adjunctive non-pharmacologic interventions, such as acupressure at the P6 (Neiguan) acupoint on the inner wrist, applied via bands or manual pressure for 5-10 minutes several times daily, to alleviate nausea with minimal risk.^[80]

Supportive and Specific Therapies

Supportive therapies for vomiting address underlying etiologies to alleviate symptoms and prevent recurrence, while specific therapies target chronic or refractory cases. For gastrointestinal obstructions causing persistent vomiting, such as infantile hypertrophic pyloric stenosis, surgical intervention via pyloromyotomy is the definitive treatment, performed laparoscopically or openly to incise the hypertrophied pyloric muscle and restore gastric emptying.^[81] This procedure achieves near-complete resolution of vomiting in over 95% of cases when performed timely.^[82] Infectious causes of vomiting, particularly bacterial gastroenteritis from pathogens like Salmonella, warrant targeted antibiotic therapy in severe or high-risk cases to eradicate the infection and halt emesis. Recommended agents include azithromycin or third-generation cephalosporins, which reduce symptom duration and prevent complications like dehydration.^[83] For peptic ulcer disease leading to vomiting due to gastric irritation or bleeding, proton pump inhibitors (PPIs) such as pantoprazole form the cornerstone of therapy, suppressing acid production to promote mucosal healing and symptom relief.^[84] Chronic management of recurrent vomiting, such as in gastroparesis or cyclic vomiting syndrome (CVS), often involves prokinetic agents like domperidone, which enhance gastric motility and reduce nausea and vomiting frequency by up to 82% in responsive patients.^[85] The 2024 American Gastroenterological Association (AGA) Clinical Practice Update recommends prophylactic therapy for moderate-to-severe CVS (≥4 episodes/year lasting >2 days with emergency visits or hospitalizations), with tricyclic antidepressants (e.g., amitriptyline 75–150 mg at bedtime) as first-line, and topiramate, aprepitant, zonisamide, or levetiracetam as second-line options; abortive therapy emphasizes early intervention with sumatriptan (20 mg intranasally or 6 mg subcutaneously) plus ondansetron (8 mg sublingual).^[86] Behavioral therapies, including cognitive behavioral therapy (CBT) combined with biofeedback, are effective for CVS by addressing triggers and improving coping mechanisms, leading to decreased episode severity in pediatric and adult cases.^[87] In severe, refractory vomiting where oral intake is impossible, advanced nutritional support through total parenteral nutrition (TPN) bypasses the gastrointestinal tract to maintain hydration and nutrition, particularly in conditions like protracted hyperemesis gravidarum or severe gastroparesis.^[88] Neuromodulators, such as tricyclic antidepressants (e.g., amitriptyline), provide benefit for central or functional causes of chronic vomiting by modulating visceral hypersensitivity, achieving symptom reduction in 68-76% of CVS patients.^[89] Tailored approaches in specific populations enhance outcomes; for instance, enteral tube feeding via gastrostomy is utilized in children with severe vomiting disorders to ensure caloric intake while minimizing aspiration risk, though monitoring for tolerance is essential.^[90] In endocrine disorders like hypothyroidism contributing to vomiting, thyroid hormone replacement therapy resolves gastrointestinal symptoms by normalizing metabolic function.^[91] Emerging biologics, including neurokinin-1 (NK1) receptor antagonists like aprepitant, offer promise for refractory vomiting unresponsive to standard antiemetics, with clinical trials demonstrating complete response rates of 68-80% in CVS and chemotherapy-induced cases.^[92]^[93]

Prevention Strategies

Lifestyle modifications play a key role in preventing vomiting, particularly through dietary adjustments that minimize gastric irritation. Consuming small, frequent meals throughout the day rather than large portions helps maintain stable stomach acid levels and reduces the likelihood of nausea triggered by an empty or overly full stomach.^[94] Avoiding trigger foods such as fatty, greasy, spicy, or overly sweet items is recommended, as these can slow gastric emptying and exacerbate symptoms.^[95] Bland, dry foods like crackers, toast, or rice are preferable in at-risk situations to promote tolerance and prevent episodes.^[96] Additionally, maintaining consistent hydration habits, such as taking small sips of clear fluids frequently, prevents dehydration that could otherwise intensify nausea and lead to vomiting.^[97] Pharmacologic prophylaxis targets specific high-risk scenarios to avert vomiting onset. For patients undergoing chemotherapy, guidelines endorse a combination of dexamethasone (typically 12-20 mg) and a 5-HT3 receptor antagonist such as ondansetron as first-line preventive therapy, which significantly reduces both acute and delayed emesis.^[98] This regimen is particularly effective for highly emetogenic agents, with network meta-analyses confirming its superior control over monotherapy options.^[99] In motion sickness, transdermal scopolamine patches applied behind the ear 4-6 hours prior to exposure prevent nausea and vomiting by blocking muscarinic receptors, offering protection for up to 72 hours.^[100] Clinical trials demonstrate this approach reduces symptom incidence and severity by 60-80% compared to placebo.^[101] Public health measures emphasize vaccination and education to curb infectious causes of vomiting. The rotavirus vaccine, administered orally to infants in a two- or three-dose series, reduces severe pediatric gastroenteritis by 85%, thereby preventing associated vomiting and hospitalization.^[102] Food safety education, including practices like thorough handwashing, separating raw and cooked foods, cooking to safe internal temperatures, and prompt refrigeration, mitigates foodborne pathogens that trigger vomiting.^[103] These interventions, promoted by agencies such as the FDA and USDA, lower outbreak risks in communities.^[104] Context-specific strategies address procedural and physiological vulnerabilities. Preoperative fasting guidelines recommend withholding solids for at least 6 hours and clear liquids for 2 hours before anesthesia to minimize aspiration risk and postoperative vomiting, while allowing carbohydrate-rich fluids closer to surgery in enhanced recovery protocols.^[105] For pregnancy, counseling on early dietary modifications—such as small, frequent bland meals and ginger supplementation—helps prevent progression to hyperemesis gravidarum, with preemptive use of vitamin B6 and doxylamine showing efficacy in reducing symptom severity.^[106]^[107] Psychological approaches, including mindfulness and cognitive behavioral therapy (CBT), offer prevention for psychogenic vomiting by addressing underlying anxiety or phobic responses. Recent randomized trials indicate that CBT targeting specific phobia of vomiting achieves clinically significant reductions in episode frequency for 50% of participants, through techniques like exposure and cognitive restructuring.^[108] Mindfulness-based interventions complement this by promoting stress reduction and body awareness, further decreasing psychogenic triggers in susceptible individuals.^[109]

Complications

Acute Complications

One of the most serious acute complications of vomiting is aspiration, where gastric contents are inhaled into the lungs, potentially leading to aspiration pneumonia or chemical pneumonitis.^[110] This risk is heightened in patients who are supine during vomiting episodes, as the position facilitates the passage of vomit into the airway.^[111] Chemical pneumonitis arises specifically from the acidic nature of vomited material irritating lung tissue, causing inflammation and acute respiratory distress.^[112] Elderly individuals and those who are intoxicated face an elevated risk of aspiration due to impaired swallowing reflexes and reduced consciousness, respectively.^[113]^[114] Vomiting can rapidly induce dehydration through substantial fluid loss, with each episode potentially expelling several hundred milliliters of fluid, leading to symptoms such as orthostatic hypotension, dry mucous membranes, and tachycardia.^[70]^[115] This fluid depletion is compounded by the loss of electrolytes, including sodium and potassium, resulting in imbalances like hyponatremia and hypokalemia that can exacerbate cardiovascular instability and muscle weakness.^[73]^[116] Forceful or repeated retching during vomiting may cause a Mallory-Weiss tear, a longitudinal mucosal laceration at the gastroesophageal junction that presents with hematemesis.^[117] This complication accounts for 5% to 15% of cases of acute upper gastrointestinal bleeding.^[118] The acidic gastric contents in vomit can also erode tooth enamel upon contact, leading to dental erosion that increases susceptibility to caries and tooth sensitivity.^[119] This enamel demineralization occurs due to the low pH of vomited material, which dissolves the protective surface layer of teeth.^[120]

