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Panic Attacks

We all know the feeling of being stressed and anxious. Our heart beats fast whenever a big presentation or a tough exam is approaching. Some get butterflies in their tummy whenever they see their crushes or when they're in love. We are so much concerned about family and school problems or we feel nervous at the idea of asking our boss for an increase in salary.

However, if worries and doubts are preventing and prohibiting you from possessing a life free of stress, you may be suffering from anxiety disorder and might experience panic attacks symptoms.

The good news is that, there are lots of self-help methods that you could work out with to overcome anxiety disorders as well as cut down symptoms of panic attacks and settle your life the way you want it to be.


What is Anxiety

Before you are able to address your panic attacks symptoms, it's important to know what an anxiety is. It's normal to feel frightened, nervous, or to worry much when you're under pressure or facing a very stressful situation. Actually, anxiety is the usual reaction of our body to danger it's an automated alarm that naturally goes off when we're threatened.

Though anxiety could be disagreeable, it's not often a bad thing. As a matter of fact, anxiety can help us keep concentrated and aware, prompts us to act, and motivates us to find solutions to our problems. However, when anxiety becomes overwhelming or stable, it can intervene with your usual activities - this is the moment when you have already overpowered, the usual anxiety to anxiety disorders.

How would you know that you're experiencing anxiety disorders?

The greatest way to find out if you have this disorder is to verify if you're experiencing symptoms of panic attacks. Such as:

Symptoms of Physical Anxiety Panic Attacks

Muscle tension, Sweating, Diarrhea and urinating frequently , Throbbing heart , Twitches and tremors, shortness of breath or dyspnea, Fatigue, Headaches, Insomnia, Lightheadedness or upset belly

Symptoms of Emotional Anxiety Panic Attacks

Feeling of dread or nervousness, feeling agitated and stress, duduk perkara in focusing, irritability, anticipating the most horrible, restlessness, looking for uncommon signs of danger, and incapability to focus or concentrate.

Treatment for Panic Attacks Symptoms

Panic Attacks Symptoms

Not everybody who is stressed and worried a lot is suffering anxiety disorder. You can feel worried since you lack sleep or exercise, you are very busy and you have no time to for yourself any longer, you're stressed at home works, or possibly because you had drink too much coffee.

The point here is that, when you possess unhealthy and stressful way of life, you are more apt to feel worried, in spite of whether or not you're suffering from the disorder. Therefore take a moment to evaluate how well you are taking care of yourself.

1. Do you get both the emotional and physical support you require?
2. Are you freely asking for support and help once you need it?
3. Are you offering yourself a few moment to unwind and have fun?
4. Are you overloaded with responsibilities or work?
5. Do you offer enough care to yourself?

Wound

A wound occurs when the integrity of any tissue is compromised, for example, when skin breaks, muscle tears, burns, or bone fractures. A wound may be caused by an act, such as a gunshot, fall, or surgical procedure; by an infectious disease; or by an underlying condition.

Description

Types and causes of wounds are wide ranging, and health care professionals have several different ways of classifying them. They may be chronic, such as the skin ulcers caused by diabetes mellitus, or acute, such as a gunshot wound or animal bite.

Wounds may also be referred to as open, in which the skin has been compromised and underlying tissues are exposed, or closed, in which the skin has not been compromised, but syok to underlying structures has occurred, such as a bruised rib or cerebral contusion.

Emergency personnel and first-aid workers generally place acute wounds in one of eight categories:

• Abrasions. Also called scrapes, they occur when the skin is rubbed away by friction against another rough surface (e.g. rope burns and skinned knees).
• Avulsions. These occur when an entire structure or part of it is forcibly pulled away, such as the loss of a permanent tooth or an ear lobe. Explosions, gunshots, and animal bites may cause avulsions.
• Contusions. Also called bruises, these result from forceful syok that injures an internal structure without breaking the skin. Blows to the chest, abdomen, or head with a blunt instrument (e.g. a football or a fist) can cause contusions.
• Crush wounds occur when a heavy object falls onto a person, splitting the skin and shattering or tearing underlying structures.
• Cuts are slicing wounds made with a sharp instrument, leaving even edges. They may be as minimal as a paper cut or as significant as a surgical incision.
• Lacerations. Also called tears, these are separating wounds that produce ragged edges. They are produced by a tremendous force against the body, either from an internal source as in childbirth, or from an external source like a punch.
• Missile wounds. Also called velocity wounds, they are caused by an object entering the body at a high speed, typically a bullet.
• Punctures are deep, narrow wounds produced by sharp objects such as nails, knives, and broken glass.

