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Nausea is an unpleasant, diffuse sensation of unease and discomfort, often perceived as an urge to vomit. Nausea is a non-specific symptomwhich means that it has many possible causes. Some common causes of nausea are gastroenteritis and other gastrointestinal disordersfood poisoningmotion sicknessdizzinessmigrainefainting and low blood sugar.
Nausea is a side effect of many medications including chemotherapy, or morning sickness in early pregnancy. Nausea may also be caused by anxietydisgust and depression. Medications taken to prevent and treat nausea are called antiemetics.
The most commonly prescribed antiemetics in the US are promethazinemetoclopramide and the newer, extremely effective ondansetron. Aside from morning sickness, there are no sex differences in complaints of nausea. After childhood, doctor consultations decrease steadily with age. Only a fraction of one percent of doctor visits by those over 65 are due to nausea.
Gastrointestinal infection is one of the most common causes of acute nausea and vomiting. Food poisoning usually causes an abrupt onset of nausea and vomiting one to six hours after ingestion of contaminated food and lasts for one to two days. Many medications can potentially cause nausea. An old cure for migraine, ergotamineis well known to cause devastating nausea in some patients; a person using it for the first time will be prescribed an antiemetic for relief if needed.
Nausea or " morning sickness " is common during early pregnancy but may occasionally continue into the second and third trimesters. A number of conditions involving balance such as motion sickness and vertigo can lead to nausea and vomiting. Nausea may be caused by depressionanxiety disorders and eating disorders.
While most causes of nausea are not serious, some serious conditions are associated with nausea. These include: pancreatitissmall bowel obstructionappendicitischolecystitishepatitisAddisonian crisisdiabetic ketoacidosisincreased intracranial pressureSpontaneous Intracranial Hypotensionbrain tumorsmeningitisheart attack carbon monoxide poisoning and many others.
Taking a thorough patient Frank Jews - Seven Minutes Of Nausea / Patareni - Seven Minutes Of Nausea / Patareni may reveal important clues to the cause of nausea and vomiting.
If the patient's symptoms have an acute onset, then drugs, toxins, and infections are likely. In contrast, a long-standing history of nausea will point towards a chronic illness as the culprit.
The timing of nausea and vomiting after eating food is an important factor to pay attention to. Symptoms that occur within an hour of eating may indicate an obstruction proximal to the small intestine, such as gastroparesis or pyloric stenosis. An obstruction further down in the intestine or colon will cause delayed vomiting.
An infectious cause of nausea and vomiting such as gastroenteritis may present several hours to days after the food was ingested. Bits of fecal matter in the emesis indicate obstruction in the distal intestine or the colon. Emesis that is of a bilious nature greenish in color localizes the obstruction to a point past the stomach. Emesis of undigested food points to an obstruction prior to the gastric outlet, such as achalasia or Zenker's diverticulum. If patient experiences reduced abdominal pain after vomiting, then obstruction is a likely etiology.
However, vomiting does not relieve the pain brought on by pancreatitis or cholecystitis. It is important to watch out for signs of dehydration, such as orthostatic hypotension and loss of skin turgor. Auscultation of the abdomen can produce several clues to the cause of nausea and vomiting.
A high-pitched tinkling sound indicates possible bowel obstructionwhile a splashing " succussion " sound is more indicative of gastric outlet obstruction. Eliciting pain on the abdominal exam when pressing on the patient may indicate an inflammatory process. Signs such as papilledema, visual field losses, Frank Jews - Seven Minutes Of Nausea / Patareni - Seven Minutes Of Nausea / Patareni focal neurological deficits are red flag signs for elevated intracranial pressure.
When a history and physical exam are not enough to determine the cause of nausea and vomiting, certain diagnostic tests may prove useful. A chemistry panel would be useful for electrolyte and metabolic abnormalities. More advanced imaging and procedures may be necessary, such as a CT scan, upper endoscopy, colonoscopy, barium enema, or MRI. Abnormal GI motility can be assessed using specific tests like gastric scintigraphy, wireless motility capsules, and small-intestinal manometry.
Research on nausea and vomiting has relied on using animal models to mimic the anatomy and neuropharmacologic features of the human body.
There are four general pathways that are activated by specific triggers in the human body that go on to create the sensation of nausea and vomiting.
Signals from any of these pathways then travel to the brainstem, activating several structures including the nucleus Karawane - Various - Formation 60 the solitary tractthe dorsal motor nucleus of the vagus, and central pattern generator.
The body's motor muscle responses involve halting the muscles of the gastrointestinal tract, and in fact causing reversed propulsion of gastric contents towards the mouth while increasing abdominal muscle contraction.
Autonomic effects involve increased salivation and the sensation of feeling faint that often occurs with nausea and vomiting. If dehydration is present due to loss of fluids from Polvo - Ellen Allien - Tsugi Sampler 40 - F M vomiting, rehydration with oral electrolyte solutions is preferred. Many pharmacologic medications are available for the treatment of nausea.
There is no medication that is clearly superior to other medications for all cases of nausea. For people with motion sickness and vertigo, antihistamines and anticholinergics such as meclizine and scopolamine are particularly effective.
In certain people, cannabinoids may be effective in reducing chemotherapy associated nausea and vomiting. In hospital settings topical anti-nausea gels are not indicated because of lack of research backing their efficacy. Ginger has also been shown to be potentially effective in treating several types of nausea. The outlook depends on the cause. Most people recover within few hours or a day. While short-term nausea and vomiting are generally harmless, they may sometimes indicate a more serious condition.
When associated with prolonged vomiting, it may lead to dehydration or dangerous electrolyte imbalances or both. Repeated intentional vomiting, characteristic of bulimiacan cause stomach acid to wear away Frank Jews - Seven Minutes Of Nausea / Patareni - Seven Minutes Of Nausea / Patareni the enamel in teeth.
Nausea and or vomiting is the main complaint in 1. From Wikipedia, the free encyclopedia. For other uses, see Nausea disambiguation. Aust Fam Physician Review. Mayo Clinic. Archived from the original on Aust Fam Physician. Expert Rev Gastroenterol Hepatol Review. Am Fam Physician. North Am. Therap Adv Gastroenterol Review. Nausea, Vomiting, and Indigestion. American College of Gastroenterology. Retrieved 24 January Autonomic Neuroscience. Retrieved Principles and Practice of Hospital Medicine.
European Journal of Pharmacology. American Family Physician. Retrieved 10 November Acta Anaesthesiol Scand. Journal of Pain and Symptom Management.
Weschules, D. Journal of Palliative Medicine. Nutr Rev. British Journal of Anaesthesia. Toccata From Symphony No.5 In F Minor, Op.42 No.1 - The London Symphony Orchestra, The Choir Of West 6 September Archived from the original on 25 July Frank Jews - Seven Minutes Of Nausea / Patareni - Seven Minutes Of Nausea / Patareni 26 July ICD - 10 : R MedlinePlus : Diseases of the digestive system primarily K20—K93— Proctitis Radiation proctitis Proctalgia fugax Rectal prolapse Anismus.
Upper Hematemesis Melena Lower Hematochezia. Peritonitis Spontaneous bacterial peritonitis Hemoperitoneum Pneumoperitoneum. Symptoms and signs : digestive system and abdomen R10—R19, Categories : Symptoms and signs: Digestive system and abdomen Vomiting. Hidden categories: Articles containing Junkie - Poe - Hello Greek-language text.