Chronic and Systemic Complications

Chronic vomiting, especially when associated with purging behaviors in eating disorders such as anorexia nervosa and bulimia nervosa, frequently results in malnutrition and substantial weight loss. The repeated expulsion of stomach contents deprives the body of vital nutrients, proteins, and calories, leading to deficiencies in vitamins, minerals, and electrolytes that impair overall metabolic function.^[121] ^[122] This nutritional depletion exacerbates muscle wasting and weakens immune response, creating a cycle of further health deterioration.^[123] Gastrointestinal damage from prolonged vomiting includes esophagitis, where the esophageal lining becomes inflamed due to repeated exposure to gastric acid and mechanical trauma.^[124] In extreme instances, forceful vomiting can precipitate Boerhaave syndrome, a spontaneous full-thickness rupture of the esophagus, which carries a mortality rate of approximately 35-40% even with intervention.^[125] This perforation often stems from increased intraluminal pressure during retching, leading to mediastinal contamination and sepsis if not promptly addressed.^[126] Systemically, the loss of hydrogen ions and chloride through vomiting induces metabolic alkalosis, shifting the body's acid-base balance and potentially causing hypokalemia or hypochloremia.^[127] Electrolyte imbalances, particularly low potassium and magnesium levels, heighten the risk of cardiac arrhythmias, including potentially fatal ventricular rhythms.^[123] ^[128] In conditions like hyperemesis gravidarum, persistent vomiting contributes to renal strain through dehydration and hypovolemia, which can progress to acute kidney injury in severe cases.^[129] Among vulnerable populations, children experiencing recurrent vomiting, as seen in cyclic vomiting syndrome, often face growth delays due to chronic dehydration, poor nutrient absorption, and disrupted feeding patterns.^[130] Similarly, individuals with purging-type eating disorders develop osteoporosis from sustained malnutrition, which suppresses estrogen production and bone mineralization, increasing fracture risk over time.^[131] ^[132]

Epidemiology

Prevalence and Distribution

Vomiting is a widespread symptom, primarily occurring as part of acute gastrointestinal illnesses that affect a significant portion of the global population annually. Norovirus alone causes approximately 685 million cases of acute gastroenteritis worldwide each year, leading to diarrhea and vomiting in about one in five instances. Overall, diarrheal diseases, which frequently include vomiting, result in nearly 1.7 billion cases among children under five globally per year, according to World Health Organization estimates as of 2024. Recent estimates as of 2024 show a continued decline, with prevalence among under-5s at approximately 10.9% globally, reflecting improvements in sanitation and vaccination.^[133]^[134] Chronic vomiting, defined as recurrent episodes lasting weeks or more without identifiable pathology, has a prevalence of 1-2% in adults, often linked to conditions like cyclic vomiting syndrome (CVS), which affects 0.3-2% of the population depending on the region.^[135] Demographic patterns show vomiting is particularly prevalent among certain groups. In children, acute episodes from viral gastroenteritis are common, with most experiencing at least one episode by age five due to pathogens like rotavirus. Among pregnant women, nausea and vomiting of pregnancy (NVP) impacts 70-80% to varying degrees, with mild cases predominant and severe hyperemesis gravidarum affecting 0.3-3% of pregnancies. Travelers to developing regions face elevated risks, with travelers' diarrhea occurring in 30-70% of short-term visitors and vomiting as an accompanying symptom in approximately 10-30% of cases.^[136]^[137]^[138]^[139] Geographically, infectious causes of vomiting are more prevalent in low- and middle-income countries, where limited sanitation contributes to higher rates of gastroenteritis; for instance, the burden is disproportionately borne by children in these regions, accounting for the majority of the 1.7 billion annual childhood cases. In contrast, high-income settings see lower infectious rates but higher recognition of non-infectious chronic forms. Post-2020 trends indicate a resurgence in viral etiologies, such as norovirus, with outbreaks and cases spiking above pre-pandemic levels in 2023-2025 due to reduced population immunity during COVID-19 restrictions. Additionally, vomiting related to mental health contexts, particularly eating disorders like bulimia nervosa (prevalence 0.3%), remains underreported, though 2024 data show a 73% rise in eating disorder program admissions, many involving purging behaviors.^[133]^[140]^[141]^[142]

Risk Factors and Outcomes

Risk factors for vomiting can be categorized as modifiable or non-modifiable, influencing the likelihood of episodes across various etiologies such as infections, treatments, and underlying conditions. Modifiable risks include poor personal hygiene, which facilitates the transmission of pathogens like norovirus, a leading cause of acute gastroenteritis and vomiting.^[143] Travel to endemic areas heightens exposure to infectious agents such as Vibrio cholerae or other enteropathogens that provoke severe vomiting. Exposure to chemotherapy is a significant modifiable risk in oncology patients, with up to 70-80% experiencing chemotherapy-induced nausea and vomiting depending on the regimen's emetogenic potential.^[144] Non-modifiable risks encompass demographic and inherent factors that cannot be altered. Infants and the elderly are particularly susceptible due to immature or declining physiological reserves, increasing vulnerability to dehydration from even mild episodes.^[145] Genetic predispositions, such as family history of migraines, elevate the risk of cyclic vomiting syndrome, characterized by recurrent severe episodes.^[146] Comorbidities like diabetes mellitus contribute through mechanisms such as gastroparesis or diabetic ketoacidosis, both of which frequently manifest with persistent vomiting.^[147] Most acute vomiting cases, often due to viral gastroenteritis, resolve spontaneously within 24-48 hours in approximately 95% of instances, with supportive care addressing hydration and symptom relief.^[148] In contrast, chronic conditions like untreated hyperemesis gravidarum carry a poorer prognosis, with many cases requiring hospitalization for dehydration and nutritional support (estimated in 0.5-2% of pregnancies).^[59] Mortality from vomiting itself is rare, occurring in less than 0.1% of cases, primarily as a result of complications such as severe dehydration in infants and the elderly or aspiration pneumonia in vulnerable groups with impaired swallowing.^[143]^[145] Recent 2025 projections indicate that climate change will exacerbate foodborne risks leading to vomiting, with models forecasting a 10-20% rise in Salmonella-related illnesses due to warmer temperatures and altered precipitation patterns favoring pathogen growth in produce.^[149] Additionally, expanded vector-borne diseases like dengue, which often present with vomiting, are expected to increase by up to 15% in endemic regions due to shifting mosquito habitats.^[150]