Causes and symptoms

Acute wounds have a wide range of causes. Often, they are the unintentional results of motor vehicle accidents, falls, mishandling of sharp objects, or sports-related injury. Wounds may also be the intentional result of violence involving assault with weapons, including fists, knives, or guns.

The general symptoms of a wound are localized pain and bleeding. Specific symptoms include:

• An abrasion usually appears as lines of scraped skin with tiny spots of bleeding.
• An avulsion has heavy, rapid bleeding and a noticeable absence of tissue.
• A contusion may appear as a bruise beneath the skin or may appear only on imaging tests; an internal wound may also generate symptoms such as weakness, perspiration, and pain.
• A crush wound may have irregular margins like a laceration; however, the wound will be deeper and syok to muscle and bone may be apparent.
• A cut may have little or profuse bleeding depending on its depth and length; its even edges readily line up.
• A laceration too may have little or profuse bleeding; the tissue damage is generally greater and the wound’s ragged edges do not readily line up.
• A missile entry wound may be accompanied by an exit wound, and bleeding may be profuse, depending on the nature of the injury.
• A puncture wound will be greater than its length, therefore there is usually little bleeding around the outside of the wound and more bleeding inside, causing discoloration.

Diagnosis

A diagnosis is made by visual examination and may be confirmed by a report of the causal events. Medical personnel will also assess the extent of the wound and what effect it has had on the patient’s well-being (e.g. profound blood loss, damage to the nervous system or skeletal system).

In cases of severe injury, or when a physician suspects possible internal injury, tests might be made to determine the extent of a wound. In late 2001, a new ultrasound (imaging inside the body via sound waves) technique was introduced that might help doctors diagnose internal bleeding, a serious complication of some injuries. The technique could help prevent invasive surgery for diagnosis.

Treatment

Treatment of wounds involves stopping any bleeding, then cleaning and dressing the wound to prevent infection. Additional medical attention may be required if the effects of the wound have compromised the body’s ability to function effectively.

Stopping the bleeding

Most bleeding may be stopped by direct pressure. Direct pressure is applied by placing a clean cloth or dressing over the wound and pressing the palm of the hand over the entire area. This limits local bleeding without disrupting a significant portion of the circulation. The cloth absorbs blood and allows clot formation; the clot should not be disturbed, so if blood soaks through the cloth, another cloth should be placed directly on top rather than replacing the original cloth.

If the wound is on an arm or leg that does not appear to have a broken bone, the wound should be elevated to a height above the person’s heart while direct pressure is applied. Elevating the wound allows gravity to slow down the flow of blood to that area.

If severe bleeding cannot be stopped by direct pressure or with elevation, the next step is to apply pressure to the major artery supplying blood to the area of the wound.

In the arm, pressure would be applied to the brachial artery by pressing the inside of the upper arm against the bone. In the leg, pressure would be applied to the femoral artery by pressing on the inner crease of the groin against the pelvic bone.

If the bleeding from an arm or leg is so extreme as to be life-threatening and if it cannot be stopped by any other means, a tourniquet—a device used to check or prevent bleeding or blood flow—may be required. However, in the process of limiting further blood loss, the tourniquet also drastically deprives the limb tissues of oxygen. As a result, the patient may live but the limb may die.

Dressing the wound

Once the bleeding has been stopped, cleaning and dressing the wound is important for preventing infection. Although the flowing blood flushes debris from the wound, running water should also be used to rinse away dirt. Embedded particles such as wood slivers and glass splinters, if not too deep, may be removed with a needle or pair of tweezers that has been sterilized in rubbing alcohol or in the heat of a flame.

Once the wound has been cleared of foreign material and washed, it should be gently blotted dry, with care not to disturb the blood clot. An antibiotic ointment may be applied. The wound should then be covered with a clean dressing and bandaged to hold the dressing in place.

