Vomiting very frequently occurs in children, especially at an early age. The causes of vomiting are very diverse. And, although in some cases it is sometimes possible to determine the nature of vomit, vomiting, as a rule, characterizes the condition, urgently requiring the attention of a qualified physician.
What happens when you vomit?
Vomiting in child is a sudden emptying of the stomach through the mouth. Starts vomiting “on command” vomiting center located in the medulla oblongata. It can be excited by impulses from the stomach, intestine, liver, kidney, uterine, vestibular apparatus, as well as the irritation of the higher nervous centres (e.g., vomiting to odors). Vomiting also may occur as a result of action on the vomiting center various toxic substances, medicines.
In most cases vomiting is preceded by nausea, increased salivation, rapid and deep breathing.
The vomiting mechanism may be schematically described as: consistently occurs prolapse of the diaphragm, closure of the glottis (which prevents the reflux of vomitus into the respiratory tract), the lower section of the stomach spazmiruyutsya, and the top relaxes. A quick contraction of the diaphragm and abdominal muscles leads to the release of contents from the stomach.
The causes of vomiting are varied. Communicable diseases, diseases of the gastrointestinal tract, surgical diseases, pathology of the Central nervous system and etc. depending on them, vomiting may be single and multiple, rich and poor, to receive in certain intervals of time. The nature of vomit (digested or not digested food, mucus, blood, bile), you can sometimes determine the cause of the vomiting.
It is also necessary to distinguish between vomiting and regurgitation. Regurgitation usually occurs without effort, the tension of the abdominal muscles and diaphragm, and is the result of the overflow of the stomach with food or air.
In children vomiting occurs very often, especially at an early age. Special danger of vomiting in toddlers determines the fact that in young children the protective mechanisms are imperfect and vomit can get into the respiratory tract.
What to do if the child has nausea and vomiting?
Parents of every child (especially a baby!) should know that in some cases, the appearance of vomiting requires immediate medical attention.
So, you need to call an ambulance, if the child has the following symptoms:
- in the vomit blood red or brown color;
- frequent repeated vomiting (more than four times in 2 hours), leads to rapid dehydration;
- vomiting, which is accompanied by high fever, significant weakness of the child, semi-conscious or unconscious state;
- vomiting that occurs after the fall of the child, head injury;
- vomiting, which is accompanied by pain in the abdomen, lack of stool (peristalsis).
Rules aid in cases of simple vomiting
- If a child has been vomiting, it is impossible to leave the.
- To prevent the reflux of vomitus into the respiratory tract, baby, you need to deploy on his side, lay half-upright in position or held upright in the hands.
- After each bout of vomiting, rinse mouth child clean boiled water (using a 20-CC syringe without a needle or sprintsovki), and a good wash all skin areas contaminated with vomit (to avoid irritation).
- To establish the causes of vomiting, do not give your child medicine and do not feed him.
Causes of vomiting in infants and young children
- In the first day copious vomiting may occur with the ingestion of a large amount of amniotic fluid. Usually at this time a mother and her child is in the hospital and gets the help they need. This condition usually goes away within a day.
- the Appearance of vomiting shortly after birth, which is accompanied by breathing problems and asthma attacks may be a symptom of atresia Joan (the so-called critical stenosis or atresia of the nasal passages). For breathing into the child’s mouth is inserted into the duct, after which the baby requires urgent surgical treatment.
Another urgent surgical condition in which vomiting is esophageal atresia (congenital obstruction of the esophagus, which is accompanied by the formation of connections (fistulae) with the trachea). Often the diagnosis is made to induce vomiting by the appearance of abundant foamy discharge from the mouth, increased salivation, frequent pomerianian. Because of the violation of breath appears blue around the lips.
- Attempt to feed the newborn leads to a significant degradation due to throwing food into the respiratory tract. Rapidly developing inflammation and chemical burns of the lungs. If you suspect an esophageal atresia baby give elevated position, set a permanent probe for extraction of the contents, administered intravenous fluids and urgently transferred to the surgical hospital.