Society and Culture

Historical and Cultural Views

In ancient Greek medicine, Hippocrates and his followers viewed vomiting as a key mechanism for restoring humoral balance, prescribing emetics to purge excess phlegm or bile and treat conditions like fevers and digestive disorders.^[151] This approach stemmed from the theory of four humors—blood, phlegm, yellow bile, and black bile—where imbalance caused illness, and induced vomiting served as a therapeutic purgation to expel morbid matter.^[152] Similarly, ancient Egyptian healers documented the use of emetic substances in medical papyri, such as mustard seeds and onions, to induce vomiting for relieving chest pains, treating snakebites, and facilitating bodily detoxification as part of purification practices.^[153]^[154] From the medieval period through the 19th century, emetics remained central to Western medical practice, particularly for poisoning cases, with ipecacuanha root gaining prominence as a reliable vomitive after its introduction to Europe in the 17th century and widespread adoption by the 1800s for evacuating toxins from the stomach.^[155] By the mid-20th century, this paradigm shifted toward antiemetic therapies; the synthesis of chlorpromazine in 1950 and its clinical introduction in 1952 marked a breakthrough, initially employed to control postoperative nausea and vomiting before its broader antipsychotic applications.^[156] This transition reflected growing recognition of vomiting's physiological triggers, moving away from routine purgation toward targeted suppression. Cross-culturally, vomiting has carried diverse symbolic meanings beyond pathology. In ancient Indian Ayurvedic traditions, part of broader Asian healing systems, therapeutic emesis (vamana) forms a cornerstone of panchakarma detoxification, inducing vomiting with herbal preparations to cleanse the body of toxins (ama) and promote spiritual purification by balancing doshas.^[157] Conversely, Western cultural norms have historically stigmatized public vomiting as a breach of decorum and bodily control, associating it with intemperance or weakness, particularly from the Victorian era onward when etiquette emphasized restraint in bodily functions.^[158] Certain taboos have further shaped perceptions, notably the 19th- and early 20th-century medicalization of pregnancy-related vomiting (hyperemesis gravidarum) as a manifestation of female hysteria, attributing severe nausea to psychological instability rather than physiological causes, which delayed recognition of it as a distinct medical condition.^[159] Indigenous North American practices offer another perspective, with tribes like the Zuni employing over a dozen emetic plants—such as decoctions of bark or roots—to induce vomiting for treating stomach ailments, fevers, and as part of holistic healing rituals that integrate physical and spiritual wellness.^[160] Vomiting is frequently linked to psychological conditions, where acute emotional distress can trigger physiological responses. Anxiety disorders, including panic attacks, often precipitate episodes of vomiting through heightened autonomic nervous system activation, as seen in cyclic vomiting syndrome where emotional stress serves as a key trigger.^[161] In post-traumatic stress disorder (PTSD), conditioned associations with trauma can lead to vomiting as a somatic manifestation of re-experiencing symptoms, with studies identifying PTSD as a precipitant in adult cases of recurrent vomiting.^[162] Self-induced vomiting plays a central role in bulimia nervosa, an eating disorder characterized by recurrent binge eating followed by compensatory purging behaviors, such as self-induced vomiting, which occurs in the majority of diagnosed individuals and contributes to severe medical complications.^[163] Socially, vomiting evokes widespread aversion, particularly in public settings, where the fear of embarrassment drives avoidance behaviors and is a core feature of emetophobia, a specific phobia affecting daily functioning and social interactions.^[164] Media representations amplify these dynamics, frequently depicting vomiting as comedic relief in films during party or intoxication scenes or as a horrific element in horror genres to evoke disgust and tension.^[165] This portrayal reinforces cultural taboos, heightening individual distress. Stigma surrounding vomiting profoundly impacts health-seeking behavior, with embarrassment often leading to delayed medical care, especially among those with eating disorders where purging is involved and shame exacerbates secrecy.^[166] Gender differences further influence experiences, as women report greater sensitivity to nausea and are more prone to vomiting in response to stressors like motion or postoperative recovery compared to men.^[167] Post-pandemic mental health surges have intensified these issues, with 2023-2024 studies documenting a 11-44% rise in gut-brain interaction disorders involving nausea and vomiting, attributed to elevated stress levels.^[168] A 2025 European guideline on chronic nausea and vomiting underscores the roles of biological, psychological, and social factors in these conditions.^[169] Effective interventions for psychogenic vomiting include cognitive behavioral therapy (CBT), which targets underlying anxiety and avoidance patterns, achieving symptom reduction in cases linked to social phobia or specific vomiting fears.^[170] Support groups, such as those facilitated by the National Eating Disorders Association, offer peer-based emotional relief and coping strategies for individuals managing vomiting-related psychological burdens.^[171]

