One of the most common patient issues that I see at my office is when someone comes in for nausea and/or vomiting. The reason for this is that nausea and vomiting is not only very annoying but also associated with some serious medical conditions. Consequently, there is some real anxiety around persistent vomiting.
So what are the top causes of vomiting and how do they differ by age group as taken from the online resource Uptodate?
Acid Reflux: Physiologic gastroesophageal reflux in newborns and infants is common, and is characterized by effortless regurgitation in an otherwise healthy infant (a "happy spitter"). This symptom may be described as vomiting by parents. The symptom gradually improves in most infants during the first year of life, and may be minimized by conservative antireflux measures.
Food Intolerance: Intolerance to dietary proteins (most commonly milk protein) typically manifests as colitis, presenting with bloody stools. However, in some infants the dietary protein causes enteritis, with or without associated colitis, and affected infants may present with vomiting, diarrhea, and failure to thrive.
Intestinal Obstruction: There are multiple causes of intestinal obstruction in neonates and young infants.
Older Infants and children
Gastroenteritis: Gastroenteritis usually is viral in etiology, occurring in clusters, sudden in onset, and quick to resolve. Bacterial causes may be associated with more prolonged and severe illness.
Other Infections: Pharyngitis (particularly streptococcal pharyngitis) and urinary tract infections frequently present with nausea and/or vomiting.
In addition to the disorders affecting children listed above, some of the more common causes of nausea and vomiting in adolescents include gastroenteritis, appendicitis, inflammatory bowel disease (IBD), pregnancy, and toxic ingestions.
The good news is that in my experience the majority of cases of nausea and vomiting resolve without serious ramifications. However, there are certainly times when seeing a doctor is necessary such as when there is significant abdominal discomfort, prolonged or vigorous vomiting, bloody vomiting, high fever, dehydration, or when someone is not improving.
Of course, the advice in this post should not be substituted for the advice of your personal physician. If you have a need to be seen for this issue I can certainly help.
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