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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Feeding problems, anorexia and vomiting are common in infants and children with chronic renal failure (CRF), and play a major role in the growth failure often found in this condition. However, the gastroenterological and nutritional aspects of CRF in children have received little attention, hence therapeutic interventions are usually empirical and often ineffective. Gastritis, duodenitis and peptic ulcer are often found in adults with CRF on regular haemodialysis and following renal transplantation. Despite persistent hypergastrinaemia, gastric acid secretion is decreased rather than increased in most of these patients, and active peptic disease appears to be promoted by the removal of the acid output inhibition (neutralisation of gastric acid by ammonia) that follows active treatment. Helicobacter pylori, on the other hand, does not seem to play a significant role in the pathogenesis of peptic disease in CRF. Gastro-oesophageal reflux has been found in about 70% of infants and children with CRF suffering from vomiting and feeding problems, and thus appears to be a major problem in these patients. In a number of symptomatic patients with CRF, gastric dysrhythmias and delayed gastric emptying have also been found; hence there appears to be a complex disorder of gastrointestinal motility in CRF. Serum levels of several polypeptide hormones involved in the modulation of gastrointestinal motility [e.g. gastrin, cholecystokinin (CCK), neurotensin] and the regulation of hunger and satiety (e.g. glucagon, CCK) are significantly raised as a consequence of renal insufficiency, and can be reverted to normal by renal transplantation. Furthermore, several other humoral abnormalities (e.g. hypercalcaemia, hypokalaemia, acidosis, etc.) are not uncommon in CRF. By directly affecting the smooth muscle of the gut or stimulating particular areas within the central nervous system, all these humoral alterations may well play a major role in the gastrointestinal dysmotility, anorexia, nausea and vomiting in patients with CRF. Specific pharmacological and nutritional interventions should thus be considered for the treatment of vomiting and feeding problems in CRF.
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PMID:Gastrointestinal function in chronic renal failure. 874 22

The 3 eating disorders--anorexia nervosa, bulimia nervosa, and binge eating--occur at a frequency far greater than usually realized. Anorexia has been found to be present in up to 1% of teenage and young adult women, whereas estimates of bulimia have ranged up to 5%. The prevalence of binge-eating disorder is not known, but may be higher than bulimia. Anorexia nervosa is characterized by weight loss, body image disturbance, and a morbid fear of weight gain. Bulimia nervosa is characterized by binge eating and compensatory purging by vomiting; use of laxatives, diuretics, or diet pills; exercise; or fasting. Binge-eating disorder is characterized by binge behavior and loss of control of food intake, with an absence of purging. Eating disorders create significant mortality and morbidity. Medical complications associated with anorexia are those related to malnutrition and semistarvation. Medical complications associated with bulimia are those related to electrolyte imbalance and the physical effects of vomiting. The mortality rate of eating disorders may be as high as 15%, including deaths from arrhythmia, gastric hemorrhaging, and suicide. The core struggle within women with anorexia is the "2 Ps": feeling powerless and striving towards perfectionism. The core conflict within a bulimic person appears to be the "2 Ds": deprivation and dependency. The treatment of eating disorders includes psychotherapy, and, frequently, psychopharmacologic intervention. The psychotherapy primarily addresses issues of chaotic eating, hunger, inadequate caloric intake, conditioned response, and profound fear of expressing impulses and feelings, especially those of anger and sadness. Antidepressants, especially serotonergic agents, have been found to be useful, particularly in the treatment of bulimia.
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PMID:What's New in the Treatment of Anorexia Nervosa and Bulimia? 974 43

In early palliative stages effective nutrition can improve well-being. In late stages and in dying patients excessive amounts of proteins and lipids may induce nausea and vomiting, due to cachexia and subsequent changes in the metabolism. Excessive hydration may give rise to oedema and dyspnoea. In these late stages the patient rarely feels hungry or thirsty. The goal should therefore be to do good, not to harm and to respect the autonomy of the patient. Thus, the well-being of the patient should be in focus: to avoid hunger, thirst, nausea, vomiting, oedemas and dyspnoea. The consequences are that small amounts of carbohydrates and water often constitute the optimum for these patients.
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PMID:[Quality of life is the most important goal of nutritional support of the dying]. 1075 Mar 87