References

[1]
Nausea and Vomiting - Clinical Methods - NCBI Bookshelf - NIH
Vomiting, or emesis, is the forceful retrograde expulsion of gastric contents from the body. Nausea is the unpleasant sensation that precedes vomiting.
[2]
Why is the neurobiology of nausea and vomiting so important? - PMC
A vomit (expulsion of gastric contents) is usually preceded by several retching responses, but retching and vomiting can occur separately (Andrews et al., 1990) ...
[3]
Mechanisms of Nausea and Vomiting - PubMed Central - NIH
Nausea is the unpleasant sensation of having the urge to vomit, whereas vomiting (emesis) is a physical event and is the forceful expulsion of intestinal and ...
[4]
Nausea, Vomiting, and Hiccups: A Review of Mechanisms and ...
Vomiting or emesis, which is the actual oral expulsion of gastrointestinal contents, is the result of contractions of the gut and the thoracoabdominal wall ...
[5]
Nausea and vomiting Causes - Mayo Clinic
Motion sickness and drinking alcohol are among the many common causes of nausea and vomiting. Serious diseases can also have this effect.Cyclic vomiting syndrome · When to see a doctor · Print
[6]
Nausea and Vomiting in 2021: A Comprehensive Update - PMC
A comprehensive review of treatments for nausea and vomiting. Nausea and vomiting (N/V) are common symptoms encountered in medicine.
[7]
Nausea and vomiting When to see a doctor - Mayo Clinic
Seek prompt medical attention if nausea and vomiting are accompanied by other warning signs, such as: Chest pain; Severe abdominal pain or cramping; Blurred ...
[8]
Neuroanatomy, Medulla Oblongata - StatPearls - NCBI Bookshelf
It is also known as the vomiting center. It is positioned to detect emetic toxins in the blood and the CSF. The cells in the area postrema are unique ...
[9]
Chronic Unexplained Nausea and Vomiting or Gastric ...
Nausea is the subjective, unpleasant sensation of the need to vomit, and vomiting is the forceful expulsion of gastric contents out of the mouth. It is ...
[10]
Hemoptysis - Clinical Methods - NCBI Bookshelf - NIH
Hemoptysis is the expectoration of blood or blood-tinged sputum from the lungs or tracheobronchial tree.
[11]
Signals for nausea and emesis: Implications for models of upper ...
In most animals vomiting is a protective function that serves to expel toxins from the gastrointestinal tract prior to absorption, but in some species it is ...
[12]
Physiology of Vomiting
To summarize, two basic sets of pathways - one neural and one humoral - lead to activation of centers in the brain that initiate and control vomition. Think of ...
[13]
Physiology of the Digestive Tract Correlates of Vomiting - PMC
Jan 30, 2023 · The gastrointestinal correlates of vomiting can occur totally independent of the laryngeal and pharyngeal phases of the vomit process (Fig. 10).Missing: treatment | Show results with:treatment
[14]
Gastric Content - an overview | ScienceDirect Topics
Composition of normal gastric juice pH 1.0–1.5 due to the HCl produced by the parietal cells. Water content about 97–99 per cent.
[15]
Throwing up bile: Causes, treatment, and prevention
a yellow or greenish liquid — for many reasons. These include pregnancy, bile reflux, an intestinal blockage, and ...Missing: composition | Show results with:composition
[16]
Bile Reflux: Symptoms, Treatment, Causes & What It Is
Bile reflux occurs when bile from the small intestine backwashes into the stomach, and sometimes into the esophagus.
[17]
Can You Throw Up Poop? Causes, Symptoms, and More - Healthline
Mar 11, 2021 · You can vomit up fecal matter. It typically occurs due to an obstruction in the intestines, which requires emergency medical care.
[18]
Coffee Ground Emesis (Vomitus): Causes, What it Is & Treatment
What is the difference between coffee ground vomit and hematemesis? Hematemesis means vomiting blood, so coffee ground emesis is one type of hematemesis.
[19]
All About pH for Stomach Acid - Healthline
Apr 14, 2022 · Stomach acid has a pH between 1 and 2, which makes it quite acidic. Keep in mind that battery acid can dissolve materials like metal and bone. ...
[20]
When does constipation become an emergency?
Vomiting stool or bile can indicate a bowel obstruction. The vomit may smell like stool, and it may be dark brown or brown-purple. If a person vomits bile, the ...Vomiting stool or bile · Fecal impaction · Very few bowel movements · In toddlersMissing: odor ileus
[21]
Viral Gastroenteritis - StatPearls - NCBI Bookshelf - NIH
May 4, 2025 · Viral gastroenteritis is a known cause of nausea, vomiting, diarrhea, anorexia, weight loss, and dehydration. Isolated cases can occur.
[22]
Gastric Outlet Obstruction - StatPearls - NCBI Bookshelf
Feb 15, 2025 · Hypertrophic pyloric stenosis (HPS) is a common cause of GOO ... causes abdominal pain, vomiting, weight loss, and resulting malnutrition.
[23]
Acute Gastric Dilatation: A Cause for Concern - PMC - NIH
Feb 12, 2021 · Causes of mechanical obstruction include postsurgical strictures/adhesions, pyloric stenosis, gastric volvulus, and superior mesenteric artery ...
[24]
Postoperative Ileus - StatPearls - NCBI Bookshelf
Jul 31, 2023 · Postoperative ileus causes delayed bowel movement or flatus with abdominal distention and possible nausea or vomiting. It is crucial to ...Missing: adhesions | Show results with:adhesions
[25]
Norovirus - StatPearls - NCBI Bookshelf - NIH
Feb 17, 2025 · Norovirus has since become the most common cause of gastroenteritis, particularly in children in countries with rotavirus vaccination programs.
[26]
Incidence, Etiology, and Healthcare Utilization for Acute ... - CDC
Oct 12, 2022 · Among those not meeting the AGE case definition, we observed a norovirus prevalence of 1.4% and a rotavirus prevalence of 5.8% by qRT-PCR; both ...
[27]
Appendicitis - NIDDK
Appendicitis symptoms include abdominal pain, lack of appetite, vomiting, constipation, or diarrhea. See a doctor or go to the emergency room right away if ...Symptoms & Causes · Definition & Facts · Treatment · Diagnosis
[28]
Peptic Ulcers (Stomach or Duodenal Ulcers) - NIDDK
Common symptoms of peptic ulcers include pain or discomfort in your abdomen, feeling full too soon during or too full after a meal, nausea, bloating, and ...Definition & Facts · Symptoms & Causes · Diagnosis · Treatment
[29]
Gastroparesis - StatPearls - NCBI Bookshelf - NIH
Feb 28, 2024 · Gastroparesis causes symptoms such as nausea, vomiting, bloating, early satiety, and abdominal pain.[1] Delayed or ineffective gastric emptying ...
[30]
Cyclic Vomiting Syndrome - NIDDK
Cyclic vomiting syndrome, or CVS, is a disorder that causes sudden, repeated attacks—called episodes—of severe nausea and vomiting. Episodes can last from a ...Symptoms & Causes · Treatment · Definitions & Facts · Diagnosis
[31]
Abdominal Adhesions - NIDDK
Abdominal adhesions are common and often develop after abdominal surgery. In abdominal surgery, surgeons enter a patient's abdomen through an incision, or cut.
[32]
Increased Intracranial Pressure - StatPearls - NCBI Bookshelf - NIH
Sep 14, 2025 · Intracranial hypertension refers to a clinical condition characterized by elevated pressure within the cranial vault.
[33]
[Vomiting as a first neurological sign of brain tumors in children]
Intracranial pathology also can cause vomiting, both by increased intracranial pressure and by direct stimulation of the vomiting centre in the brainstem.
[34]
Clinical Presentation - Holland-Frei Cancer Medicine - NCBI Bookshelf
Projectile vomiting is not usually a presenting symptom but may occur with rapid rises in intracranial pressure. Disequilibrium and even true vertigo may occur ...
[35]
Lateral Medullary Syndrome (Wallenberg Syndrome) - StatPearls
