Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Own data and analysis of previous publications show that situations where accidental ingestion of corrosive substances by children may have happened are frequent, but severe corrosive esophagitis leading to perforation or stricture formation is very rare. In case of suspected esophageal injury, esophagoscopy and glucocorticoid treatment become necessary. The evaluation of the initial symptoms in patients from our own material and from the literature indicates that all children with serious esophageal burns had one or more of the following symptoms: visible burns in the oral cavity, hypersalivation, retching, vomiting, retrosternal or epigastric pain, cardiovascular collaps, airway stenosis. Hence, children with an uncertain history of ingestion and without any of these symptoms need not be treated. After ingestion of liquid substances, but never of dry or granular products, lesions in the esophagus without accompanying burns in the oral cavity were observed. The evaluation of 1158 cases of accidental ingestions of several types of household products and a collection of data from the literature on the causticity of these substances shows that cleaners containing mainly detergents and phosphates (with pH values generally between 9 and 11), and household bleaches on sodium hypochlorite basis, are relatively harmless. Drain cleaners (NaOH), decalcifiers (formic acid) and detergents for automatic dish washing machines (metasilicates) are very caustic and are responsible for the majority of serious accidents in children.
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PMID:Local injuries by accidental ingestion of corrosive substances by children. 2 63

Of 136 institutionalized severely retarded children, 20 (15%) had recurrent vomiting. Of these 20, 15 had gastroesophageal reflux diagnosed by x-ray examination, acid reflux text, or both. Esophagitis was noted by endoscopy in ten of 14 patients with GER. Four patients were anemic and six had had one or more episodes of aspiration pneumonia in the 12 months prior to study. Reduced basal lower esophageal sphincter pressure was the most common manometric abnormality noted in the patients with GER. Responses of the LES to bethanechol and swallow were normal, as was the basal pressure of the upper esophageal sphincter. Abnormal propagation of esophageal peristalsis was seen in six patients, all of whom had moderate or severe esophagitis. When compared to the nonvomiting retarded patients, the GER patients had significantly lower mental age and higher incidence of scoliosis. Patients with GER who had basal LES pressure less than 10 mm Hg did not improve with medical management. Recurrent vomiting is a common and serious problem in severely retarded children, the organic cause of which can be demonstrated by the application of appropriate investigative techniques.
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PMID:Gastroesophageal reflux among severely retarded children. 15 51

Twenty previously untreated patients with small cell carcinoma of the lung were treated with cyclophosphamide, 400 mg/m2 and Adriamycin, 40 mg/m2 IV on day 1, followed by cytosine arabinoside, 20 mg/m2, every 12 hours subcutaneously on days 5--9; this regimen was repeated every 28 days. On days 14--28 of the first cycle, each patient received 3,000 rads to the primary tumor and whole brain. Following eleven courses, Adriamycin was discontinued and patients received cyclophosphamide, 800 mg/m2 IV on day 1 and methotrexate, 15 mg/m2 IV on days 5--7. This regimen was repeated every 28 days. Toxicity included nausea, vomiting, alopecia, leukopenia, thrombocytopenia, and esophagitis. Overall response rate was 65%. Media survival in limited disease was 14.5 months, and in extended disease it was 4.5 months. This combination is active in localized small cell carcinoma but provides no superiority over other regimens.
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PMID:Combination radiotherapy and chemotherapy for small cell carcinoma of the lung. 23 39

Gastro-oesophageal reflux can lead to peptic oesophagitis and stricture formation. This is particularly true in infants in whom the condition should be suspected if the patient presents with vomiting, anaemia and failure to thrive. The anatomy of the oesophago-gastric junction is described. The inferior oesophageal sphincter is the main barrier to reflux, and marks the functional junction between oesophagus and stomach. It is under nervous and hormonal control. It is weak in the neonate who therefore frequently refluxes. An hiatus hernia can cause problems due to its bulk but the main problem of peptic oesophagitis is due to gastro-oesophageal reflux. The radiological examination should be carried out carefully with the patient swallowing in a prone position. The patient should be put in the Trendenlenberg position and compression applied to the abdomen. Reflux is intermittent and a negative examination should be repeated if the clinical findings suggest a diagnosis of peptic oesophagitis. Associated pyloric stenosis should always be excluded. Radiological examination of the gastro-oesophageal junction remains the quickest, simplest, and most convenient and safe technique as long as its limitations are appreciated.
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PMID:Gastro-oesophageal reflux, hiatus hernia and the radiologist, with special reference to children. 32 Oct 66

Alkaline gastritis and alkaline esophagitis are now precisely defined syndromes. They occur most often after gastric surgery in which function of the pyloric and lower esophageal sphincter is compromised. Reflux of bile in these patients can then lead to severe inflammation of the gastric and lower esophageal mucosa. Epigastric pain, nausea and bilious vomiting are characteristic symptoms. Gastroscopy with biopsy is, therefore, the definitive diagnostic test; during endoscopy bile is seen in the lower esophagus or stomach, and the mucosa is red, friable and contains acute erosions. Conservative therapy including the administration of cholestyramine has not been helpful. Surgery consisting of diversion of the duodenal contents away from the stomach and lower esophagus is the treatment of choice. The Roux-en-Y procedure has been used most often and has resulted in the amelioration of the symptoms and signs in most patients.
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PMID:Alkaline gastritis and alkaline esophagitis: a review. 32 67

