Nausea & Vomiting

Words: Dr Narayan C Deshpande

Our digestive physiology, as a standard textbook puts it, is the component of ‘nutriture’ that provides the substances necessary to support bioenergetics. That is, the role of the digestive process is to prepare and separate individual nutrients from the complex food matrix that enters the body. This process begins with ingestion of the proper complement of macro- and micronutrients in the food matrix.

Individual nutrient needs can vary substantially depending upon genetics, health status and history, age, gender, environmental factors, and even location of residence. In addition, the food matrix consumed by a person is influenced by cultural background, location, access to various foods, economic and political issues, sensory and health perceptions, and habits. In much of the developed world, there is greater food diversity available all-year-round today than at any other period in human history. Foods can be raw, minimally processed, shelf-stable, pre-packaged, prepared, nutrient-dense, or nutrient-depleted. The selection of what foods to ingest determines the quality of the diet and the ultimate influence it has on physiological function.

Nausea, by definition is the feeling you get in your stomach before you vomit. Vomiting, likewise, occurs when you throw up your stomach contents through your mouth. You can have nausea and vomiting together, or separately.

Nausea, in other words, is also the unpleasant subjective sensation that usually precedes and accompanies an episode of vomiting, or a sensation of vomiting that may, or may not terminate, in vomiting. Put simply, vomiting is the act of expelling the contents of the stomach through the mouth.

Regurgitation of oesophageal contents may, at times, be mistaken for vomiting by the patient, or sometimes by the doctor. Rumination syndrome, or ‘mercyism,’ refers to the ability of certain rare individuals to voluntarily bring up undigested contents of stomach. In such cases, vomiting is not accompanied by nausea. A similar phenomenon is seen in normal infants, especially when they are overfed.

In retching, violent contractions of the diaphragm, abdominal wall and even of the stomach occur, accompanied by a feeling of nausea; however, the cardiac sphincter does not relax, so that the stomach contents are not evacuated.

In water brash, or pyrosis, a copious amount of clear watery fluid is brought up into the mouth from the stomach. This fluid consists of swallowed saliva may be mixed with gastric juice.

Causes

  • Gastric
  • Acute gastritis [especially after alcohol excess]
  • Chronic gastritis [especially in chronic alcoholics]
  • Corrosive and irritant poison ingestion
  • Acute dilatation of stomach
  • Gastric cancer
  • Gastric/peptic ulcer
  • Pyloric stenosis
  • Hour-glass stomach
  • Post gastrectomy [dumping syndrome]
  • Diaphragmatic hernia, gastric torsion and volvulus
  • Gastro-colic hernia
  • Intestinal
  • Enteritis due to bacterial, viral, allergic, or chemical causes
  • Intestinal obstruction
  • Following general anaesthesia
  • Following drugs, especially morphine, pethidine, digitalis, cytotoxic drugs, salicylates, phenylbutazone, indomethacin, among several other causes — systemic, or otherwise.

Investigations 

  • Blood chemistry
  • Serum electrolytes to detect electrolyte imbalance and acidosis, or alkalosis
  • Blood sugar to detect diabetic ketosis
  • Blood urea to detect uraemia
  • Blood bilirubin to detect hepatocellular damage, or biliary obstruction
  • Serum glutamic pyruvic transaminase [SGPT] which is raised in hepatocellular damage
  • Serum alkaline phosphatase, which is raised in obstructive jaundice and in space occupying hepatic lesions
  • ECG: abnormal in myocardial infarction and pericarditis with effusion
  • Gastric aspiration
  • Gastric stasis in pyloric obstruction, high acidity in peptic ulcer, malignant cells in carcinoma of stomach
  • Barium meal studies to detect peptic ulcer, carcinoma of stomach, pyloric stenosis, hypertrophic gastritis, and in carcinoma of pancreas [widening of duodenal loop], obstruction, or disease of small intestine
  • Gastroscopy to detect lesions of gastric mucosa — ulcer, malignancy, gastritis
  • Neurological causes:
  • Cerebral concussion, or contusion
  • Brain tumours, brain abscess
  • Meningitis: pyogenic or tuberculous
  • Intracranial bleeding
  • Thrombosis of cerebral venous sinuses
  • Motion sickness
  • Meniere’s disease
  • Vestibular, or neurological causes of vertigo
  • Migraine; epilepsy
  • Psychogenic causes:
  • Unpleasant sights, or smells
  • Emotional shock
  • Hysteria
  • ‘Functional vomiting’ in neurotic individuals.

Homoeopathic Treatment

  • Arsenicum album. Cannot bear the sight, or smell of food. Great thirst, but drinks little at a time. Nausea, retching, vomiting, after eating, or drinking. Vomiting of blood, bile, green mucous or brown black mixed with blood. Craves acids and coffee. Great prostration.
  • Belladonna. Nausea and vomiting; empty retching, aversion to meat and milk. Uncontrollable vomiting. Dread of drinking. Great thirst for cold water.
  • Chamomilla. Foul nausea and eructation after coffee. Bilious vomiting. Tongue is yellow; the taste in the mouth is bitter. So also is regurgitation. Aversion to warm drinks. Sweats after eating, or drinking.
  • Colchicum autumnale. The smell of food causes nausea, even fainting. Vomiting of mucous, bile and food; worse any motion. Profuse salivary secretion. Icy coldness in stomach.
  • Cuprum metallicum. Nausea. Vomiting relieved by drinking cold water. Strong metallic taste in mouth. When drinking the fluid descends with gurgling sound. Craves cool drink.
  • Ipecacuanha. Clean tongue, constant nausea and vomiting. Vomiting of food, blood, bile and mucous. Stomach feels relaxed and hanging down. Mouth moist with much saliva.
  • Kreosotum. Nausea and vomiting of food several hours after eating — of sweetish water in the morning. Feeling of coldness, as of ice water in stomach. Vomiting of blood.
  • Nux vomica. Nausea and vomiting with wretching. Stools constipated. Wants to vomit, but cannot. Weight and pain in stomach. Ravenous hunger. Sedentary lifestyle.
  • Opium. Vomiting with colic and convulsions. Faecal vomiting, Incarcerated hernia; hungry but no desire to eat.
  • Phosphorus. Water is thrown up as soon as it becomes warm in stomach, throwing ingesta by mouthfuls, post-operative vomiting. Food scarcely swallowed comes up again. Bad effects of eating too much salt. Pain in stomach relieved by cold food and ice.
  • Veratrum album. Thirst for cold water, but it is vomited as soon as swallowed. Copious vomiting and nausea aggravated by drinking and least motion. Anguish in pit of stomach. Craving for fruit, juicy, and cold things — ice and salt. Averse to warm food.

It is imperative that individuals and/or patients take the appropriate homeopathic remedy, along with other suitable measures, as may be prescribed by a professional homeopathic physician. Self-treatment is not recommended.

Dr NARAYAN C DESHPANDE, BSc, MD [Hom], was formerly Officiating Professor & HOD, A H Medical College, Bengaluru, Professor Emeritus, and former in-charge Principal, Government Homeopathic Medical College & Hospital, Bengaluru, former PG Guide, Rajiv Gandhi University of Health Sciences, Karnataka, former PG Examiner, Mangalore University, MGR University of Health Sciences, Chennai, Health University, Salem, and former Health Expert, Karnataka Public Service Commission, Bengaluru. A recipient of the prestigious Nadaprabhu Kempegowda Award for his 35+ years of commendable service to homeopathic education and alternative healthcare, Dr Deshpande lives in Bengaluru, India.

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