Aug 9, 2025 · Typical symptoms include acute onset of vertigo, dizziness, nystagmus, ataxia, nausea, vomiting, dysphagia, hiccups, dysphonia, facial pain, ...
[36]
Optimal management of severe nausea and vomiting in migraine
The main treatment of nausea and vomiting in migraine is to cease the migraine attack itself as soon as possible, with effective drugs at effective doses.
[37]
Why does vomiting stop a migraine attack? - PubMed
Migraine is commonly associated with nausea and vomiting, though, interestingly, vomiting has also been reported by some patients to be therapeutic.
[38]
Moving in a Moving World: A Review on Vestibular Motion Sickness
Feb 15, 2016 · Vestibular-only motion sickness is being provoked when conflicts occur among different sensory signals of the vestibular system. These conflicts ...
[39]
Motion Sickness - StatPearls - NCBI Bookshelf
The symptoms of motion sickness can be diverse, ranging from the most common, nausea and vomiting, too cold sweating, pallor, headache, drowsiness, yawning, ...Etiology · Epidemiology · Evaluation · Treatment / Management
[40]
Labyrinthitis - StatPearls - NCBI Bookshelf
Jul 23, 2025 · Nausea, vomiting, and severe 'room spinning' vertigo are the most commonly reported symptoms of labyrinthitis. · The differential diagnosis of ...Continuing Education Activity · History and Physical · Treatment / Management
[41]
Ménière disease - Genetics - MedlinePlus
Oct 1, 2017 · Episodes are often associated with nausea and vomiting, and they can severely disrupt activities of daily living. The episodes associated with ...
[42]
Significance of vomiting after head injury - PMC - NIH
Post-traumatic vomiting was associated with a fourfold increase in the relative risk for a skull fracture.
[43]
Radiation-induced nausea and vomiting in head and neck cancer
Oct 21, 2019 · Radiation-induced nausea and vomiting (RINV) is a frequent albeit neglected side effect of RT that can lead to delays in treatment with serious consequences on ...
[44]
Correlation of Planned Dose to Area Postrema and Dorsal Vagal ...
Head and neck cancer patients receiving radiation therapy commonly suffer nausea and vomiting, a symptom that if severe enough may interrupt or delay ...
[45]
Central vertigo and dizziness: epidemiology, differential diagnosis ...
Central vestibular lesions affecting the pons, medulla, or cerebellum cause vertigo, nausea, vomiting, severe ataxia, multidirectional nystagmus that is not ...<|control11|><|separator|>
[46]
Central Vertigo - StatPearls - NCBI Bookshelf
These patients present with an acute onset of extremely severe vertigo with nausea and vomiting, along with prominent peripheral unidirectional nystagmus.Continuing Education Activity · Introduction · Epidemiology · History and Physical
[47]
European Guideline on Chronic Nausea and Vomiting—A UEG and ...
Jan 10, 2025 · Causes of secondary chronic nausea and vomiting. Endocrine/metabolic, Pregnancy. Metabolic acidosis. Uraemia. Hypercalcaemia. Hyperthyroidism.Missing: insufficiency | Show results with:insufficiency
[48]
Diabetes mellitus and electrolyte disorders - PMC - PubMed Central
A number of factors contribute to the DKA- and HHS-associated potassium depletion, including vomiting, increased renal losses due to the osmotic diuresis and ...
[49]
Symptoms & Causes of Adrenal Insufficiency & Addison's Disease
Long-lasting fatigue is a common symptom of adrenal insufficiency. Other symptoms of adrenal insufficiency can include. nausea; vomiting; diarrhea; low blood ...
[50]
Clinical manifestations of adrenal insufficiency in adults - UpToDate
Jul 16, 2024 · (See "Causes of primary adrenal insufficiency (Addison disease)" and ... vomiting, abdominal pain, weakness, fatigue, lethargy, fever ...
[51]
A History of Drug Discovery for Treatment of Nausea and Vomiting ...
This review outlines the mechanisms of nausea and vomiting, providing a background to the discovery and pharmacology of licensed anti-emetic drugs and compounds
[52]
Pathophysiological and neurochemical mechanisms of ...
Clinical research shows that postoperative nausea and vomiting (PONV) is caused primarily by the use of inhalational anesthesia and opioid analgesics.
[53]
Pathophysiological Mechanisms of Gastrointestinal Toxicity - PMC
Premature MMC activity can be induced by opiates, erythromycin, and ... The most effective general antiemetic drugs are those that block 5-HT3 receptors ...Missing: HT3 | Show results with:HT3
[54]
Death by food - PMC - PubMed Central - NIH
Jul 15, 2017 · Symptoms include diarrhea and vomiting with hypotension, bradycardia and neurological problems such as paresthesiae and peripheral neuropathy.Infections · Fig. 2 · Natural Toxins
[55]
Scombroid and Histamine Toxicity - StatPearls - NCBI Bookshelf - NIH
Staphylococcal enterotoxin-induced food poisoning: Staphylococcus aureus causes very similar symptoms with sudden onset nausea, vomiting, and abdominal pain ...Missing: botulism | Show results with:botulism
[56]
Ethanol Toxicity - StatPearls - NCBI Bookshelf - NIH
At a BAC of 0.2% to 0.4%, patients develop nausea and vomiting, hypothermia, dysarthria, amnesia, diplopia, and nystagmus. With a BAC of greater than 0.4%, ...
[57]
Prevalence of hyperemesis gravidarum and associated factors ... - NIH
Jun 5, 2024 · There is a high incidence of nausea and vomiting in early pregnancy (NVP) that affects 50%–90% of pregnant women with HG. In 0.3%–3.6% of cases, ...
[58]
Hyperemesis Gravidarum - StatPearls - NCBI Bookshelf - NIH
Jul 6, 2025 · Characterized by persistent vomiting, significant weight loss (often more than 5% of prepregnancy weight), dehydration, and metabolic ...Epidemiology · History and Physical · Evaluation · Treatment / Management
[59]
Nausea and vomiting during acute myocardial infarction ... - PubMed
Nausea and vomiting occurring during myocardial ischemia is believed to be associated with inferior wall infarction. However, data supporting such an ...
[60]
Impact of Cardiogenic Vomiting in Patients with STEMI - NIH
Dec 5, 2015 · Cardiogenic vomiting is a useful predictor of major adverse cardiac events in STEMI patients for the hospitalization and after discharge.
[61]
Postoperative Nausea - StatPearls - NCBI Bookshelf
Postoperative nausea and vomiting (PONV) is a common occurrence following anesthesia and leads to patient dissatisfaction and discomfort.Continuing Education Activity · Introduction · Etiology · Treatment / Management
[62]
Postoperative nausea and vomiting - UpToDate
Apr 30, 2025 · The term PONV is typically used to describe nausea and/or vomiting or retching in the post-anesthesia care unit (PACU) or in the immediate 24 ...
[63]
Psychogenic vomiting: A case series - PMC - NIH
Psychogenic vomiting is a syndrome in which there is recurrent vomiting, without any organic pathology or as “functional vomiting” as a result of psychological ...
[64]
COVID-19-induced gastrointestinal autonomic dysfunction
COVID-19 can damage the nerve supply to the digestive system, leading to gastrointestinal autonomic dysfunction.
[65]
Cytokine storm induced by SARS-CoV-2 infection - PubMed Central
COVID-19 can have CNS and PNS neurological manifestations. Headache and hyposmia are common neurological symptoms. COVID-19 could trigger cytokine storm.
[66]
https://www.mayoclinic.org/symptoms/nausea/basics/symptoms/sym-20050736
[67]
Severe bradycardia induced by postoperative nausea and vomiting
Aug 25, 2023 · Postoperative nausea and vomiting are among the most common symptoms observed in PACU following general anesthesia or a surgical procedure.
[68]
Evaluation of Nausea and Vomiting | AAFP
Jul 1, 2007 · Large volume (> 1,500 mL per 24 hours), Suggests organic rather than psychiatric causes. Abdominal pain. Right upper quadrant, Biliary tract ...
[69]
Symptoms & Causes of GER & GERD in Infants - NIDDK
