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

Regurgitation, vomiting, and aspiration pneumonia in 4 young male English Bulldogs were attributed to esophageal deviation that was demonstrated by esophageal radiography. A genetic relationship among these dogs was not determined. Exploratory thoractomy, performed in 2 dogs, demonstrated an apparent compression of the esophagus by the left subclavian artery and brachiocephalic artery at the level of the 2nd and 3rd intercostal spaces. This apparent compression correlated with the roentgen location of esophageal deviation. Surgical redirection of the left subclavian artery resulted in immediate and long-lasting remission of clinical signs.
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PMID:Esophageal deviation in four English Bulldogs. 34 61

To assess gastrointestinal symptoms after colon interposition, 12 patients with colon interposition for malign disease and 33 for benign esophageal disease were interviewed. A 7-day diary, including time of eating and gastrointestinal symptoms experienced by patients during and between meals, was kept by every patient. The observations of the interview and diary were compared. No patient had swallowing difficulties or heartburn. All could also eat solid foods; 24% had no gastrointestinal gastrointestinal symptoms during follow-up. Regurgitation, vomiting, and dumping symptoms were common, being observed in 22, 31, and 18% of the cases. There were no differences with these symptoms between patients with anti- or isoperistaltic colon grafts. The information from interviews agrees with the information recorded in the diaries. We conclude that various degree reflux symptoms are common after colon interposition, being experienced by almost half of the patients.
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PMID:Gastrointestinal symptoms after colon interposition. 377 53

Regurgitation and aspiration of feedings is a significant problem in children with impaired oral intake fed via gastrostomy. Using extended (18-24 hour) esophageal pH monitoring to assess gastroesophageal reflux (GER), we studied prospectively 32 children (aged 2 to 16 years) referred for feeding gastrostomy. Twenty-five patients had repeat esophageal pH monitoring after surgery. Prior to surgery, GER was documented in 23 (72%) of the 32 children. Twenty-two of the 23 children with GER before surgery had an antireflux operation performed in conjunction with the feeding gastrostomy. Gastroesophageal reflux was clinically significant in the single failed antireflux operation and in the child with GER before surgery who only had a gastrostomy performed. All nine patients without GER only had gastrostomy performed. Six of these developed GER by pH monitoring after surgery, with significant vomiting in four. Of our 11 patients remaining at risk for GER after surgery, seven (64%) had persistent vomiting with gastrostomy feedings. Thus, 91% (29 of 32) of the children were potentially at risk for GER if a gastrostomy only was performed. We believe these data support the need for a "protective" antireflux operation in children referred for feeding gastrostomy.
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PMID:Protective antireflux operation with feeding gastrostomy. Experience with children. 400 85

The etiology, pathogenesis, diagnosis, and treatment of reflux esophagitis are reviewed. Reflux esophagitis is the subjective or objective response to gastroesophageal reflux (GER), which is defined as the entrance of gastroduodenal contents into the esophagus not associated with vomiting or belching. The pathogenesis of reflux esophagitis may involve a number of mechanisms, including changes in lower esophageal sphincter pressure, gastric volume, composition of the refluxate, esophageal acid clearance, and esophageal tissue resistance. The most common symptom of reflux esophagitis is heartburn. Regurgitation of fluid into the mouth, usually after bending or during the night, is an unequivocal symptom of GER. Treatment can be divided into three phases. Phase 1 involves the avoidance of certain foods and habits, elevation of the bed head, antacid, and alginic acid-antacid therapy. Phase 2 involves drug therapy with agents not yet approved by the FDA for this indication: bethanechol chloride, cimetidine, and metoclopramide hydrochloride. Bethanechol chloride 25 mg is generally given four times daily. Cimetidine is given in doses of 300-400 mg after meals and at bedtime. Metoclopramide hydrochloride is administered in doses of 10 mg before meals and at bedtime. Phase 3 is antireflux surgery. Clinical experience has shown that phase 1 therapy is successful for about 75% of all patients. Of the 25% that do not respond to phase 1 therapy, about 90% will respond to phase 2 therapy, leaving only 5-10% of all patients with this disorder who will require phase 3 treatment. Current data favor cimetidine and bethanechol over metoclopramide. The least proof of efficacy and the most frequent adverse side effects are seen with metoclopramide. Cimetidine and bethanechol appear to have similar efficacy and relatively infrequent side effects. Evidence confirming the superiority of cimetidine over bethanechol is lacking. Further research is needed to determine the optimal pharmacologic combinations and treatment regimens.
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PMID:Current concepts in the pathogenesis and treatment of reflux esophagitis. 636 Apr 95

