When I navigate the busy office room, I often encounter problems that seem ordinary but are troubling to patients. For example, some patients experience nausea or even retching when brushing their teeth. At first glance, it may seem like a minor problem, but when it becomes a daily obsession, it can't be ignored. Today, I would like to share a special outpatient experience that not only changed the daily life of one of my patients, but also made me realize once again the unusual reasons that may be hidden behind common symptoms. About a few months ago, a middle-aged male patient came to my office with his concerns. His main symptoms were intense nausea and retching every time he brushed his teeth, which had been going on for months. He had tried to change the brand of toothpaste and even adjust the brushing time, but none of these measures had solved the problem. As a physician with years of clinical experience, I know that while this symptom is common, the solution is not always obvious. Through a detailed history and careful physical examination, we ruled out chronic pharyngitis, which was initially suspected in the patient. The subsequent examination revealed a deeper problem that caught my heightened concern. This is not just a simple story about brushing your teeth causing nausea, but involves a condition that needs to be explored and treated in more depth.
Gastroesophageal reflux disease (GERD) and its hidden manifestations in everyday life
Gastroesophageal reflux disease (GERD) is a common digestive disorder characterized by the reflux of stomach acid or stomach contents into the esophagus, causing heartburn, retrosternal pain, or other symptoms. However, GERD may present atypical in certain situations, such as nausea and retching when brushing teeth. This symptom, which may seem unrelated to the digestive system, may actually be one of the atypical symptoms of GERD. 1. Symptom recognition: In addition to the common heartburn and acid reflux, GERD can cause a sore throat, cough, and even nausea and retching when brushing your teeth. These symptoms may occur in the absence of stomach pain, complicating the diagnosis of the disease. 2. Diagnostic process: Determining GERD usually requires a combination of the patient's clinical symptoms, medical history, and specific tests, such as esophageal endoscopy and 24-hour esophageal pH monitoring. These tests help doctors observe the condition of the esophagus and assess the severity of acid reflux.
3. Daily management and treatment: Spicy, greasy, coffee and alcohol, etc., these may aggravate symptoms. Eating habits: small and frequent meals are recommended, avoiding post-meal treatment for GERD is varied, and lifestyle modifications are usually preferred: Dietary changes: Avoid irritating foods, such as lying down immediately. Weight management: Losing weight reduces pressure in the abdomen, which reduces reflux in the esophagus. When lifestyle modifications are ineffective, medications, such as proton pump inhibitors (PPIs) and H2 receptor antagonists, may be needed to reduce stomach acid production and thus relieve symptoms. 4. Long-term concern: Since GERD may cause serious complications such as esophagitis and even esophageal cancer, patients should have regular medical follow-up and check-ups for recurrent symptoms to ensure that potential complications are detected and treated in a timely manner. Nervous vomiting reaction: When anxiety and stress affect our digestive system, nervous vomiting is a phenomenon in which psychological factors affect the digestive system, especially in cases of nervousness or anxiety. Vomiting or nausea in this condition is not directly caused by a physical illness, but rather a direct effect of the mental state on the body. For some people, even daily activities such as brushing their teeth can trigger nausea and retching due to neuropathic factors.
1. Manifestations of symptoms: Neuropathic vomiting usually occurs during times of high mental stress, such as during high-pressure events, extreme anxiety, or panic attacks. This type of vomiting is different from general dyspepsia or stomach problems and is characterized by no obvious physiological cause, but the symptoms are very real. 2. Diagnostic approach: Diagnosing nervous vomiting is often complex and requires the exclusion of other medical causes first. This includes a detailed medical history, physical examination, and necessary medical tests, such as blood tests and gastrointestinal tests, to ensure that no other physical conditions are present; 3. Treatment and management: The key to treating nervous vomiting is to deal with the patient's psychological state: Psychotherapy: Cognitive behavioural therapy (CBT) and other psychotherapeutic approaches can help patients manage and reduce symptoms related to anxiety and stress. Relaxation techniques: Techniques such as meditation, deep breathing exercises, and progressive muscle relaxation can help patients reduce tension and anxiety and reduce vomiting. Lifestyle modifications: Patients are advised to maintain a regular routine and avoid excessive fatigue and stress accumulation. 4. Long-term attention and prevention: Since nervous vomiting is closely related to psychological factors, ongoing psychological support and stress management are essential to prevent the recurrence of such symptoms. In addition, regular mental health assessments and counseling if necessary can help patients better manage their emotional and physical reactions.
Practical tip: Relieve nausea and retching when brushing your teeth
Many people experience nausea or retching while brushing their teeth, which is not serious but can affect the comfort of everyday life. Here are some practical ways to help ease this discomfort. 1. Adjust your brushing technique: Change your brushing action: Avoid inserting your toothbrush too deep into the back of your throat, especially if the part of the toothpaste is in contact with the base of the tongue or soft palate. Try brushing movements that are gentle and not so deep. Use a small-headed toothbrush: Choosing a small-headed toothbrush can reduce the chance of touching sensitive areas of the throat, thereby reducing irritation. Reduce the amount of toothpaste you use: Too much toothpaste foam may increase nausea, try brushing your teeth with a small amount of toothpaste. 2. Choose the right toothpaste: Odorless toothpaste: Some people may be sensitive to strong flavors in toothpaste, using odorless or light-tasting toothpaste may help reduce nausea. Alkaline toothpaste: Toothpastes with a higher alkaline content help neutralize oral acidity and may reduce nausea.
3. Improve the way you breathe: Take deep breaths: Try taking a few deep breaths during brushing, breathing through your nose instead of your mouth, which can help control nausea. Distraction strategies: Listening to music or watching videos while brushing your teeth to distract yourself may help reduce nausea caused by anxiety. 4. Adjust the timing and frequency of brushing: Brushing after meals: Try brushing your teeth for a period of time after a meal, rather than immediately to avoid extra pressure when you are full. Divide your brushing: If brushing all your teeth at once causes nausea, consider splitting your brushing into stages, brushing a few teeth at a time, and then resting for a while before continuing. 5. Consult a doctor: Seek professional advice: If none of the above methods are effective in relieving symptoms, it is advisable to consult a dentist or family doctor to rule out possible medical causes, such as reflux disease.