Nausea & Vomiting
Nausea is the sensation or feeling that one needs to vomit or that vomiting is about to occur. Vomiting is the organized sequence of events that leads to the rapid expulsion of the stomach contents through the mouth.
All children experience some nausea or vomiting in childhood. Persistent nausea and vomiting can lead to complications such as failure to thrive and poor weight gain.
SSM Health Cardinal Glennon Children’s Hospital has a nationally recognized gastroenterology program that offers expert, specialized care to treat frequent nausea and/or vomiting.
The treatment of nausea and vomiting varies according to the cause of the symptoms, from adjusting the diet for a few days to allow transient conditions to resolve. Making sure your child drinks small volumes of clear liquids often to counter the effects of dehydration.
However, if these conditions persist for several days or there are signs of dehydration such as decreased urination, irritability, dry eyes, and mouth. It’s time to see the doctor. Severe dehydration might have to be treated with intravenous (IV) fluids. There also are medications that can relieve nausea.
Other complications of persistent vomiting include injury to the stomach and esophagus (the tube connecting the mouth to the stomach), leading to bleeding or perforation. These will require urgent evaluation.
Chronic Conditions & Vomiting
Chronic conditions cause frequent vomiting and require specialized treatment. These treatments may include medication, permanent changes in diet or even surgery.
Some of these chronic conditions include:
Causes intense, unremitting episodes of nausea and vomiting that last from hours to days. The symptoms are almost identical each time they happen and can happen at set intervals. In between episodes, the child returns to normal.
Symptoms often begin when a child feels dizzy or nauseated. It then progresses to gagging and vomiting. CVS has multiple triggers, including infections, stress, fatigue, certain odors.
Treatment is divided into two stages, prophylaxis which involves avoiding triggers and giving a medication every day to decrease the frequency of the attacks. Abortive therapy, which aims to stop the attacks, consists of giving fluids and medication that reduces nausea. There is a close association with migraines, and treatments for migraines are often beneficial for patients with CVS.
A chronic disease of the esophagus that leads to inflammation within the esophagus; EoE can make eating and swallowing difficult. Infants and toddlers who have this disease often refuse to eat or drink, which may cause failure to thrive.
Older children may experience vomiting or recurrent bouts of reflux or abdominal pain in addition to swallowing difficulties. If inflammation is severe, the esophagus may narrow, increasing the risk that food will become stuck along the digestive tract. If this occurs, call 9-1-1 immediately.
The cause is not well-known. Allergies are thought to play an important role. Children diagnosed with EoE often have food or environmental allergies. Treatment for the disease includes identification and avoidance of allergic foods and medications aimed at reducing inflammation. If narrowing occurs, a minimally invasive procedure called esophageal dilation also might be recommended to expand the narrowed section of the esophagus.
Gastroparesis is a rare disorder that delays the movement of muscles of the stomach. When this happens, the stomach is essentially paralyzed, and food can’t move out of the stomach. It may be caused by viral infections, medical conditions like diabetes, medications, or injury to the nerves of the abdomen during surgery.
Gastroparesis can cause not only nausea and vomiting but also abdominal pain and bloating. A critical issue is when food remains in the stomach for long periods of time. It can develop into a solid mass called a bezoar, cause bacterial infection. Other complications include dehydration, malnutrition, and poor blood sugar control.
Gastroparesis can be detected in SSM Health Cardinal Glennon’s Pediatric Neuro-gastroenterology and Motility Center, where specialists diagnose and treat the disease. There is no cure for the disease, but doctors can help control symptoms with various medications and antibiotics.
Rumination syndrome is another rare disorder that causes regurgitation- the passage of stomach contents into the mouth and esophagus; these contents are then spat out or re-swallowed. It is a chronic motility disorder that affects infants, children, and adults. Although there is no single cause for rumination syndrome, this disorder is more common in children with specific conditions such as anxiety, eating disorders, and developmental problems. The hallmark symptom is the regurgitation and re-swallowing of food, but other symptoms include nausea, weight loss. Treatment options are focused on behavioral treatment.