Regurgitation of esophageal contents is referred to as esophageal emesis or esophageal vomiting. It is most likely to be confused with symptoms arising from disease proximal or distal to the esophagus, particularly the latter. Therefore, it is important to distinguish between esophageal vomiting and typical vomiting, although in the former group, the regurgitated contents are ingested food and/or saliva; recognition of the exact site of the pathological disorder may necessitate investigation. A wide variety of investigations may be necessary. Disease processes to be considered in the diagnosis include congenital stricture, achalasia and other motility disorders of the esophagus, foreign-body impaction, and acquired strictures of the esophagus, such as peptic or corrosive strictures.
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PMID:Esophageal disorders associated with emesis in infants and children. 758 87

The operative results, outcome, and short-term follow-up after laparoscopic exploration for Nissen fundoplication were evaluated in 35 patients with symptomatic gastroesophageal reflux and reflux-induced pulmonary disease. There were 19 female and 16 male patients, ranging in age from 17 to 72 years (mean: 42 years, SD: 11.6 years). In 20 patients, the symptoms were predominantly of regurgitation and heartburn; the remaining 15 patients had mixed regurgitation/heartburn and pulmonary symptoms. All patients underwent 24-hour pH monitoring, upper endoscopy, and manometry. The indication for surgery was medical failure or the need for long-term medical management with omeprazole. The operation, which was performed laparoscopically, is identical to the conventional Nissen fundoplication. There was a mortality rate of 0% and a morbidity rate of 25.7%. Five patients required conversion to open Nissen fundoplication, which was due to hemodynamic instability secondary to presumed pneumothorax in three patients and colotomy and a distal esophageal perforation in the other two patients. Thirty patients underwent laparoscopic Nissen fundoplication. Three patients developed early dysphagia, and one patient experienced a perforation of the piriform sinus due to nasogastric tube manipulation under anesthesia. All these patients had an uncomplicated postoperative course, and there was no long-term disability. The total surgical time of laparoscopic Nissen fundoplication was on average 107 minutes (SD: 35.3 minutes). Discharge usually occurred on the evening of postoperative day 2 (mean: 3.3 days; SD: 1.5 days). Twenty-six of the 30 patients who underwent laparoscopic Nissen fundoplication described the outcome as excellent and good (87%); however, 4 patients (13%) were unsatisfied. Fifteen patients (50%) had difficulty belching or vomiting, and moderate dysphagia was described by 7 patients (24%) in follow-up. Regurgitation and heartburn were cured in 96%, whereas reflux-induced pulmonary disease was cured in 50%. The results of laparoscopic Nissen fundoplication compare favorably with those of conventional Nissen fundoplication with respect to mortality, complications, and outcome.
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PMID:Laparoscopic Nissen fundoplication: operative results and short-term follow-up. 831 Nov 32

Thirteen dogs with postanesthetic esophageal dysfunction were identified; 10 of these animals had esophageal stricture. Regurgitation was noted in six dogs during the inciting anesthetic event. Clinical problems common to all dogs included vomiting/regurgitation and weight loss. Coughing was noted in six dogs, and aspiration pneumonia was present in four of these dogs. The associated mortality rate was 23%. The duration of symptoms ranged from 17 to 150 days, and the diagnosis was often delayed (up to 76 days from onset of clinical signs to diagnosis). Postanesthetic esophageal dysfunction was a debilitating and costly problem that developed in one dog despite current preventative treatment.
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PMID:Postanesthetic esophageal dysfunction in 13 dogs. 1553 65

