Guide
When the average patient reports abdominal pain, nausea, and vomiting, the first thing we think of is a digestive disorder. But these symptoms can also be caused by various diseases throughout the body, can you think of the causes and symptoms that these symptoms may represent?
Abdominal pain is a common clinical symptom and a cause of patient visits. Abdominal pain is mostly caused by some strong stimulation or damage to the tissues or organs in the abdomen, and can also be caused by chest diseases and systemic diseases. In addition, abdominal pain is a subjective feeling, the nature and intensity of abdominal pain, not only affected by the lesion situation and the degree of stimulation, but also by neurological and psychological factors. That is, there are differences in the sensitivity of patients to pain stimuli, and abdominal pain caused by stimulation of the same lesion in different patients or at different times in the same patient varies in nature, intensity and duration. Therefore, only by analyzing the pathophysiology, neurophysiology, psychology and clinical aspects of the disease can we have a correct understanding of abdominal pain.
Abdominal pain is often clinically divided into acute and chronic categories. The location of abdominal pain can provide clues to the cause of the disease and has localization significance for the lesion. Below is a classification of acute and chronic pain sites. But the pain of many diseases may appear in more than one part, and may even change parts. In the clinic, it is still necessary to analyze according to the situation.
Acute abdominal pain may occur
Chronic pain may occur
Nausea is a feeling of discomfort in the upper abdomen and a pressing desire to throw up. Vomiting is a common clinical symptom, nausea is often a precursor to vomiting, but it can also appear alone, showing special discomfort in the upper abdomen, often accompanied by symptoms of vagus nerve excitation such as dizziness, salivation, slow pulse, and decreased blood pressure. The causes of malignancy and vomiting are also diverse.
1. Abdominal lesions
(1) Mechanical obstruction: pyloric obstruction, small intestinal obstruction
(2) Dynamic disorders: chronic pseudo-intestinal obstruction, functional dyspepsia, gastroparesis.
(3) Other intra-abdominal lesions: acute appendicitis, acute cholecystitis, acute hepatitis, acute mesenteric ischemia, Crohn's disease, peptic ulcer, pancreatitis and pancreatic tumors, peritonitis and peritoneal tumors, superior mesenteric artery syndrome, posterior peritoneal lesions, etc.
2. Neuropathy
Migraine, intracranial tumors, hemorrhage, infarction, abscesses, hydrocephalus, meningitis, autonomic nervous system diseases, demyelinating diseases, labyrinth diseases, such as motion sickness, labyrinthitis, Meniere's disease, otitis media, etc.
3. Diseases of the metabolic and endocrine systems
Diabetes mellitus, diabetic ketosis, hyperparathyroidism, hypercalcemia, hypoparathyroidism, hyponatremia, hyperthyroidism, adrenal hypocortex, acute intermittent porphyria, pregnancy, etc.
4. Infection
Acute gastroenteritis, systemic infectious diseases.
5. Drugs and poisons
Chemotherapy drugs for tumors, antipyretic analgesics, anesthetics, oral contraceptives, cardiovascular system drugs (eg, digoxin, antiarrhythmic drugs), antibiotics, central nervous system drugs (such as levodopa and other dopamine agonists for the treatment of Parkinson's disease and antiepileptic drugs), theophylline drugs. Others include alcohol abuse, vitamin A poisoning, drug use, etc.
6. Miscellaneous
Postoperative status, radiation therapy, systemic lupus erythematosus, scleroderma, myocardial ischemia, myocardial infarction, starvation, and neurological disorders.
7. Functional nausea, vomiting
The Rome type III diagnostic criteria classify functional nausea and vomiting without organic lesions into chronic idiopathic nausea, functional vomiting, and periodic vomiting syndromes.
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bibliography:
[1] Clinical analysis of the causes of nausea and vomiting in patients with gastroenterology.2016.1(18):69,71
[2] Analysis of influencing factors of nausea and vomiting during hepatic artery chemoembolization.2016.33(1)189-190
[3] Research progress on nausea and vomiting caused by chemotherapy.2016.13(13):17-21
[4] Gastroenterology (People's Medical Publishing House, 2015 edition)