What are the symptoms of GER and GERD in infants? · vomit that contains blood or looks like coffee grounds · rectal bleeding or stool that contains blood.
[70]
Dehydration - Symptoms & causes - Mayo Clinic
May 2, 2025 · In general, the higher the fever, the more severe dehydration might be. The problem is even worse when there's fever plus diarrhea and vomiting.
[71]
Evaluation of Nausea and Vomiting in Adults: A Case-Based Approach
Sep 15, 2013 · A history and physical examination can help determine the most likely cause. A food and nausea diary may help determine patterns of symptoms and ...Abstract · Acute Nausea and Vomiting · Chronic Nausea and Vomiting
[72]
Evaluation of nausea and vomiting, adults - BMJ Best Practice
Nausea and vomiting are extremely common symptoms and may be caused by a vast array of medical conditions. The presentation can be acute or chronic ...
[73]
Adult Dehydration - StatPearls - NCBI Bookshelf - NIH
Mar 5, 2025 · The resulting cellular dehydration can lead to neurological symptoms such as confusion, seizures, and coma.[20]. Hypotonic dehydration: This ...
[74]
Oral rehydration salts - World Health Organization (WHO)
Jan 1, 2006 · Dehydration from diarrhoea can be prevented by giving extra fluids at home, or it can be treated simply, effectively, and cheaply in all age-groups.
[75]
Ondansetron - StatPearls - NCBI Bookshelf - NIH
Standard dosing to prevent postoperative nausea and vomiting includes 8 mg every 12 hours orally or 4 mg given intravenously. No dosage adjustments are ...
[76]
Metoclopramide (oral route) - Side effects & dosage - Mayo Clinic
Metoclopramide is used to treat the symptoms of slow stomach emptying (gastroparesis) in patients with diabetes. ... It relieves symptoms such as nausea, vomiting ...
[77]
American Gastroenterological Association medical position statement
Management of nausea and vomiting should include, first, recognition and correction of any consequences or complications; second, identification, wherever ...
[78]
Doxylamine-pyridoxine for nausea and vomiting of pregnancy ... - NIH
Jan 17, 2018 · Doxylamine-pyridoxine is recommended as a first line treatment for nausea and vomiting during pregnancy and it is commonly prescribed.
[79]
Hypokalemia Treatment & Management - Medscape Reference
Mar 13, 2023 · Use potassium-sparing diuretics if diuretic therapy is required (eg, severe heart failure). Treat diarrhea or vomiting. Administer H2 blockers ...Decreasing Potassium Losses · Replenishment of Potassium · Consultations
[80]
Evidence Summary for Nonpharmacological Management of ... - NIH
Nov 23, 2022 · It is recommended to use acupressure, acupuncture, and other comprehensive methods combined with antiemetics to relieve CINV symptoms in cancer ...Missing: post- | Show results with:post-
[81]
Open Versus Laparoscopic Pyloromyotomy for Pyloric Stenosis - NIH
This is the only large prospective randomized trial comparing laparoscopic and open pyloromyotomy for pyloric stenosis. The data obtained in this controlled ...
[82]
Open versus laparoscopic pyloromyotomy for pyloric stenosis
Open versus laparoscopic pyloromyotomy for pyloric stenosis: a prospective, randomized trial. Ann Surg. 2006 Sep;244(3):363-70. doi: 10.1097/01.sla ...
[83]
Clinical Overview of Salmonellosis | Salmonella Infection - CDC
Oct 7, 2024 · Recommended first-line antibiotics include fluoroquinolones, azithromycin, and third-generation cephalosporins. Follow-up stool culture may be ...Diagnosis · Patient Management · Who Should Receive Treatment
[84]
Peptic Ulcer Disease - StatPearls - NCBI Bookshelf - NIH
First-line treatment for H. pylori-induced PUD is a triple regimen comprising two antibiotics and a proton pump inhibitor. Pantoprazole, clarithromycin, and ...
[85]
Cardiac safety and clinical efficacy of high-dose domperidone for ...
The mean severity of vomiting and nausea was improved by 82% and 55%, respectively. Long-term treatment with high doses of domperidone (40-120 mg/day) improved ...
[86]
Cyclical vomiting syndrome: Recognition, assessment and ...
A case report by Slutsker explored using cognitive behavioural therapy (CBT) with biofeedback training in a phase oriented manner, targeting on the prevention ...
[87]
Peripheral parenteral nutrition in protracted hyperemesis gravidarum
Hyperemesis gravidarum is defined as severe nausea and vomiting during the first trimester of pregnancy. It is characterized by dehydration, electrolyte ...<|control11|><|separator|>
[88]
Newest Drugs for Chronic Unexplained Nausea and Vomiting - PMC
Furthermore, new options are in testing as novel antiemetic, neuromodulator, and prokinetic therapies for different causes of nausea and vomiting.
[89]
Chapter 17 Enteral Tube Management - Nursing Skills - NCBI - NIH
MANAGING INTOLERANCES AND IMBALANCES. Patients should be monitored daily for signs of tube feeding intolerance, such as abdominal bloating, nausea, vomiting, ...
[90]
Recurrent nausea, vomiting and abdominal pain due to ... - NIH
Mar 30, 2010 · After initiating thyroid hormone replacement therapy, all of the patient's symptoms resolved. ... Hypothyroidism is one of the most common ...
[91]
Efficacy of aprepitant as a prophylactic medication in adults with ...
Aprepitant is a safe and effective prophylactic medication in adults with refractory CVS. Adequate insurance coverage is a major barrier preventing its use.
[92]
Aprepitant and Fosaprepitant: A 10-Year Review of Efficacy and Safety
Significantly more aprepitant recipients than controls achieved no vomiting (76.2% vs. 62.1%; p < .001) and complete response (68.7% vs. 56.3%; p < .001) in the ...
[93]
[PDF] Managing Nausea and Vomiting | Alberta Health Services
• Try to eat small meals and snacks often throughout the day, instead of eating large amounts of food at one time. An empty stomach can make nausea worse.
[94]
Symptom Management - Nutrition Program - UNC Lineberger
Tips for Managing Nausea and Vomiting Eat bland foods, instead of foods that are very sweet, fatty, greasy, or spicy. Eat dry foods (such as crackers, toast, ...
[95]
Eating When You Have Nausea and Vomiting - Breastcancer.org
Eat small meals frequently. If you feel sick to your stomach between meals, try to eat 6 to 8 small meals during the day and a snack at bedtime. ; Eat food cold ...
[96]
How to Avoid Dehydration During Diarrhea and Vomiting | Banner
Jul 18, 2025 · 1. Start with small sips · 2. Choose the right fluids · 3. Use oral rehydration solutions (ORS) · 4. Eat bland, easy foods when ready · 5. Check ...
[97]
Role of dexamethasone dosage in combination with 5-HT3 ...
Dexamethasone (20 mg) or its equivalent in combination with 5-HT3 antagonists appears to be the gold-standard dose for antiemetic prophylaxis.
[98]
Efficacy and safety of antiemetic regimens for highly emetogenic ...
Regimens containing a combination of dexamethasone and 5-HT3 antagonist have the lowest probability of being the most effective regimen in terms of complete, ...
[99]
Scopolamine (transdermal route) - Side effects & dosage - Mayo Clinic
Aug 31, 2025 · Scopolamine transdermal patch is used to prevent nausea and vomiting after anesthesia, narcotic pain medicines, and surgery.
[100]
Transdermal scopolamine for prevention of motion sickness - PubMed
TTS-S has proved to be significantly superior to placebo in reducing the incidence and severity of motion sickness by 60-80%.
[101]
Safety and Efficacy of an Attenuated Vaccine against Severe ...
The efficacy of the vaccine against severe rotavirus gastroenteritis and against rotavirus-associated hospitalization was 85 percent (P<0.001 for the ...
[102]
Safe Food Handling - FDA
Mar 5, 2024 · To keep your family safer from food poisoning, follow these four simple steps: clean, separate, cook, and chill.
[103]