Homeopathic remedies

In addition to the conventional treatments described above, there are alternative therapies that may help support the injured person. Homeopathy can be very effective in acute wound situations. Ledum (Ledum palustre) is recommended for puncture wounds (taken internally). Calendula (Calendula officinalis) is the primary homeopathic remedy for wounds.

Other effective treatments

A naturally occurring antiseptic is tea tree oil (Melaleuca spp.), which can be mixed with water for cleaning wounds. Aloe (Aloe barbadensis) can be applied topically to soothe skin during healing.

When wounds affect the nerves, especially in the arms and legs, St. John’s wort (Hypericum perforatum) can be helpful when taken internally or applied topically. Also, an important Chinese herb preparation called Yunnan Bai Yao, which includes the main herbal ingredient san chi, is used very effectively to stop bleeding, and promote healing for all sorts of wounds.

Other herbal remedies include Hypericum for nerve pain, and arnica for soft tissue damage. Acupuncture can help support the healing process by restoring the energy flow in the meridians that have been affected by the wound. In some cases, vitamin E taken orally or applied topically can speed healing and lessen scarring.

Allopathic treatment

A person who has become impaled on a fixed object, such as a fence post or a stake in the ground, should only be moved by emergency medical personnel. Foreign objects embedded in the eye should only be removed by a doctor. Larger penetrating objects, such as a fishhook or an arrow, should only be removed by a doctor to prevent further damage as they exit.

Additional medical attention is necessary in several instances. Wounds that penetrate the muscle beneath the skin should be cleaned and treated by a doctor. Such a wound may require stitches to keep it closed during healing.

Some deep wounds, which do not extend to the underlying muscle may only require butterfly bandages to keep them closed during healing. Wounds to the face and neck, even small ones, should always be examined and treated by a doctor to preserve sensory function and minimize scarring.

Deep wounds to the hands and wrists should be examined for nerve and tendon damage. Puncture wounds may require a tetanus shot to prevent serious infection. Animal bites should always be examined and the possibility of rabies infection determined.

Infection

Wounds that develop signs of infection should also be brought to a doctor’s attention. Signs of infection are swelling, redness, tenderness, throbbing pain, localized warmth, fever, swollen lymph glands, the presence of pus either in the wound or draining from it, and red streaks spreading away from the wound.

Emergency treatment

With even as little as one quart of blood lost, a person may lose consciousness and go into traumatic shock. Because this is life-threatening, emergency medical assistance should be called immediately.

If the person stops breathing, artificial respiration (also called mouth-to-mouth resuscitation or rescue breathing) should be administered. In the absence of a pulse, cardiopulmonary resuscitation (CPR) must be performed. Once the person is breathing unassisted, the bleeding may be attended to.

In cases of severe blood loss, medical treatment may include the intravenous replacement of body fluids. This may be infusion with saline or plasma, or a transfusion of whole blood.

Expected results

Without the complication of infection, most wounds heal well with time. Depending on the depth and size of the wound, it may or may not leave a visible scar.

Prevention

Most actions that result in wounds are preventable. Injuries from motor vehicle accidents may be reduced by wearing seat belts and placing children in size-appropriate car seats in the back seat.

Sharp, jagged, or pointed objects or machinery parts should be used according to the manufacturer’s instructions and only for their intended purpose, as well as educating children on the proper way to hold and handle them, or keeping them out from their reach.

Firearms and explosives should be used only by adults with explicit training; they should also be kept locked and away from children. Persons engaging in sports, games, and recreational activities should wear all proper protective equipment and follow safety rules.

Wheezing

Wheezing is a high-pitched whistling sound associated with labored breathing.

Wheezing occurs when a person tries to breathe deeply through air passages (bronchia) that are narrowed because of muscle contractions or filled with mucus as a result of: allergy, infection, illness, or irritation. Wheezing is experienced by 10-15% of the population.

Wheezing most commonly occurs when a person is exhaling. It is sometimes accompanied by a mild sensation of tightness in the chest. Anxiety about not being able to breathe easily can cause muscle tension that makes the wheezing worse.