A prerequisite for preventive measures is to diagnose erosive tooth wear and to evaluate the different etiological factors in order to identify persons at risk. No diagnostic device is available for the assessment of erosive defects. Thus, they can only be detected clinically. Consequently, erosion not diagnosed in the early stage may render timely preventive measures difficult. In order to assess the risk factors, patient should record their dietary intake for a distinct period of time. Then a dentist can determine the erosive potential of the diet. Particularly, patients with more than four dietary acid intakes have a higher risk for erosion when other risk factors (such as holding the drink in the mouth) are present. Regurgitation of gastric acids (reflux, vomiting, alcohol abuse, etc.) is a further important risk factor for the development of erosion which has to be taken into account. Based on these analyses, an individually tailored preventive program may be suggested to the patients. It may comprise dietary advice, optimization of fluoride regimes, stimulation of salivary flow rate, use of buffering medicaments and particular motivation for nondestructive toothbrushing habits with a low abrasive toothpaste. The frequent use of fluoride gel and fluoride solution in addition to fluoride toothpaste offers the opportunity to reduce somewhat abrasion of tooth substance. It is also advisable to avoid abrasive tooth cleaning and whitening products, since they may remove the pellicle and may render teeth more susceptible to erosion. Since erosion, attrition and abrasion often occur simultaneously all causative components must be taken into consideration when planning preventive strategies.
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PMID:Risk assessment and preventive measures. 1668 95

Complications of anaesthesia leading to death in young pregnant women might be prevented if more experienced personnel could be entrusted with the job. The contribution of anaesthesia to maternal mortality in the United Kingdom is 1.7 per million pregnancies with almost similar incidence from United States. The commonest single factor responsible for anaesthesia-related death is difficult or failed intubation. A pregnant woman with a potentially difficult airway should receive aspiration prophylaxis (mechanical or pharmacological) as soon as operative delivery is anticipated. Anaesthetists should make a plan that comes into effect as soon as failure to view the larynx or to intubate the trachea becomes evident. Unsuspected difficult airway can be managed if the skill of the anaesthetists is of high standard. Pulmonary aspiration is one cause of death in obstetric anaesthesia. Regurgitation and vomiting prevention can minimise pulmonary aspiration. In regional anaesthesia, local anaesthetics toxicity is another cause of concern. This should be tackled with some safe local anaesthetics. Preventing a high spinal or epidural block involves ways to detect inadvertent injection of local anaesthetic into the cerebrospinal fluid. Postoperative care after anaesthesia in obstetric cases is very important.
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PMID:Anaesthesia-related maternal mortality. 2231 82

On 8 May 2004, the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommended routine administration of zinc in the management of children, aged less than five years, with acute diarrhoea. In making the recommendation, WHO and UNICEF also suggested careful monitoring for adverse events associated with routine administration of zinc, particularly unusual or excess vomiting. The study assessed, in a phase IV trial, i.e. post-marketing surveillance of zinc, the occurrence of adverse events during the first hour after the administration of the first dose of zinc in children with acute or persistent diarrhoea. The study was conducted at the Dhaka Hospital of ICDDR,B and at an outpatient clinic operated by a local health NGO-Progoti Samaj Kallyan Protisthan (PSKP), Dhaka, Bangladesh. Eligible children, aged 3-59 months, were treated with 20 mg of zinc sulphate provided in a dispersible tablet formulation. The children were observed for 60 minutes following the initial treatment with zinc for adverse events, with particular attention given to vomiting or regurgitation. During the one-year observation period, 42,440 children (male 57% and female 43%) received zinc, and 20,246 (47.8%) of them were observed. Regurgitation and/or vomiting occurred in 4,392 (21.8%) of the children; 90.8% of these children had vomiting only once, 8.7% twice, and 0.5% more than twice. No children revisited the hospital for recurrent vomiting following their discharge. A significant proportion of infants and children may experience vomiting or regurgitation, usually once, following the administration of the first dose of zinc. This is a transient phenomenon that did not impact on continuation of treatment with zinc.
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PMID:Introduction of routine zinc therapy for children with diarrhoea: evaluation of safety. 1798 14


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