Chapter 039. Nausea, Vomiting, and Indigestion (Part 2)

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Differential Diagnosis Nausea and vomiting are caused by conditions within and outside the gut as well as by drugs and circulating toxins (Table 39-1). Table 39-1 Causes of Nausea and Vomiting Intraperitoneal Extraperitoneal Medications/Metabolic Disorders Obstructing Cardiopulmonary Drugs disorders disease Cancer chemotherapy Pyloric obstruction Cardiomyopathy Antibiotics Myocardial Small obstruction Labyrinthine Colonic obstruction Motion sickness disease bowel infarction Cardiac antiarrhythmics Digoxin Oral hypoglycemics Oral contraceptives Superior Labyrinthitis mesenteric syndrome artery Malignancy Endocrine/metabolic disease Enteric infections Intracerebral disorders Pregnancy Viral Malignancy Bacterial Hemorrhage Inflammatory diseases Abscess Uremia Ketoacidosis Thyroid parathyroid disease and Cholecystitis Hydrocephalus Adrenal insufficiency ...

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Chapter 039. Nausea, Vomiting, and Indigestion (Part 2) Differential Diagnosis Nausea and vomiting are caused by conditions within and outside the gut as well as by drugs and circulating toxins (Table 39-1). Table 39-1 Causes of Nausea and Vomiting Intraperitoneal Extraperitoneal Medications/Metabolic Disorders Obstructing Cardiopulmonary Drugs
disorders disease Cancer chemotherapy Pyloric Cardiomyopathy Antibiotics obstruction Myocardial Cardiac Small bowel infarction antiarrhythmics obstruction Labyrinthine Digoxin Colonic disease Oral hypoglycemics obstruction Motion sickness Oral contraceptives Superior Labyrinthitis mesenteric artery Endocrine/metabolic syndrome Malignancy disease Enteric infections Intracerebral Pregnancy disorders Viral Uremia Malignancy Bacterial Ketoacidosis Hemorrhage Inflammatory Thyroid and diseases Abscess parathyroid disease Cholecystitis Hydrocephalus Adrenal insufficiency
Pancreatitis Psychiatric Toxins illness Appendicitis Liver failure Anorexia and Hepatitis Ethanol bulimia nervosa Altered Depression sensorimotor function Postoperative Gastroparesis vomiting Intestinal pseudoobstruction Functional dyspepsia Gastroesophageal reflux Chronic idiopathic nausea Functional vomiting
Cyclic vomiting syndrome Biliary colic Abdominal irradiation Intraperitoneal Disorders Visceral obstruction and inflammation of hollow and solid viscera may produce vomiting as the main symptom. Gastric obstruction results from ulcer disease and malignancy, while small-bowel and colonic obstruction occur because of adhesions, benign or malignant tumors, volvulus, intussusception, or inflammatory diseases such as Crohn's disease. The superior mesenteric artery syndrome, occurring after weight loss or prolonged bed rest, results when the duodenum is compressed by the overlying superior mesenteric artery. Abdominal irradiation impairs intestinal contractile function and induces strictures. Biliary colic causes nausea via action on visceral afferent nerves. Vomiting with pancreatitis, cholecystitis, and appendicitis is due to localized visceral irritation and induction of ileus. Enteric infections with viruses or bacteria such as Staphylococcus aureus and Bacillus cereus are common causes of acute vomiting,
especially in children. Opportunistic infections such as cytomegalovirus or herpes simplex virus induce emesis in immunocompromised individuals.