Foodborne Illness and Disease | Food Safety and Inspection Service
Cook raw meat, poultry, and egg products to a safe temperature. Do not eat raw or undercooked eggs. Avoid consuming raw or unpasteurized milk or other dairy ...
[104]
[PDF] Practice Guidelines for Preoperative Fasting
Antiemetics may be preoperatively administered to patients at increased risk of postoperative nausea and vomiting. • The routine preoperative administration of ...
[105]
Hyperemesis Gravidarum: Causes, Symptoms & Treatment
Dietary changes: Small, frequent meals (every two hours) of bland, dry food can help with nausea and vomiting. Crackers, toast, white potatoes or rice are good ...Missing: counseling | Show results with:counseling
[106]
Treatment of Hyperemesis Gravidarum - PMC - PubMed Central
Medicinal methods of prevention and treatment include nutritional supplements and alternative methods, such as hypnosis and acupuncture, as well as ...
[107]
[PDF] Cognitive behaviour therapy for specific phobia of vomiting ...
Six (50%) of the participants receiving CBT achieved clinically significant ... treatment of psychogenic nausea: report of two cases. Behavioural ...
[108]
Psychological Interventions in Chemotherapy-Induced Nausea ... - NIH
Kim and colleagues reported that CBT reduced chemotherapy-induced nausea and vomiting in women with breast cancer through stress management, breathing and ...
[109]
Aspiration Risk - StatPearls - NCBI Bookshelf
Mar 16, 2023 · Aspiration is common, even in healthy patients. Aspiration can have significant morbidity and mortality in certain circumstances.
[110]
Prevention of Aspiration in Adults | Critical Care Nurse
Feb 1, 2016 · Evidence indicates that a sustained supine position (0° head-of-bed elevation) increases gastroesophageal reflux and the probability of aspiration.
[111]
Aspiration Pneumonia and Chemical Pneumonitis - MSD Manuals
A commonly inhaled toxic material is stomach acid, so that chemical pneumonitis may result whenever a person inhales what has been vomited up. Inhalation of ...
[112]
Preventing Aspiration in Older Adults with Dysphagia | HIGN
The older adult with one of these conditions is at even greater risk for aspiration because the dysphagia is superimposed on the slowed swallowing rate ...
[113]
Alcoholism in the Elderly - AAFP
Mar 15, 2000 · Aspiration pneumonia occurs with vomiting and a decreased level of consciousness during intoxication. Many older adults were exposed to ...
[114]
[PDF] Alberta Health Services Acute Childhood Vomiting & Diarrhea ...
• If active vomiting, encourage frequent small volumes of fluids. • Encourage ... - assume ~ 8 ml/kg for the volume lost per one vomit or one diarrhea.
[115]
Dehydration - Hormonal and Metabolic Disorders - Merck Manuals
The reason is that although the common causes of dehydration (such as profuse sweating, vomiting, and diarrhea) result in a loss of electrolytes (especially ...
[116]
Mallory-Weiss Syndrome - StatPearls - NCBI Bookshelf - NIH
Jul 31, 2023 · MWS accounts for 1% to 15% of the causes of upper GI bleeding in adults and less than 5% in children in the United States. The age of highest ...Introduction · Etiology · Evaluation · Treatment / Management
[117]
Mallory-Weiss syndrome - UpToDate
The reported incidence of Mallory-Weiss syndrome among patients presenting with upper gastrointestinal bleeding ranges from 7.5 to ...Missing: hematemesis | Show results with:hematemesis
[118]
Self-induced vomiting and dental erosion – a clinical study - PMC
Jul 29, 2014 · It is likely that individuals who induce vomiting up to several times per day have a higher risk of developing dental erosion than those who ...
[119]
Dental erosion - Oral Health Foundation
Because there are high levels of acid in the vomit, this can cause damage to tooth enamel. Acids produced by the stomach can come up into the mouth (this is ...
[120]
Anorexia Nervosa - StatPearls - NCBI Bookshelf
Anorexia nervosa is an eating disorder defined by restriction of energy intake relative to requirements, leading to a significantly low body weight.
[121]
The Medical Complications Associated with Purging - PMC - NIH
Feb 15, 2016 · Purging behaviors, including self-induced vomiting, laxative abuse, and diuretic abuse, are present across many of the eating disorders.Missing: malnutrition | Show results with:malnutrition<|separator|>
[122]
How eating disorders can damage the heart
Feb 26, 2024 · Excessive weight loss, malnutrition and electrolyte imbalances from eating disorders can cause serious cardiovascular issues that can lead ...
[123]
Esophagitis - Harvard Health
Similar to acid reflux, frequent vomiting can cause acid burn in the esophagus. Esophagitis sometimes is seen in people with eating disorders ...
[124]
Boerhaave Syndrome (Spontaneous Esophageal Perforation)
Jul 2, 2025 · A reported mortality estimate is approximately 35-40%, making it the most lethal perforation of the gastrointestinal tract. The best outcomes ...
[125]
Boerhaave Syndrome - StatPearls - NCBI Bookshelf - NIH
Dec 4, 2023 · Delayed diagnosis poses substantial challenges, leading to adverse outcomes, with mortality rates reaching 60% despite intervention and nearly ...
[126]
Pathophysiology, Evaluation, and Management of Metabolic Alkalosis
Jan 21, 2021 · The removal of gastric HCl due to vomiting or nasogastric (NG) suction results in metabolic alkalosis because HCO3− is added to the ECF (rather ...
[127]
Electrolyte Abnormalities in Patients Presenting With Ventricular ...
Aug 15, 2020 · Electrolyte abnormalities are a known trigger for ventricular arrhythmia ... Vomiting / epidemiology; Water-Electrolyte Imbalance / blood; Water ...
[128]
Acute kidney injury in pregnancy - PMC - NIH
Hyperemesis gravidarum is a common cause of pregnancy-related AKI during the first trimester, and complications like preeclampsia, preeclampsia, hemolysis, ...
[129]
Cyclic Vomiting Syndrome in Children - PMC - PubMed Central - NIH
Nov 2, 2020 · Recent evidence suggests that aberrant brain-gut pathways, mitochondrial enzymopathies, gastrointestinal motility disorders, calcium channel ...
[130]
Eating Disorders and Bone Metabolism in Women - PMC
Eating Disorders are psychiatric disorders associated with high risk for low bone mineral density (BMD) and fractures. Low BMD is likely to be a consequence ...<|separator|>
[131]
a follow-up study of patients with anorexia and bulimia nervosa
This study prospectively investigated the course of bone mineral density (BMD) in patients with anorexia nervosa (AN) and bulimia nervosa (BN) over a 3.6-yr ...
[132]
Impact and experiences of vestibular disorders and psychological ...
Nov 1, 2023 · Anxiety, depression and cognitive problems often co‐present with vestibular disorders and can aggravate symptoms and prolong clinical recovery.Missing: sickness | Show results with:sickness
[133]
Norovirus Facts and Stats - CDC
May 8, 2024 · Norovirus worldwide. Worldwide, norovirus causes about 1 out of every 5 cases of acute gastroenteritis that leads to diarrhea and vomiting.
[134]
Diarrhoeal disease - World Health Organization (WHO)
Mar 7, 2024 · Globally, there are nearly 1.7 billion cases of childhood diarrhoeal disease every year. Diarrhoea is a leading cause of malnutrition in ...
[135]
Cyclic Vomiting Syndrome - StatPearls - NCBI Bookshelf - NIH
Cyclic vomiting syndrome is characterized by recurrent episodes of nausea and vomiting lasting from hours to days in the absence of identifiable pathology.Cyclic Vomiting Syndrome · Evaluation · Treatment / Management<|control11|><|separator|>
[136]
Burden of acute gastroenteritis among children younger than 5 ...
Jun 18, 2012 · By the age of five, most children will have had at least one episode of rotavirus infection [12, 13]. The incidence of rotavirus gastroenteritis ...
