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Prolonged and excessive vomiting depletes the body of water (dehydration), and may alter the electrolyte status. Gastric vomiting leads to the loss of acid (protons) and chloride directly. Combined with the resulting alkaline tide, this leads to hypochloremic metabolic alkalosis (low chloride levels together with high HCO − 3 and CO
Infections of the lungs or urinary tract in children may also cause vomiting or diarrhea. [1] Classical diabetic ketoacidosis (DKA) presents with abdominal pain, nausea, and vomiting, but without diarrhea. [1] One study found that 17% of children with DKA were initially diagnosed as having gastroenteritis. [1]
Fecal vomiting or copremesis is a kind of vomiting wherein the material vomited is of fecal origin. It is a common symptom of gastrojejunocolic fistula and intestinal obstruction in the ileum . [ 1 ] [ 2 ] Fecal vomiting is often accompanied by gastrointestinal symptoms, including abdominal pain , abdominal distension , dehydration , and diarrhea .
The cause in children is typically unknown; in adults a lead point is sometimes present. [1] Risk factors in children include certain infections, diseases like cystic fibrosis, and intestinal polyps. [1] Risk factors in adults include endometriosis, bowel adhesions, and intestinal tumors. [1] Diagnosis is often supported by medical imaging. [1]
The timing of nausea and vomiting after eating food is an important factor to pay attention to. Symptoms that occur within an hour of eating may indicate an obstruction proximal to the small intestine, such as gastroparesis or pyloric stenosis. An obstruction further down in the intestine or colon will cause delayed vomiting.
Recovery phase is typically the phase where vomiting ceases, nausea diminishes or is absent, and appetite returns. "Cyclic vomiting syndrome (CVS) is a rare abnormality of the neuroendocrine system that affects 2% of children." [1] This disorder is thought to be closely related to migraines and family history of migraines. [2] [3]
Unlike rumination, gastroparesis causes vomiting (in contrast to regurgitation) of food, which is not being digested further, from the stomach. This vomiting occurs several hours after a meal is ingested, preceded by nausea and retching, and has the bitter or sour taste typical of vomit. [4]
Some vomiting may be expected during the first days after surgery as the gastrointestinal tract settles. Rarely, the myotomy procedure performed is incomplete and projectile vomiting continues, requiring repeat surgery. Pyloric stenosis generally has no long term side-effects or impact on the child's future. [citation needed]