Eating and vomiting

Introduction Eating and vomiting is one of the clinical symptoms of digestive tract ulcers. Gastrointestinal ulcers mainly refer to chronic ulcers that occur in the stomach and duodenum. They can also occur in the lower esophagus, around the gastric jejunostomy, and in the ectopic gastric mucosa. (MECKEL) diverticulum. The formation of these ulcers is related to the digestion of gastric acid and pepsin, so it is called peptic ulcer.

Cause

1. Inheritance: In gastric ulcers, especially among relatives of males, the incidence rate is higher than that of ordinary people. Sometimes it can be seen that several generations of families have peptic ulcers. The twins who are separated from each other have the same disease. Cases have occasionally been discovered, revealing that the disease may be related to heredity.

2, geographical environment and climate change: the incidence of this disease has significant geographical differences, such as in the United States, Britain and other countries, duodenal ulcer is more common than gastric ulcer, but in Japan, the opposite, stomach The incidence of ulcers is higher than the incidence of duodenal ulcers. Changes in the climate season are also significantly associated with the onset of gastric ulcers, which occur in the late fall and early spring.

3. Diet: Food can cause physical or chemical damage to the gastric mucosa. According to reports in the literature, there is a kind of kimchi in Japan that can cause severe antral sinusitis, which may be a causative factor of gastric ulcer. Whether alcohol has any effect on the etiology of this disease is still inconclusive, but most people think that the wine cellar is susceptible to this disease. In addition, malnutrition, binge drinking, and binge eating can induce gastric ulcer disease.

4, emotions: continued strong mental stress and anxiety, depression and other emotions, long-term excessive mental work, lack of proper adjustment and rest, have an impact on the incidence of gastric ulcer and the severity of the disease.

5. Smoking: Smoking is a condition for the formation of gastric ulcers and exacerbates existing ulcers, which has been accepted by most people.

6, drugs: some drugs such as aspirin, indomethacin, phenylbutazone, glucocorticoids have been classified as ulcerative substances. Among them, aspirin is the most important ulcer-producing drug. Many antipyretic analgesics and drugs for treating colds contain aspirin, which can cause stomach ulcers when taken for a long time.

7, certain diseases: such as gastrinoma, primary hyperparathyroidism, emphysema, cirrhosis, renal insufficiency and excessive intestinal resection are prone to ulcer disease, these have been more The more you pay attention. For example, patients with emphysema may be caused by a decrease in the acid resistance of the local mucosa. Gastrinoma is undoubtedly due to the secretion of a large amount of gastrin to stimulate parietal cells, causing a large amount of gastric acid secretion and damage the gastric mucosa, leading to gastric ulcer. form.

an examination

Related inspection

Esophagography esophageal barium meal perspective

1. Chronic, periodic, rhythmic mid-abdominal pain: The common clinical manifestations of digestive ulcers are abdominal pain limited to the upper abdomen, which can be summarized as limitations, slowness and rhythm.

2. In addition to pain, there are often other gastrointestinal symptoms, such as hernia, acid reflux, heartburn, nausea, vomiting, etc. Vomiting and nausea mostly reflect the high degree of activity of the ulcer.

3. Systemic symptoms: Patients may have manifestations of neurosis such as insomnia, which may affect the diet and may cause weight loss and anemia.

4. There is generally no obvious signs during the remission period. The tenderness of gastric ulcer in active period is often in the middle or upper abdomen; the duodenal bulb ulcer is often in the right side; the posterior wall penetrating ulcer is on the 11th and 12th thoracic vertebrae in the back.

Differential diagnosis

1, abdominal pain with nausea, vomiting: abdominal pain with nausea, vomiting is one of the clinical manifestations of acute pancreatitis.

2, neurological vomiting: neurological vomiting This disease is characterized by recurrent vomiting, no organic disease as the basis, does not meet the diagnostic criteria of mental illness, no obvious other symptoms except vomiting, vomiting is often related to psychosocial factors . Clinically, the initial symptoms are common, and careful observation and exploration of motivation factors are often re-diagnosed as other mental disorders. It happens mostly due to unpleasant circumstances or psychological stress. Repeated involuntary vomiting episodes usually occur after eating, sudden jet vomiting, no obvious nausea and other discomfort, no appetite, eating after vomiting, no weight loss, no endocrine disorders, often rickets Sexual character.

3, vomiting after strenuous exercise: vomiting after exercise is one of the clinical manifestations of sports gastrointestinal syndrome, refers to the occurrence of gastrointestinal dysfunction, manifested as abdominal pain, nausea and vomiting, diarrhea, etc. during exercise or exercise A group of syndromes of symptoms.

4, right lower quadrant pain with vomiting: typical clinical manifestations of acute appendicitis, gradually appearing pain in the upper abdomen or around the umbilicus, abdominal pain transferred to the right lower abdomen after a few hours. Often accompanied by loss of appetite, nausea or vomiting.

5, nausea and vomiting: nausea and vomiting are common clinical symptoms. Nausea is often a precursor to vomiting and can also appear alone. It shows the special discomfort of the upper abdomen, often accompanied by dizziness, runny, pulsation, blood pressure and other symptoms of exacerbation. Vomiting refers to a complex reflex action of the contents of the stomach or a portion of the contents of the small intestine that flow out of the mouth through the esophagus. Vomiting can remove harmful substances from the stomach, and people can play a protective role, but persistent and severe vomiting can cause technical water, electrolyte imbalance, metabolic alkalosis and malnutrition, and even esophageal and gastric mucosal tears (MallmpWiess) Syndrome) complications.

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