Nausea is a very common symptom and, as we all know, often results in vomiting. About il three percent of access to the emergency room linked precisely to the presence of these two disorders, to which it is useless to try to resist, as he explains Massimiliano Etteri, specialist in internal medicine and head of the Emergency Department of the Irccs San Raffaele Hospital in Milan: Nausea and vomiting are generally the response to a pathogenic stimulus in the stomach that the body tries to eliminate. They therefore represent a protective evolutionary mechanism of survival.
What are the most common causes?
In most cases they are triggered viral gastroenteritis caused by common viruses (Adenovirus, Rotavirus, Norovirus) or food poisoning. In these cases, a third symptom is often added, diarrhea, and sometimes fever. Generally these are benign and self-limiting causes, as is the annoying hyperemesis gravidarum. More rarely nausea and vomiting can be warning signs of more serious diseases such as brain neoplasms, metabolic, gastrointestinal diseases, bacterial toxin infections or psychiatric diseases. Among the commonly used drugs they can give these ailments as a side effect this includes opiates (for example codeine and tramadol). Nausea and vomiting arise as a result of sthymolation of receptors located within the gastrointestinal system or the vestibular system of the ear or central nervous system in the presence of other causes. Through these receptors, the production of certain neurotransmitters is stimulated, including serotonin, dopamine and ketamine, which give the body the input to nausea and vomiting.
What can be done?
In most cases, nausea and vomiting they resolve spontaneously within 24-72 hours. However, if symptoms persist or are disabling, especially when they are associated with intense abdominal pain, blood in the vomit and severe malaise, it is advisable contact your doctor or go to the emergency room. The presence of blood in the sputum material can be very frightening and, although it is usually indicative of the rupture of capillaries of the gastroesophageal mucosa induced by continuous episodes of vomiting, it is very important not to underestimate it. Among the warning signs that should lead to requesting a very timely medical evaluation are there also jet vomiting (involving a sudden, almost unnoticed evacuation), signs of lethargy and intense abdominal pain.
What are the possible treatments?
If there are no alarm bells, some can be used supportive medications, particularly paracetamol, in case of fever or pain, and anti-emetics (metoclopramide). It also needs to try to reintroduce lost fluids by drinking water in small sips. When there are improvements, you can start taking solid foods, dissociated from liquids. The solids are assumed with pfrequent small meals on the first and second day, drinking half an hour before or half an hour later because the receptors are a little under pressure and we must therefore avoid giving a further bump of vomiting to a situation of gastroesophageal distress. Through these small steps it is generally possible to avoid dehydration. On the other hand, when this complication occurs, there is a peremptory indication to go to the emergency room.
How to immediately catch the signs of dehydration?
Dehydration is the most common complication in the presence of nausea and vomiting. The most at risk are small children and the elderly in which it is useful to pay attention to suggestive signs and symptoms such as less urine and a darker color. Other warning signs are thirst, dry mucous membranes (dry mouth) and a feeling of general malaise. If dehydration is important, tachycardia and orthostatic hypotension can occur: in practice, when you go from lying down to standing, the pressure drops considerably. Typical signs of dehydration that can be detected instead in small children are: dry skin, crying without tears, reduction of skin turgor and reduced reactivity. To prevent dehydration related to excessive water loss as a result of vomiting and sometimes even the diarrhea that may accompany it, it is essential to take fluids. You can opt for plain water, generally better tolerated by the suffering gastric mucosa, but hydrosaline rehydrating solutions, drinks or fruit juices are also good.
June 16, 2021 (change June 17, 2021 | 06:53)
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