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Vomiting, also known as emesis and throwing up, among other terms, is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose.
Vomiting can be caused by a wide variety of conditions; it may present as a specific response to ailments like gastritis or poisoning, or as a non-specific sequela of disorders ranging from brain tumors and elevated intracranial pressure to overexposure to ionizing radiation. The feeling that one is about to vomit is called nausea, which often precedes, but does not always lead to, vomiting. Antiemetics are sometimes necessary to suppress nausea and vomiting. In severe cases, where dehydration develops, intravenous fluid may be required.
Vomiting is different from regurgitation, although the two terms are often used interchangeably. Regurgitation is the return of undigested food back up the esophagus to the mouth, without the force and displeasure associated with vomiting. The causes of vomiting and regurgitation are generally different.
Vomiting can be dangerous if the gastric content enters the respiratory tract. Under normal circumstances the gag reflex and coughing prevent this from occurring; however, these protective reflexes are compromised in persons under the influences of certain substances such as alcohol or anesthesia. The individual may choke and asphyxiate or suffer an aspiration pneumonia.
- Color of vomit
- The chemoreceptor trigger zone at the base of the fourth ventricle has numerous dopamine D2 receptors, serotonin 5-HT3 receptors, opioid receptors, acetylcholine receptors, and receptors for substance P. Stimulation of different receptors are involved in different pathways leading to emesis, in the final common pathway substance P appears involved.
- The vestibular system, which sends information to the brain via cranial nerve VIII (vestibulocochlear nerve), plays a major role in motion sickness, and is rich in muscarinic receptors and histamine H1 receptors.
- The cranial nerve X (vagus nerve) is activated when the pharynx is irritated, leading to a gag reflex.
- The vagal and enteric nervous system inputs transmit information regarding the state of the gastrointestinal system. Irritation of the GI mucosa by chemotherapy, radiation, distention, or acute infectious gastroenteritis activates the 5-HT3 receptors of these inputs.
- The CNS mediates vomiting that arises from psychiatric disorders and stress from higher brain centers.
- Bright red in the vomit suggests bleeding from the esophagus
- Dark red vomit with liver-like clots suggests profuse bleeding in the stomach, such as from a perforated ulcer
- Coffee-ground-like vomit suggests less severe bleeding in the stomach, because the gastric acid has had time to change the composition of the blood
- Yellow vomit suggests bile, indicating that the pyloric valve is open and bile is flowing into the stomach from the duodenum (this is more common in older people)
Eating disorders (anorexia nervosa or bulimia nervosa)
- To eliminate an ingested poison (some poisons should not be vomited as they may be more toxic when inhaled or aspirated; it is better to ask for help before inducing vomiting)
- Some people who engage in binge drinking induce vomiting to make room in their stomachs for more alcohol consumption.
- People suffering from nausea may induce vomiting in hopes of feeling better.
- Projectile vomiting refers to vomiting that ejects the gastric contents with great force. It is a classic symptom of infantile hypertrophic pyloric stenosis, in which it typically follows feeding and can be so forceful that some material exits through the nose.
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