Vomiting in adults

Vomiting in adults can result from a wide range of causes, including gastrointestinal disorders, infections, systemic illnesses, medications, and psychological factors. Below is a comprehensive overview of the potential causes:

Gastrointestinal Causes

1. Gastroenteritis:
   • Description: Inflammation of the stomach and intestines, often due to infections.
   • Causes: Viral (e.g., norovirus, rotavirus), bacterial (e.g., Salmonella, E. coli), or parasitic infections.
2. Peptic Ulcer Disease:
   • Description: Ulcers in the stomach or duodenum.
   • Symptoms: Nausea, vomiting, abdominal pain, and sometimes hematemesis (vomiting blood).
3. Gastroparesis:
   • Description: Delayed gastric emptying.
   • Symptoms: Nausea, vomiting, early satiety, and abdominal bloating.
   • Causes: Diabetes, post-surgical, idiopathic.
4. Gastroesophageal Reflux Disease (GERD):
   • Description: Chronic acid reflux.
   • Symptoms: Heartburn, regurgitation, and sometimes vomiting.
5. Bowel Obstruction:
   • Description: Blockage in the intestines.
   • Symptoms: Vomiting, abdominal pain, constipation, and distension.
   • Causes: Hernias, adhesions, tumors, or volvulus.
6. Appendicitis:
   • Description: Inflammation of the appendix.
   • Symptoms: Nausea, vomiting, and right lower quadrant abdominal pain.
7. Pancreatitis:
   • Description: Inflammation of the pancreas.
   • Symptoms: Severe abdominal pain, nausea, vomiting, and sometimes fever.
8. Cholecystitis:
   • Description: Inflammation of the gallbladder.
   • Symptoms: Right upper quadrant pain, nausea, vomiting, and fever.

Infectious Causes

1. Viral Infections:
   • Examples: Norovirus, rotavirus, influenza.
   • Symptoms: Nausea, vomiting, diarrhea, and sometimes fever.
2. Bacterial Infections:
   • Examples: Food poisoning (e.g., Salmonella, E. coli), Helicobacter pylori infection.
   • Symptoms: Nausea, vomiting, diarrhea, and abdominal pain.
3. Parasitic Infections:
   • Examples: Giardiasis, amoebiasis.
   • Symptoms: Nausea, vomiting, diarrhea, and abdominal cramps.

Systemic Causes

1. Pregnancy:
   • Description: Morning sickness or hyperemesis gravidarum.
   • Symptoms: Nausea and vomiting, particularly in the first trimester.
2. Metabolic Disorders:
   • Diabetic Ketoacidosis (DKA): Nausea, vomiting, abdominal pain, and altered mental status.
   • Uremia: Due to kidney failure, causing nausea and vomiting.
3. Electrolyte Imbalances:
   • Examples: Hyponatremia, hypercalcemia.
   • Symptoms: Nausea, vomiting, and sometimes neurological symptoms.
4. Liver Disease:
   • Examples: Hepatitis, cirrhosis.
   • Symptoms: Nausea, vomiting, jaundice, and abdominal pain.
5. Adrenal Insufficiency:
   • Description: Insufficient production of adrenal hormones.
   • Symptoms: Nausea, vomiting, fatigue, and hypotension.

Neurological Causes

1. Migraine:
   • Description: Severe headaches often accompanied by nausea and vomiting.
2. Increased Intracranial Pressure:
   • Causes: Brain tumors, cerebral edema, hydrocephalus.
   • Symptoms: Nausea, vomiting, headache, and sometimes altered mental status.
3. Vestibular Disorders:
   • Examples: Labyrinthitis, Meniere’s disease.
   • Symptoms: Vertigo, nausea, and vomiting.

Medications and Toxins

1. Chemotherapy:
   • Description: Common side effect of cancer treatment.
   • Symptoms: Nausea and vomiting.
2. Opioids:
   • Description: Pain medications that can cause nausea and vomiting.
3. Alcohol and Substance Abuse:
   • Description: Excessive consumption can lead to nausea and vomiting.
4. Toxins:
   • Examples: Food poisoning, heavy metals, carbon monoxide poisoning.
   • Symptoms: Nausea, vomiting, and sometimes systemic effects.

Psychological Causes

1. Anxiety and Stress:
   • Description: Can trigger nausea and vomiting.
2. Eating Disorders:
   • Examples: Bulimia nervosa.
   • Symptoms: Self-induced vomiting.

Evaluation and Diagnosis

When evaluating vomiting in adults, healthcare providers consider several factors:

• Duration and Frequency: Acute vs. chronic.
• Associated Symptoms: Abdominal pain, fever, weight loss, neurological symptoms.
• Medical History: Medications, recent travel, dietary habits.

Diagnostic Tests:

• Blood Tests: To check for infections, electrolyte imbalances, liver function, and metabolic disorders.
• Imaging: Abdominal ultrasound, CT scan, or MRI to assess for structural abnormalities.
• Endoscopy: To visualize the gastrointestinal tract.
• Pregnancy Test: For women of childbearing age.

Conclusion

Vomiting in adults can be caused by a wide array of factors, ranging from benign to serious conditions. A thorough clinical evaluation, including history, physical examination, and appropriate diagnostic tests, is essential to determine the underlying cause and guide treatment. Adults experiencing persistent or severe vomiting should seek medical attention to ensure proper diagnosis and management.

For more detailed information, consulting a healthcare provider or referring to medical literature is recommended.