The previous article about nausea and vomiting talked about many causes of nausea and vomiting, not only due to stomach problems, and listed common causes of nausea and vomiting, interested friends can take a look at the previous article. Today's article talks about how to identify common diseases that cause nausea and vomiting.
First, for the identification of the causes of nausea and vomiting, we must first understand the basic situation:
1. Whether there are common triggers for nausea and vomiting: such as whether you eat unclean food, whether you eat toxic drugs, whether you eat drugs that can easily cause nausea and vomiting, whether you have alcoholism, whether women of childbearing age have delayed menstruation after sex, whether they have poor blood pressure and blood sugar control, whether they have kidney disease, whether they have abdominal diseases or abdominal surgery, whether they have brain diseases or a history of brain trauma.
2. Features of vomiting help diagnose the cause: Projectile vomiting is common in intracranial hypertension and intracranial tumors. Massive vomiting is seen in gastric retention and gastric distention.
3. The relationship between vomiting and eating is helpful for diagnosis: morning vomiting in women of gestational age is more common in early pregnancy reaction, nocturnal vomiting is more common in pyloric obstruction, and collective onset after eating is more common in food poisoning.
4. Helpful diagnosis through the nature of vomit: vomiting a large amount of sourdough is more common in pyloric obstruction, and vomit with fecal odor is more common in low-lying small bowel obstruction.
5. Different accompanying symptoms help the diagnosis of nausea and vomiting: vomiting with abdominal pain, diarrhea is more common in acute gastroenteritis, vomiting with fever, chills, jaundice is more common in acute cholecystitis, acute cholangitis. Vomiting with severe headache is more common in glaucoma and intracranial hypertension, vomiting with vertigo and nystagmus is seen in vestibular lesions, labyrinthitis, and motion sickness.
Second, nausea and vomiting common routine examination:
1. Blood routine: helps determine whether there is bacterial infection, anemia and severity.
2. Urinalysis: helps to determine whether there is urinary tract infection, kidney disease and severity.
3. Liver and kidney function: help to determine whether there are diseases such as hepatobiliary and kidney and their severity.
4. Blood urine amylase, lipase: help determine whether there is pancreatitis and its severity.
5. Blood sugar, blood ketones, blood PH: help determine whether there is diabetic ketoacidosis and its severity.
6. Blood HCG, urine pregnancy test: help determine whether there is pregnancy.
7. Cerebrospinal fluid routine, cranial CT and magnetic resonance: helpful in the diagnosis and identification of brain diseases.
8. Toxicological analysis of vomit: helpful in the diagnosis of food poisoning.
9. Abdominal ultrasound, abdominal X-ray, gastrointestinal barium angiography, gastroscopy, colonoscopy: helpful in the diagnosis of digestive diseases.
10. Electrocardiogram: helps in the diagnosis of heart disease.
11. Fundus: Helps in the diagnosis of eye diseases.
12. Laryngoscopy: helpful in the diagnosis of throat diseases.
Third, the identification of nausea and vomiting caused by different digestive diseases:
1. Key points in the diagnosis of acute gastritis or acute gastroenteritis: people who often eat together have the same illness, and there are more cases of eating unclean diet, and the more they eat, the more serious the disease; often accompanied by epigastric or peri-navel cramps; often accompanied by fever; Blood tests may show elevated white blood cells and neutrophils; Stool examination may have white blood cells and can isolate pathogens.
2. Key points in the diagnosis of acute perforation of peptic ulcer: history of recurrent peptic ulcer for many years; severe epigastric pain with nausea and vomiting; Touching the stomach with your hands is very hard as a plate, there is obvious tenderness, abdominal muscles are tense; An abdominal x-ray is helpful in diagnosis.
3. Antral tumors due to edema or mechanical factors caused by pyloric obstruction are also more common. Key points of diagnosis: more likely to have a similar family history, more common in middle-aged male men; previous history of gastritis, significant weight loss in recent times; Nausea and vomiting accompanied by hematemesis, black stool, irregular epigastric pain, gastrointestinal bleeding, etc.; Routine examination of stool can detect occult blood, and upper gastrointestinal angiography, gastroscopy combined with pathological biopsy can help confirm the diagnosis.
4. Duodenal accumulation disease: refers to the clinical syndrome caused by duodenal obstruction caused by various reasons, resulting in proximal dilation and chyme accumulation at the site of duodenal obstruction. Key points of diagnosis: typical clinical manifestations are an important basis for diagnosis, hiccups, nausea, vomiting are common clinical manifestations, mainly after eating, vomit contains bile, discomfort can be reduced according to body position changes; Barium x-rays are helpful in diagnosis; Selective superior mesenteric arteriogram may be done if needed to confirm the diagnosis.
5. Acute peritonitis: acute severe abdominal pain, extensive abdominal tenderness when pressed by hand.
6. Intestinal obstruction: abdominal pain, cessation of bowel movements and exhaust, hyperbowel sounds, intestinal type.
7. Gastric mucosal irritation or inflammation: unclean eating, or acute infection, or a history of poisoning.
8. Pyloric obstruction or duodenal obstruction: mostly ejected periodic vomiting, gastric peristalsis waves, and water vibration.
9. Superior mesenteric artery syndrome: more common in slender women, prone position can relieve symptoms, X-ray barium shows duodenal segment dilation.
10. Outlet loop obstruction: vomiting with large amounts of bile 8 to 12 days after gastrectomy.
11. Acute pancreatitis: severe epigastric pain, radiating to the lower back, elevated hemuria amylase and lipase.
Combined with the previous article, the common causes and identification points of modern medicine for nausea and vomiting have been discussed, and the treatment of modern medicine includes the use of symptomatic antiemetics to relieve symptoms, and more importantly, according to the specific cause of nausea and vomiting for the treatment of the disease itself. Later, we will talk about the understanding and treatment of nausea and vomiting in Chinese medicine. Interested friends can continue to follow.