Thirteen infants with haematemesis associated with hypertrophic pyloric stenosis were investigated in order to elucidate the source of bleeding. All 13 patients showed endoscopic evidence of oesophagitis, moderate in 4 and severe in 9. No significant gastric mucosal lesion was found. It was concluded that the site of the haemorrhage was the oesophageal mucosa in all 13 infants. Eleven of the patients experienced troublesome postoperative vomiting.
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PMID:Haematemesis in infantile hypertrophic pyloric stenosis: the source of the bleeding. 51 73

Metoclopramide, 4-amino-5-chloro-2-methoxy-N-(2-diethyl-aminoethyl) benzamide, is advocated for use in gastro-intestinal diagnostics, and in treating various types of vomiting and a variety of functional and organic gastro-intestinal disorders. Published data have indicated that metoclopramide assists radiological identification of lesions in the small intestine, facilitates duodenal intubation and small intestine biopsy, and eases emergency endoscopy in upper gastro-intestinal haemorrhage. Metoclopramide reduces post-operative vomiting and radiation sickness, and ameliorates some types of drug-induced vomiting. It may provide symptomatic relief in dyspepsia and possibly in vertigo, reflux oesophagitis and hiccups, but further controlled trials are needed to confirm the efficacy of metoclopramide in these proposed areas of use. It promotes gastric emptying prior to anaesthesia. Its effects in healing gastric ulcer and preventing relapse of duodenal ulcer remain unproven. Side-effects are few and transient, though alarming extrapyramidal reactions can occur in a small proportion of patients receiving therapeutic doses but more usually following excessive doses in young subjects. They respond rapidly to withdrawal of the drug.
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PMID:Metoclopramide: a review of its pharmacological properties and clinical use. 78 7

Fifty-five infants and children with complications of gastroesophageal reflux required operative management for control of symptoms. All patients, except those with severe esophageal stricture, received a six-week trial with 60-degree constant elevation before an operation was considered necessary. The operation was performed to control (1) persistent vomiting, (2) vomiting with growth retardation, (3) esophagitis, (4) esophagitis with stricture, and (5) recurrent aspiration pneumonia. Preoperative and postoperative evaluation involved both X-ray fluoroscopy and esophageal manometry with pH studies. A good surgical result was not dependent upon an increase in the lower esophageal pressure following operation. The Boerema anterior gastropexy is simple and effective for controlling gastroesophageal reflux for cases uncomplicated by esophagitis, stricture, or previous operation. Complex cases with inflammatory or operative changes in the lower esophagus are more effectively treated by Nissen fundoplication.
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PMID:Evaluation of gastroesophageal reflux surgery in children. 84 May 43

Two infants with torticollis and hiatus hernia (Sandifer Syndrome) are presented. Both infants improved with medical management. Abnormal head and neck positioning is attributed to esophagitis secondary to gastroesophageal reflux, with or without hiatus hernia. Since esophagitis due to reflux is not necessarily accompanied by vomiting, infants with torticollis shoud be studied for gastroesophageal reflux. If present, medical management is usually successful.
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PMID:Torticollis with hiatus hernia in infancy. Sandifer syndrome. 85 42

Anorexia nervosa and bulimia nervosa are prevalent illnesses affecting between 1% and 10% of adolescent and college age women. Developmental, family dynamic, and biologic factors are all important in the cause of this disorder. Anorexia nervosa is diagnosed when a person refuses to maintain his or her body weight over a minimal normal weight for age and height, such as 15% below that expected, has an intense fear of gaining weight, has a disturbed body image, and, in women, has primary or secondary amenorrhea. A diagnosis of bulimia nervosa is made when a person has recurrent episodes of binge eating, a feeling of lack of control over behavior during binges, regular use of self-induced vomiting, laxatives, diuretics, strict dieting, or vigorous exercise to prevent weight gain, a minimum of 2 binge episodes a week for at least 3 months, and persistent overconcern with body shape and weight. Patients with eating disorders are usually secretive and often come to the attention of physicians only at the insistence of others. Practitioners also should be alert for medical complications including hypothermia, edema, hypotension, bradycardia, infertility, and osteoporosis in patients with anorexia nervosa and fluid or electrolyte imbalance, hyperamylasemia, gastritis, esophagitis, gastric dilation, edema, dental erosion, swollen parotid glands, and gingivitis in patients with bulimia nervosa. Treatment involves combining individual, behavioral, group, and family therapy with, possibly, psychopharmaceuticals. Primary care professionals are frequently the first to evaluate these patients, and their encouragement and support may help patients accept treatment. The treatment proceeds most smoothly if the primary care physician and psychiatrist work collaboratively with clear and frequent communication.
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PMID:Eating disorders. A review and update. 147 50


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