NAUSEA

NAUSEA - a kind of painful feeling in the pit of the stomach, breast, oral cavity, often precedes vomiting and is often accompanied by general weakness, sweating, hypersalivation, cold extremities, pale skin, decreased blood pressure.

Nausea is observed in many disease states, including at various intoxications, diseases of internal organs, central nervous system dysfunction of the vestibular system (motor nausea), metabolic disorders. It also happens when psychogenic nausea unpleasant visual and olfactory sensations in excitable individuals, sometimes as a manifestation of neurosis, psychosis.

Pathogenesis of nausea associated with the excitation of the emetic center, still insufficient for the formation of the act of vomiting, but accompanied anastaltic contractions of the stomach, which is associated with a feeling of nausea. At the heart of nausea reflex is irritation of the vagus nerve impulses to mechanical or chemical irritants receptors different reflex zones. Such receptors contain the back of the throat, the tongue, the gastrointestinal tract, liver, biliary tract and bladder, pancreas, serous membranes (peritoneum, pleura, pericardium), bronchus, kidney, uterus with appendages. Gastric Nausea is the most common and often occurs when the weakening of gastric acid secretion, gastric motility and tone; occurs after meals and is often associated with its nature (fatty foods, alcohol, and so on. n.).

Toxic nausea, occurred when poisoning, infections and intoxications, caused by the excitation of the chemoreceptor trigger zone in the area of ​​the bottom of the IV ventricle, which activate the vomiting center. Last is also activated during the vestibular apparatus overstimulation of receptors (during rocking, rotating on a carousel, diseases of the inner ear, Meniere's disease). The origin of the brain nausea are the most important increase in intracranial pressure due to cerebral edema or violation liquorodynamics when tumors, traumatic brain injury, an inflammation of the meninges. Metabolic nausea (with hypovitaminosis, iron deficiency anemia , endocrine and other diseases) is not uniform on the pathogenesis and depends on the nature of the effects of disturbed metabolism in the various organs with the activation of the vomiting center in some cases, reflexively, and in others - or a combination of toxic effects.

Being a non-specific symptom of many diseases, nausea, has diagnostic value only in conjunction with other signs of the disease (eg, signs of peritoneal irritation in acute appendicitis). Determine the specificity is connected with certain sickness provoking its factors (eating, changing body position, and so on. D.). Clinical anamnesis thus collected as well as during vomiting. If the patient complains only of nausea that occurs, for example, daily, other symptoms of the disease should be identified through active interrogation of the patient followed by a focused survey. Thus, the detection of the accompanying nausea other dyspeptic complaints (belching, a feeling of heaviness in the epigastric region, and others.) And nausea due to food intake should be suspected of the digestive system diseases (gastritis, cholecystitis , pancreatitis , gastric tumor, and so on. D.) And carry Gastroenterological inspection; with a combination of nausea with headache, sensitivity disorders or motions necessary neurological examination, and so on. d.

Symptomatic treatment is necessary when pronounced in patients with acute developing pathological conditions (often with vestibular dysfunction) and in cases where the treatment of the underlying disease inefficiently. Severe central effect is neuroleptics, especially thiethylperazine (torekan), which is administered at a dose of 6.5 - 13 mg (1 - 2 mL) intramuscularly and etaperazin. Close to them on the mechanism of action of metoclopramide (Raglan, Reglan) and sulpiride (eglonil dogma). The drug of choice is the Aeron used 1 tablet sublingually (up to 3 times a day). Sometimes nausea reflex relieves validol (menthol), benzocaine in small doses.