Vomiting after strenuous exercise

Introduction Vomiting after strenuous exercise is one of the clinical manifestations of sports gastrointestinal syndrome. It refers to a group of syndromes that occur during exercise or after exercise, and have gastrointestinal dysfunction, manifested as abdominal pain, nausea and vomiting, and diarrhea. The cause of the disease is insufficient blood supply to the gastrointestinal tract, redistribution of visceral blood during exercise, dehydration, high temperature and other conditions are more serious gastrointestinal blood supply disorders, secretion of vasoactive substances such as catecholamines, release of oxygen free radicals and other gastrointestinal mucosal microcirculation Ischemia.

Cause

Pathogenesis and cause:

1, gastrointestinal spasm: mental stress, over-satisfaction, fasting can cause abnormal secretion of gastrointestinal hormones, gastrointestinal movements are not coordinated to cause gastrointestinal spasm.

2, gastrointestinal tract blood supply: visceral blood redistribution during exercise, dehydration, high temperature and other conditions are more serious gastrointestinal blood supply disorders, catecholamines and other vasoactive substances secretion, oxygen free radicals and other exacerbations of gastrointestinal mucosal microcirculation deficiency blood.

3, ligament, organ surface tension tension, rectus abdominis: respiratory movement incoordination can cause liver and spleen congestion, mechanical stimulation to maintain the ligaments of the abdominal organs excessive traction, stimulate vagus nerve reflex, dehydration, electrolyte imbalance, Increased muscle excitability causes the rectus abdominis.

an examination

Related inspection

Gastric examination, gastric ultrasound, gastroscope

History: Repeated abdominal pain, nausea and vomiting during exercise. Abdominal pain: mostly located in the umbilical cord, right upper abdomen or mid-upper abdomen, may be burning or cramping, paroxysmal, no radiation pain, nausea. Vomiting: Vomiting water-like stomach contents or food after meals, deliberate or defecation can not be controlled. Diarrhea: more manifested as watery diarrhea.

Physical examination and laboratory examination: Abdominal signs were mild, no fixed tenderness, and a small number of patients had mild tenderness in the abdomen. Related examinations: blood routine, fecal routine, liver function, blood, urine amylase examination is generally normal, abdominal ultrasound is normal, gastrointestinal angiography, gastroscopy, colonoscopy and other tests are negative.

Diagnosis: A history of frequent abdominal pain during exercise, and the abdominal signs are not consistent with the symptoms. The relevant examinations can rule out the diagnosis of chronic diseases and organic diseases of the abdomen.

Differential diagnosis

Neurological vomiting: Neurological vomiting This manifestation of recurrent vomiting, no organic disease as the basis, does not meet the diagnostic criteria of psychosis, 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.

Reflex vomiting: A type of peripheral vomiting. Its characteristics are: there are signs of nausea, not feeling relaxed after vomiting, although the stomach has been empty but still retching. Seen in the inflammation of the abdominal organs (such as appendicitis, cholecystitis, pancreatitis, peritonitis), biliary ascariasis, intestinal obstruction.

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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