[137]
Nausea and Vomiting of Pregnancy - PMC - PubMed Central
Nausea and vomiting are common experiences in pregnancy, affecting 70–80% of all pregnant women. Although most women with nausea and vomiting of pregnancy (NVP) ...
[138]
Travelers' Diarrhea | Yellow Book - CDC
Apr 23, 2025 · Antibiotics are effective in reducing the duration of diarrhea by approximately 1–2 days in cases caused by bacterial pathogens susceptible to ...Prevention · Prophylactic Antibiotics · Treatment
[139]
Predicted norovirus resurgence in 2021–2022 due to the relaxation ...
We report that susceptibility to norovirus infection has likely increased between March 2020 and mid-2021. Depending upon assumptions of future contact patterns ...
[140]
Eating Disorders - National Institute of Mental Health (NIMH)
The overall prevalence of bulimia nervosa was 0.3%. · Prevalence of bulimia nervosa was five times higher among females (0.5%) than males (0.1%).
[141]
Children's Hospital Colorado reports spike in eating disorder patients
Oct 20, 2025 · Children's Hospital Colorado reports a 73% rise in patients who used its Eating Disorders Program over the last year.
[142]
Risk Factors Associated with Chemotherapy-Induced Nausea ... - NIH
Apr 8, 2024 · Younger age, female sex, history of vomiting during pregnancy and history of motion sickness are some of the patient-related factors that have ...Missing: travel | Show results with:travel
[143]
Aspiration Pneumonia - StatPearls - NCBI Bookshelf - NIH
Mar 20, 2024 · Aspiration pneumonia is a pulmonary infection resulting from the inhalation of bacterial-rich fluids, such as oropharyngeal secretions, particulate matter, or ...
[144]
Cyclic Vomiting Syndrome - Symptoms, Causes, Treatment | NORD
Cyclic vomiting syndrome does not meet the definition of a rare disease in the U.S. (fewer than 200,000 Americans). NORD posts this report because limited ...
[145]
Treatment of Diabetes Mellitus in Children and Adolescents - NCBI
Jun 28, 2021 · Children with intercurrent illnesses such as fever or vomiting, should be closely monitored for the development of hyperglycemia and ketonuria.
[146]
Norovirus infection - Symptoms & causes - Mayo Clinic
Signs and symptoms of norovirus infection may start suddenly and include: Nausea; Vomiting; Stomach pain or cramps; Watery or loose diarrhea; Feeling ill; Low- ...Overview · Symptoms · Causes<|separator|>
[147]
Climate Change Increases Foodborne Illness Risk From Raw Produce
Aug 29, 2024 · Climate change will increase the risk of the foodborne illness from Salmonella enterica, according to a new study.
[148]
Climate change and the global food chain: a catalyst for emerging ...
Aug 11, 2025 · A growing amount of research substantiates climate's influence on the transmission and proliferation of vector-borne illnesses, including ...
[149]
When foods become remedies in ancient Greece: The curious case ...
As is the case here, in the Hippocratic Corpus, the word 'pharmakon' usually refers to a purgative drug (laxative or emetic) and the word 'sition' refers to ...
[150]
Hippocrates - an overview | ScienceDirect Topics
Either the body was freed of excess fluids by blood letting, a purge, an emetic, or some other means, or the disorder was treated by its opposite: e.g., “cold” ...
[151]
[PDF] Practicing Medicine in Ancient Egypt
Mar 28, 2017 · Common salt, a mild emetic (inducing vomiting), had a wide use, being taken orally, by enema, or applied locally to the eyes, ears, and skin ...
[152]
The Brooklyn Papyrus Snakebite and Medicinal Treatments' Magico ...
The most frequent use of the onion in the Brooklyn Papyrus is, in fact, as an emetic to induce vomiting and usually when the bite was from a venomous snake. The ...
[153]
Ipecacuanha: the South American vomiting root - PubMed
Ipecacuanha, its root and the pure alkaloid emetine have now been abandoned on the grounds of toxicity. ... History, 19th Century; History, 20th Century ...Missing: poisoning | Show results with:poisoning
[154]
History of the discovery and clinical introduction of chlorpromazine
The discovery of the antipsychotic properties of chlorpromazine in the 1950s was a fundamental event for the practice of psychiatry and for the genesis of ...
[155]
Ancient Purification Rituals: Exploring Cleansing and Spiritual ...
Aug 25, 2023 · The first of these treatments is Vamana (emesis) which involves therapeutic vomiting. Then there is Virechana (Purgation) during which ...
[156]
[PDF] Violation of Eating Norms and Disgust Response - Whitman College
The emotional response of disgust is often accompanied by feelings of unpleasantness, discomfort, nausea, desire to vomit, ... and Western cultures as well.
[157]
Evidence Against a Link Between Hyperemesis Gravidarum ... - NIH
... hysteria). In this pilot study, we examined ... Validation of the Nausea and Vomiting of Pregnancy-specific Health-Related Quality of Life questionnaire.
[158]
Medicinal Plants - Petroglyph National Monument (U.S. National ...
For example today at Zuni Pueblo, 14 different plants with emetic qualities have been identified for treatment of stomachaches because they induce vomiting. In ...
[159]
NAEB Text Search - BRIT - Native American Ethnobotany Database
Decoction of bark taken as an emetic for coughs, colds and fevers. Holmes, E.M., 1884, Medicinal Plants Used by Cree Indians, Hudson's Bay Territory, The ...
[160]
Symptoms & Causes of Cyclic Vomiting Syndrome - NIDDK
The main symptoms of cyclic vomiting syndrome are sudden, repeated attacks—called episodes—of severe nausea and vomiting. You may vomit several times an hour.
[161]
Adult Cyclic Vomiting Syndrome Is Treatable and Curable:...
Six major “triggers” were identified (some patients having >1): anxiety in 17, post-traumatic stress disorder in 2, migraines in 5, chronic marijuana use in 5, ...Missing: conditioned psychological<|separator|>
[162]
Bulimia Nervosa: What It Is, Symptoms & Treatment - Cleveland Clinic
Bulimia nervosa is an eating disorder that causes you to eat large amounts of food at one time (binge) and then get rid of it (purge).Missing: prevalence 50%
[163]
Emetophobia (Fear of Vomiting) - Cleveland Clinic
Jul 3, 2023 · Emetophobia is the fear of vomiting. Seeing vomit, hearing words associated with vomiting and feeling nauseous may trigger this fear.
[164]
The Guide #63: How vomiting became Hollywood's favourite party trick
Dec 2, 2022 · A throwing-up scene is often sudden, shocking and visceral, though not in a way that is likely to get you rapped on the knuckles by the censors ...
[165]
Understanding stigma in the context of help-seeking for eating ...
Sep 2, 2024 · The current study examined the associations between perceived stigma, self-stigma, shame, and help-seeking behaviour in a community sample of individuals with ...
[166]
Gender Differences in Postoperative Pain, Nausea and Vomiting ...
Aug 18, 2020 · The objective of this study was to investigate whether women are more sensitive to pain and PONV after laparoscopic cholecystectomy (LC).Missing: higher | Show results with:higher
[167]
COVID's Gut Punch: Some GI Disorders Rose Post-Pandemic
Aug 1, 2025 · The prevalence of disorders of gut-brain interaction rose from 38.3% before the COVID-19 pandemic to 42.6% afterward. The largest increases were ...
[168]
Behavioral treatment of psychogenic vomiting in the context of social ...
A case of psychogenic vomiting in the context of social phobia was treated by a combination of exposure in vivo, social skills training, and cognitive ...
[169]
NEDA | Eating Disorders Support, Awareness & Recovery
Access support, explore resources, join community events, and take a free eating disorders screening—start your recovery journey with NEDA!Get Help · Screening Tool · Grace Holland Cozine... · About Us