- Dangerous symptom is the appearance of the newborn at 1-3 days of life abundant vomiting with bile, of green, of feces. This can be a symptom ofthe congenital complete or partial intestinal obstruction. Also vomit bile, greens can appear in lesions of the intestine (necrotizing enterocolitis) as a result of infection, sepsis, immaturity of the intestine, or as a consequence of pronounced oxygen starvation (after severe asphyxia).
The disease is accompanied by abdominal distension, absence of peristalsis, food stagnation in the stomach, vomiting (in this case the volume of vomit more volume of received milk). In this case, the child stops feeding, prescribe fluids and nutrients intravenously. Child examined by a surgeon. If necessary, conducted x-rays, ultrasonography, fibrogastroscopy. In identifying intestinal obstruction and in later stages of necrotizing enterocolitis, surgical treatment for health reasons.
Immediately after birth in children vomiting unaltered milk may receive as a result of the disruption of the cardiac sphincter of the stomach (chalasia, achalasia cardia). Milk can be trapped in the esophagus or incomplete closure of the upper gastric sphincter is constantly thrown into the esophagus. Vomiting often occurs in the supine position, left side, by changing the position, in the stroking of the abdomen.
Shown feeding in an upright position, often and in small portions. In severe cases, the elevated position of the need to observe the clock. If vomiting occurs frequently, the child is not gaining weight, becoming lethargic, it is necessarily necessary to consult a surgeon.
Pyloric stenosis appears at 2-4 weeks of age. This is a malformation of the pyloric stomach (circular muscle located at the junction of the stomach and intestines), which leads to its obstruction. The main symptom is vomiting a fountain storagename milk, in a volume greater than the volume of the feeding frequency from 3 to 16 times per day. Appears hungry constipation. The child is excited, a progressive lose weight. Surgical treatment.
- Vomiting in newborns may occur if Central nervous system after suffering asphyxia, intrauterine hypoxia, after undergoing intrauterine infections (toxoplasmosis, herpes, cytomegalovirus). This vomiting is accompanied by strong excitation or inhibition of a child, strabismus and other oculomotor disorders, convulsive twitchings, a long tremor of the chin and extremities. The signs in such a child needs special care of mother, thorough gentle care. Observation and treatment is carried out with mandatory participation of the neurologist. In accurate diagnosis can help ultrasound of the brain.
When persistent vomiting in newborns it is also necessary to exclude adrenogenital syndrome, which arises as a result of increasing the secretion of hormones by the adrenal cortex. Accompanied by uncontrollable vomiting, severe oppression of the child by a sudden drop in body weight. A characteristic feature is the increase of the genital organs. For emergency care of the child with such symptoms should be hospitalized in the NICU.
- in addition to these causes of vomiting in newborn can also be noted the immaturity of the gastrointestinal tract, poor feeding, intolerance to cow’s milk, galactosemia (an inherited intolerance to milk), hypervitaminosis D etc.
To determine the cause of vomiting in newborns, be sure to consult with your doctor. If the baby vomited once, this is not necessarily a symptom of pathology. Once calm the gag reflex it is necessary to feed, hold upright.
Vomiting in Teens
Under the supervision of doctors, in children during the first years of life vomiting with the greatest frequency occurs in the beginning of acute infectious processes and with food poisoning, surgical diseases. The older children vomiting often associated with pathology of the gastrointestinal tract, the Central nervous system.
In General, the vast majority of cases of vomiting in children occurs with infections (including poisoning), surgical pathology, diseases of the Central nervous system, in violation of psychoemotional state, but also because of the development of acetonemic syndrome. What is useful to know about these five States, where most often there is vomiting in the boys and girls emerging from infancy?
In infectious processes (intestinal infections, viral respiratory infections, pneumonia, otitis, urinary tract disease) vomiting occurs after the nausea, against the background of increasing temperature, deterioration of General condition, often accompanied by diarrhea. Vomiting can additionally trigger coughing, especially if coughing child swallows the sputum.