A retrospective audit was carried out to assess patient outcome in relation to the timing of feeding after pyloromyotomy for hypertrophic pyloric stenosis. Fifty-two patients received the first feed within 8 hours of surgery and 49 patients were fed between 13 and 20 hours post-operatively. Seventy-seven per cent of patients in the early group vomited compared to 53% in the late group. Sixty-one per cent of patients in the early group produced large vomits compared to 29% in the late feeding group. However, time to establish feeding and post-operative stay were comparable in both groups. We recommend feeding to be delayed for 12 hours after pyloromyotomy unless the patient is distressed because of hunger in which case the parents are warned of the increased risk of vomiting.
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PMID:An audit of post-pyloromyotomy feeding regimens. 1137 Sep 75

Bulimia nervosa is an eating disorder characterised by recurrent episodes of binge eating and associated efforts to purge the ingested calories through self-induced vomiting, laxative or diuretic abuse, fasting or intensive exercise. The aetiopathogenesis and pathophysiology of the disorder are currently unclear. Biological bases have been proposed repeatedly, based on several lines of evidence: hunger, satiety and food choice are regulated by neurotransmitters and neuropeptides, and impairment of eating habits may be related to alterations in the secretion of these chemicals; genetic studies suggest that these neurotransmitter systems are dysfunctional in individuals with bulimia nervosa; and the frequent comorbidity of bulimia nervosa with major depressive and obsessive-compulsive disorders, conditions in which multiple alterations of brain biochemical functions have been demonstrated. Data in the literature suggest that levels of noradrenaline (norepinephrine) and serotonin (5-hydroxytryptamine; 5-HT) are lower in individuals with bulimia nervosa than in healthy controls. Levels of dopamine are similar to, or lower than, those in controls. After remission of the disorder, noradrenergic function returns to that seen in controls, whereas dopaminergic and serotonergic function rebound to levels higher than in controls. Among the neuropeptides, alterations in the levels of neuropeptide Y, peptide YY, beta-endorphin, corticotrophin-releasing hormone, somatostatin, cholecystokinin and vasopressin have been found in the symptomatic phase of bulimia nervosa, with a return to levels seen in controls after remission. Pharmacological treatment of bulimia nervosa that is directed at correction of the neurochemical alterations observed is difficult because of the complexity of the impairments. However, such treatment is necessary and should be continued long after symptomatic remission to ensure reinstitution of cerebral biochemical homeostasis.
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PMID:Aetiopathogenesis and pathophysiology of bulimia nervosa: biological bases and implications for treatment. 1146 Aug 90

A questionnaire to diagnose dyspepsia was created. The questionnaire consists in 9 items written in very clear and understandable language and related to the cardinal symptoms of dyspepsia (easy sensation of fullness, postprandial epigastric fullness, heartburn, regurgitation, nausea, vomiting, postprandial epigastric pain, excessive belching and hunger pain). The questionnaire also includes a system of quantification levels for each symptom, taking into account its frequency and intensity of presentation in the previous two weeks: 1 point, if the symptom did not bother at all or only infrequently; 2 points, if it bothered only a little; 3 points, if it bothered moderately; and 4 points, if it bothered a lot. The questionnaire was applied to 40 patients with dyspepsia and 20 healthy control subjects, and their answers were compared with data obtained by anamnesis. For the comparison, three criteria were considered to define, with the questionnaire, the existence of dyspepsia: A) Presence of a minimum of 2 symptoms, and at least one of them with a quantification level of 2 points or more; B) Presence of a minimum of 2 symptoms, and at least one of them with a quantification level of 3 points or more; and C) Presence of a minimum of 2 symptoms with a quantification level of 3 points or more. Of these three criteria, criterion B was found to be the best, and following it, the sensitivity and specificity of the questionnaire were, respectively, 95% and 100%. The new questionnaire will be, for sure, a useful instrument to accurately investigate dyspepsia, specially in large population groups.
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PMID:A new questionnaire for the diagnosis of dyspepsia. 1213 88