Causes and symptoms

Wheezing is the symptom most associated with asthma. It can be aggravated by dry air and high altitude. A 2001 study also found a connection between nighttime wheezing/asthma and gastroesophageal reflux, or the flow of stomach acid backward into the lower part of the esophagus.

Wheezing can be caused by:

• exposure to allergens (food, pollen, and other substances that cause a person to have an allergic reaction)
• fumes
• ice-cold drinks, or very cold air
• medication
• strenuous exercise
• weather changes
• foreign objects trapped in the airway
• cystic fibrosis and other genetic disorders
• respiratory illnesses like pneumonia, bronchitis, congestive heart failure, and emphysema

The symptoms of wheezing are: labored breathing, whistling sound upon breathing, shortness of breath, and a tight or heavy feeling in the chest.

Medical emergencies

Breathing problems can be life-threatening. Immediate medical attention is required whenever a person:

• turns blue or gray and stops breathing
• becomes extremely short of breath, and is unable to speak
• coughs up bubbly pink or white phlegm
• seems to be suffocating
• develops a fever of 101°F (38.3°C) or higher
• wheezes most of the time, and coughs up gray or greenish phlegm

Diagnosis

A family physician, allergist, or pulmonary specialist takes a medical history that includes questions about allergies, or unexplained symptoms that may be the result of allergic reactions. If the pattern of the patient’s symptoms suggests the existence of allergy, skin and blood tests are performed to identify the precise nature of the problem.

A pulmonary function test may be ordered to measure the amount of air moving through the patient’s breathing passages. X rays are sometimes indicated for patients whose wheezing seems to be caused by chronic bronchitis or emphysema.

Treatment

Patients whose wheezing is related to asthma, chronic bronchitis, emphysema, or a severe allergic reaction may benefit from alternative medicine but they must continue to have their condition monitored by a conventional physician.

Mild wheezing may be relieved by drinking plenty of juice, water, weak tea, and broth. This helps to replace fluids lost because of rapid breathing and loosen mucus in the air passages. Ice-cold drinks should be avoided.

A vaporizer can help clear air passages. A steam tent, created by lowering the face toward a sink filled with hot water, placing a towel over the head and sink, and inhaling the steam, can do likewise.

Herbal remedies

Several herbal remedies exist for the treatment of wheezing and asthma.

• Baical skullcap (Scutellaria baicalensis) decoction relieves wheezing.
• Coltsfoot tea may relieve wheezing.
• Cramp bark (Viburnum opulus) tincture eases breathing.
• Elecampane (Inula helenium) can help to clear mucus.
• Garlic (Allium sativum) can ease asthma symptoms.
• German chamomile (Chamomilla recutita) infusion can relieve wheezing.
• Ginkgo (Ginkgo biloba) eases asthma symptoms.
• Marsh mallow (Althaea officinalis) root eases asthma symptoms.
• Mullein (Verbascum thapsus) tea in a vaporizer relieves wheezing.
• Nettle (Urtica dioca) infusion relieves wheezing.
• Passionflower (Passiflora incarnata) relaxes muscle spasms leading to a reduction in wheezing.
• Thyme (Thymus vulgaris) infusion relieves wheezing.

Ayurvedic treatment

Wheezing can be alleviated by drinking licorice tea. The tea is prepared by steeping one teaspoon of licorice (Yashti madbu) root in one cup of water, adding 5-10 drops of mahanarayan oil just before drinking.

The patient should take one sip every 5-10 minutes. A remedy for breathlessness is a mixture of onion juice (one quarter cup), black pepper (0.125 tsp), and honey (1 tsp).

Mustard seeds have bronchial system healing properties. Brown mustard oil may be massaged onto the chest. A mustard tea (one quarter teaspoon each ground mustard seed and pippali or black pepper) with honey may be drunk two or three times daily or sipped throughout the day. Another mustard remedy is taking brown mustard oil (1 tsp) with natural sugar (1 tsp) two or three times daily.

Homeopathy

Homeopathic remedies are chosen for each patient based on his or her pattern of symptoms. Arsenicum is indicated for patients who experience restlessness, fearfulness, wheezing, and shortness of breath between the hours of midnight and 3 A.M.

