This document discusses nausea and vomiting. It defines nausea as an unpleasant feeling of sickness or urge to vomit, while vomiting is the forceful expulsion of stomach contents through the mouth. It describes the phases and causes of vomiting, including psychological, metabolic, drug-related and alimentary factors. Diagnosis involves physical exams and tests of the blood, electrolytes and organs. Management focuses on correcting fluid and electrolyte imbalances, reducing discomfort, and restoring balance through fasting, diet, acupuncture, aromatherapy, massage, hydrotherapy, mud therapy and yoga.

1. NAUSEA AND
VOMITING
By:- Anupma kumari

2. INTRODUCTION
 NAUSEA
It is an unpleasant sensation of feeling sick or
an uneasiness of stomach which presents as feeling or
urge to vomit.
 VOMITING
It is an uncontrollable reflex that expels the
stomach contents through mouth or forcing the contents
of the stomach up through the oesophagus and out of
the mouth.
it is the combined effect of both somatic and
autonomic neural pathway.

3. INTRODUCTION
 Synchronus contraction of the diaphragm
,intercoastal muscle and abdominal muscle raises
intraabdominal pressure combined with relaxation
of the lower oesophageal sphincter results in
forcible ejection of the gastric contents.

4. VOMITING RELEX

5.  Vomiting centre-lateral reticular formation of
medulla oblongata .
 Chemoreceptor trigger zone (CTZ)-floor of fourth
ventricle ,vagal afferent of the gut.
 CTZ triggers the vomiting centre

6. PHASES OF VOMITING
 Nausea- An involuntary urge to vomit,often
associated with autonomic effect including
hypersalivation,pallor and vomiting.
 Retching(dry heaving)-An strong invulantary effort
to vomit
 Vomiting- expulsion of the gastric contents through
the stomach

7. ETIOLOGY
Psychogenic
• Raised intracranial
pressure
• Meningitis
• Middle ear disorders
Metabolic/
functional
• pregnancy
• Diabetic ketoacidosis
• Uremia
• Hypercalcaemia,
• Hyper-
parathyroidism
• Addison’s disease
• hyperthyroidism
Severe pain
• Myocardial infarction
• Renal colic
• Appendicitis
• Cholecystitits
• pancreatitis

8. ETILOGY
Drugs
• Alcohol
• Chemotherapy
• Opioids
• Theophyllin
• Antidepressant
• Anaesthesia,etc.
Psychological
• Anxiety
• Anorexia nervosa
• Bullemia nervosa
• rumination
Other
Alimentary
causes
• GERD
• Peptic ulcer
• Cancer
• Food poisoning
• Gastroenteritis
• Worm infestation

9. NAUSEA
 Intermittent nausea:
associated with early satiety and
postprandial fullness /bloating. Nausea relieved by
vomiting i.e. of small volume and is forceful.
35-45 % associated with abdominal cramps and
altered bowel movements.
 Persistent nausea:
aggravated by sight and smell of food,
unrelieved by vomiting which suggest chemical causes
,activate the CTZ .
occur in 30-40 % cases

10. NAUSEA
 Early morning nausea and vomiting:
 associated with headache.
 suggest raised intracranial pressure.
 Nausea associated with movements:
including motion sickness and vertigo which
indicates a vestibular component.
Note:-Nausea and vomiting associated with anxiety
suggesting a cortical component.

11. NATUROPATHY UNDERSTANDING OF
NAUSEA AND VOMITING
Food poisoning ,overeating medicine, etc
Accumulation of toxins
Promotes elimination through acute disease

12. NATUROPATHY UNDERSTANDING
elimination by acute disease
stimulates natural therapy suppression
health chronic disease

13. DIAGNOSIS
 Physical examination
- skin turgidity
- mucus membrane
- jaundice
- thyrotoxicosis
- lymphadenopathy
- loss of tooth enamel
- anxiety/depression
 Abdominal examination
abdominal distension with tenderness =bowel obs.
abdominal bloating = gastro-paresis
absence of bowel sounds= acute intestinal obs.

14. DIAGNOSIS
 Test :
1.CBC = for leucocytosis or inflammation
2.elecrolyte level = acidosis, alkalosis, hypokalaemia,
azotemia.
3.LFT & pancreatic enzyme = to rule out involvement of
liver and pancreas in patient with upper abdominal pain
or jaundice.
4.pregnancy test
5.protein value = malnutrition /systemic illness
6.Thyroid function test = thyrotoxicosis

15. DIAGNOSIS

16. APPROACH

17. MANAGEMENT
 AIM: correcting fluid & electrolyte imbalnce,nutritional
imbalance.
- reducing the discomfort
- restoring physiological balance.
Fasting and diet therapy:
-short term fasting
- dried ginger root powder
- tender coconut water (for electrolyte imbalance)
-smelling or sucking of lemon ,orange , cinnamon
sticks (reduce the metallic taste inside the mouth
and also reduce the heightened sense of smell)

18. MANAGEMENT
 Acupuncture and acupressure
Baihui (gv 20)
Zusanli (St 36)
Neiguan ( P 6 )
Zhongwan (CV 12 )
Zhangmen ( liv 13 )
(Acc. To clinical acupuncture by anton
jayasurya)
shousanli (LI 10 )
 Aromatherapy
essential oil of peppermint, ginger , cardamon

19. MANAGEMENT
 Massage therapy
foot massage (reduses nausea)
stimulation of reflex areas
Note:- commonly used in nausea and vomiting of
psychological origin
 Hydrotherapy
- Enema
- cold abdominal compress
- cold hip bath
- ice cold water sipping
- ice massage on P 6 area

20. MANAGEMENT
 Mud therapy
direct mud to abdomen or mud pack over
abdomen for 20 min helps in reducing acid reflux
from the stomach
 Yoga therapy
-Vaman dhouti
- Asanas – padahastasana , vajrasana , ardha-
chakrasana ,trikonasana , ushtrasana , vakrasana.
-Balancing pranayama
-Yoga nidra
-Aum chanting