Emesis may be modulated via multiple mechanisms. The actions of ghrelin suggest an ability to couple an induction of hunger with preparation of the stomach for ingestion of food. Such a process might reduce any tendency to vomit, so an anti-emetic activity of ghrelin was investigated in the ferret cisplatin-induced emesis model. In controls, intra-peritoneal cisplatin (10 mg/kg) induced 41.4+/-8.4 episodes of emesis comprising 310.4+/-55.3 retches and 28.8+/-6.9 vomits during the 6h observation; the latency to onset of the first emetic episode was 108.9+/-4.8 min. Intra-peritoneal ghrelin (1mg/kg, split as a 30 min pre- and 30 min-post dose) did not induce a change in behaviour or modify cisplatin-induced emesis (p>0.05). Intracerebroventricular (i.c.v.) administration (third ventricle) was achieved via a pre-implanted cannula. At the first emetic episode following cisplatin, ghrelin or vehicle (20 microl saline) was administered i.c.v. During the 30 min following the initial episode of emesis, control animals exhibited 18.0+/-2.6 emetic episodes comprising 160.3+/-24.1 retches and 13.8+/-2.7 vomits. Ghrelin 10 microg i.c.v. reduced the number of retches by 61.5% (p<0.05) and at a dose of 30 microg i.c.v. ghrelin reduced the number of episodes, individual retches and vomits by 74.4 (p<0.05), 80.4 (p<0.01), and 72.5% (p<0.05), respectively. At subsequent time periods there were no differences between ghrelin- or saline-treated animals (p>0.05). An ability of ghrelin to reduce emesis is consistent with a role in modulating gastro-intestinal functions and identifies a novel approach to the treatment of emesis.
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PMID:Anti-emetic activity of ghrelin in ferrets exposed to the cytotoxic anti-cancer agent cisplatin. 1618 45

While there is considerable evidence that bulimic behaviors serve the function of modifying internal states (e.g., satiety, mood), there is less clarity over the roles of the different behaviors across the binge-purge cycle. The present study examines the impact of bingeing and vomiting upon these internal states at different time points, and evaluates the potential reinforcement of those behaviors by the changes in internal states. Twenty-three women with diagnoses of bulimia nervosa completed a diary of all binge-vomit episodes over the course of 7 days, rating their internal states (satiety, negative mood, positive mood) at four time points during each episode. There were substantial changes across the cycle in levels of hunger, fullness, guilt/shame, anxiety/worry, and happiness/relief, but not in other states. The changes indicate that the binge-vomit cycle is maintained by the effects of both behaviors, but that the vomiting behavior evokes the strongest pattern of reinforcement. Further research is needed to determine the levels of internal states during the binge itself.
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PMID:Changes in internal states across the binge-vomit cycle in bulimia nervosa. 1677 63

Laparoscopic sleeve gastrectomy (LSG) was initially introduced for super-obese patients in a two-step concept in order to reduce the perioperative risk. Many years before a very similar technique - the Magenstrasse and Mill (M & M) operation - was developed by Johnston in Leeds / UK as a "more physiological" bariatric procedure with acceptable weight loss, while preserving gastric emptying mechanisms and thus minimising possible side-effects such as vomiting, dumping and diarrhoea, which are common complications of gastric bypass procedures. The following manuscript analyses the current literature and our own preliminary results and parallels publications of the M & M procedure. Until now numerous modifications (e. g., bougie size and residual volume, stapler technique, use of buttress mate-rial) have been reported. However, reported -morbidity and mortality rates were equal to those of gastric banding and gastric bypass (RYGB). In conclusion, laparoscopic sleeve gastrectomy (LSG) has now proven to be as effective as the RYGB for weight loss over a three-year period. Control of hunger and feeling of fullness are -reported to be superior compared to gastric band-ing. Laparoscopic sleeve gastrectomy is no longer an experimental procedure. It should be accepted as one of the effective standard procedures for surgical treatment of morbid obesity.
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PMID:[Operative techniques and outcomes in metabolic surgery: sleeve gastrectomy]. 2019 7

Orthostatic intolerance (OI) refers to a group of clinical conditions, including postural orthostatic tachycardia syndrome (POTS) and neurally mediated hypotension (NMH), in which symptoms worsen with upright posture and are ameliorated by recumbence. The main symptoms of chronic orthostatic intolerance syndromes include light-headedness, syncope or near syncope, blurring of vision, headaches, problems with short-term memory and concentration, fatigue, intolerance of low impact exercise, palpitations, chest pain, diaphoresis, tremulousness, dyspnea or air hunger, nausea, and vomiting. This review discusses what is known about the pathophysiology of this disorder, potential treatments, and understanding its role in the patient with chronic headache pain.
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PMID:Orthostatic intolerance and the headache patient. 2054 Nov 3


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