Dyspepsia
Etiology
1.
Any severe
general illness.
2.
Any disease of
the stomach.
3.
Mental tension or
anxiety.
1.
Pain
·
Epigastric.
·
Its intensity is
variable.
·
It starts after
eating oily, spicy, hot food.
2.
Nausea and
vomiting: These are seen when the cause is disease of the stomach. Vomiting
relieves abdominal pain.
3.
Loss of appetite:
it is seen in a number of disorders. Long standing loss of weight are seen in
cancer of the stomach.
4.
Flatulence: It is
due to trapping of gas in the stomach and intestine. The gas is expelled as
burping and/or flatus.
5.
Constipation: It
may be seen alternating with diarrhea.
6.
Heartburn: There
is retrosternal burning sensation. It is often associated with sour
regurgitations.
7.
Water brash:
There is excessive salivation.
VOMITING
Vomiting is a symptom which can be due to a
large number of causes. Hence it is necessary to understand what causes
vomiting and how it takes place.
MECHANISM
1.
There is a
powerful contraction of the muscles of the stomach, abdomen, and diaphragm.
2.
There is sudden enlargement of the cardiac
opening at the same time.
3.
That results in
expulsion of the stomach contents.
4.
The process of
vomiting is controlled by the vomiting centre in the medulla oblongata.
AETIOLOGY
Causes of
vomiting
Cause
Examples
Local reflex *stimulation of the
pharynx or fauces by tickling with a finger.
Diseases of stomach *Gastritis.
*Pyloric stenosis.
Abdominal
colic * Renal colic
.
*Biliary colic.
*Intestinal colic.
Diseases of intestine *Intestinal obstruction.
*Paralytic ileus.
Diseases of appendix *Acute appendicitis.
Diseases of
peritoneum *Acute
peritonitis.
Drugs
*Concentrated
saline.
*Apomorphine.
*Morphine.
*Pethidine.
*Anticancer chemotherapy.
*Meningitis.
Increase
in
Intracranial
tension
*Intracranial tumours.
*Intracranial haemorrhage.
*Motion sickness.
Stimulation
of
Vestibule
of the ear
*meniere’s diseases.
CLINICAL FEATURES
1.
The vomiting is
forceful and large in diseases of stomach.
2.
Pain of peptic
ulcer is relieved by vomiting.
3.
The previous
day’s food is vomited in pyloric stenosis.
4.
The colour of
vomit is coffee ground in cancer of the stomach due to admixture with altered
blood.
5.
Haematemesis is
seen in portal hypertension due to oesophageal varices.
6.
Very forceful and
very large vomit is seen in acute dilation of the stomach.
7.
In appendicitis
the sequence of events is pain, vomiting, and fever.
8.
In intestinal
obstruction the vomiting is persistent and has faecal odour.
9.
Vomiting due to
raised intracranial tension is forceful and is associated with severe headache.
EFFECTS
1.
Excessive
vomiting is associated with loss of a lot fluid from the body, which causes
dehydration.
2.
There is loss of
acid and chlorides, which causes hypochloremic alkalosis.
3.
There may be
tetany.
4.
Excessive
dehydration may cause shock.
5.
The patient may
go into acute renal failure.
Acute Gastritis
It is a condition
characterized by an acute inflammation
of the stomach.
Aetiology
1.
Excessive
ingestion of alcohol.
2.
Excessive
ingestion of food
3.
Ingestion of
rotten meat, food, fruit.
4.
Food poisoning.
5.
Ingestion of any
poison.
6.
Drugs:
nonsteroidal anti-inflammatory drugs.
7.
Viral infection.
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