Severe nausea and vomiting can be prominent in viral hepatitis, even before the appearance of jaundice.
In severe infections the child should receive treatment in a hospital, with a lighter – at home under the supervision of the district pediatrician. Assigned to appropriate therapy.
Almost all surgical diseases of the abdomen accompanied by vomiting, severe pain, worsening of pain at palpation of the abdomen, disturbance of motility, constipation or diarrhea. Vomiting characteristic: appendicitis, diverticulitis, cholecystitis, intestinal obstruction, gastritis and gastric ulcer and duodenal ulcer, stenosis of the esophagus, inflammation of the pancreas, peritonitis, and hernia strangulation.
For accurate diagnosis it is necessary to note whether the vomiting with food intake or caused by other factors, whether the relief when occurs. Also important is the nature of vomit (mucus, bile, of blood, sour or rotten smell). To exclude surgical pathology is necessary to consult a surgeon, conducting tests, ultrasound, gastrofibroscopy, x-ray examination. Before diagnosis of the child can not feed, apply painkillers. The sooner the diagnosis, the better the chances of recovery!
Diseases of the Central nervous system
Causes of vomiting may include: increased intracranial pressure, inflammation of the meninges, tumors, epilepsy, migraine, toxic brain damage, damage to the inner ear. This vomiting is not depend on eating, language is not imposed, the stool is normal, abdomen is painless. Simultaneously detected by dizziness, fainting, increased heart rate, blurred vision, severe headaches. The occurrence of vomiting at night is typical for brain tumors.
In children often occurs vomiting caused by psychogenic factors: fear, anxiety, anger, excitement. Also, the cause of vomiting can be of the disease with pronounced mental component, anorexia (lack of appetite), bulimia (increased appetite). Sometimes can be demonstrative vomiting with the purpose to attract attention, or vomiting after forced feeding. In all cases the General condition is not disturbed, and vomiting may be repeated under the same circumstances.
Cyclic vomiting in the form of attacks accompanied by headache, abdominal pain, fever, is a manifestation of autonomic disorders. This condition requires constant observation and treatment by a neurologist.
If vomiting once, not accompanied by a significant increase in temperature, the child feels thirsty, you should choose expectantly-Supervisory position. It is necessary to wash, to rinse the mouth, to calm, to put to bed. Gradually to compensate the loss of fluid, often otpaivala, warm drink, small portions. Juices to give in very small quantities.
With the emergence of feelings of hunger, you can give the child a app cracker or biscuit, rice water. Diet to expand gradually throughout the week. If vomiting increases or there are other dangerous symptoms, you should immediately contact a doctor.
Often the reason for frequent vomiting in children is acetonemic crisis (as a result of accumulation in the blood of acetone and acetoacetic acid). Acetonemic syndrome can develop in the setting of severe diseases (diabetes, etc.), but may be primary – that is, to be a consequence of inappropriate reactions to normal stimuli: fear, pain, errors in diet, excess of emotion.
Acetonemic crisis is accompanied by cramping abdominal pain, nausea, fever up to 38.5°C, presence of, in urine, vomitus, breath acetone.
Need for help to a local pediatrician. Before the arrival of the doctor the baby does not feed for 6-8 hours. Give your child to drink often, small portions of a teaspoon in 10-15 minutes. Use alkaline drink (mineral water), the decoction of dried fruits, “regidron”, the solution of fructose. If the baby refuses to drink, the liquid is introduced into the mouth with dropper or syringe constantly for a few milliliters. A day a child needs to drink 100 milliliters of fluid per kilogram of body weight.
Be sure to conduct a cleansing enema with cool boiled water 25-26°C, which will help to reduce the body temperature. Good effect is given medical suppositories.
If the child’s condition worsens or he completely refuses to drink, it needs to be put in the hospital.