Spongia is recommended for those who have dry wheezing, which may occur as the patient is falling asleep, a feeling of suffocation, and a dry cough. Lobelia is for patients with chest tightness and wheezing that is worsened in cold air.

Sambucus is indicated for persons whose wheezing is worsened after midnight, but who don’t experience the fear or restlessness experienced by an arsenicum patient. Pulsatilla is recommended for those who are affectionate, and feel stifled in warm rooms.

Ipecac is for patients who have a lot of phlegm in the lungs (wheezing is accompanied by rattling sounds in the chest), coughing, and possibly vomiting. Bryonia is for patients with dry wheezing, who feel warm and thirsty, and whose symptoms are worsened by motion.


Other remedies

Other treatments for wheezing include:

• Aromatherapy. The essential oils of lavender, eucalyptus, and rosemary can relieve congestion. Adding German chamomile essential oil to a vaporizer can relieve wheezing.
• Diet. Eliminating red meat, and wheat and dairy products and following a macrobiotic diet of vegetarian foods may relieve asthma symptoms.
• Relaxation techniques. Because anxiety can worsen an asthma attack, and therefore wheezing, meditation, biofeedback, deep breathing, or other stress-reduction methods may help promote relaxation.
• Supplements. Magnesium may help to prevent bronchial spasms. The frequency of asthma attacks may be reduced by taking vitamin C and the B complex vitamins.
• Yoga. Certain yoga positions (Bridge, Cobra, Pigeon, and Sphinx) may relieve wheezing by improving breathing control and reducing stress.

Allopathic treatment

Bronchodilators (medications that help widen narrowed airways) may be prescribed for patients whose wheezing is the result of asthma. Antibiotics are generally used to cure acute bronchitis and other respiratory infections.

Expectorants (cough-producing medications) or bronchodilators are prescribed to remove excess mucus from the breathing passages. If wheezing is caused by an allergic reaction, antihistamines will probably be prescribed to neutralize body chemicals that react to the allergen.

A new type of drug was being tested in late 2001 that blocks immunoglobulin E (IgE), an antibody produced in excessive levels in patients with hay fever. The drug also appears to prevent asthma in patients with chronic hay fever. The drug, called omalizumab, is the first in a new line of drugs expected to appear in the next few years.

If wheezing and asthma symptoms worsen in the nighttime, diagnosis and treatment of possible acid reflux in the stomach might ease symptoms.

Expected results

Mild wheezing caused by infection or acute illness usually disappears when the underlying cause is eliminated.

Some doctors believe that childhood respiratory infections may activate parts of the immune system that prevent asthma from developing.

Prevention

Stopping smoking can eliminate wheezing; so can reducing or preventing exposure to allergens or conditions that cause wheezing.

A person prone to wheezing should wear a scarf or surgical mask over the nose and mouth during physical exertion outdoors during cold weather. Likewise, wearing a surgical mask outdoors during the allergy season is helpful for persons whose wheezing is triggered by allergies.

Licorice root tea may prevent asthma (wheezing) attacks. Ayurvedic herbal remedies to prevent asthma symptoms include:

• cinnamon (1 tsp) and trikatu (0.25 tsp) tea with honey twice daily
• licorice and ginger (0.25 tsp each) tea
• bay leaf (0.5 tsp) and pippali (0.25 tsp) mixed in honey taken two or three times daily
• sitopaladi (0.5 tsp), punarnova (0.5 tsp), pippali (pinch), and abrak bhasma (pinch) mixed with honey taken once daily
• spinach juice (0.125 cup) and pippali (pinch) taken twice daily

Vomiting

Vomiting is the forceful discharge of stomach contents through the mouth.

Vomiting, also called emesis, is a symptomatic response to any number of harmful triggers. Vomiting is a forceful expulsion, and is different from regurgitation — the effortless return of stomach contents to the mouth. Although unpleasant, vomiting is an important function because it rids the body of harmful substances.

Vomiting is a complex process resulting from the coordinated interaction of nerve pathways, the brain, and muscles of the gastrointestinal system. The primary vomiting trigger point in the brain is called the area postrema.


This structure is exposed to chemicals in the bloodstream and the cerebrospinal fluid (the fluid found in the brain and spinal cord). Scientific studies have shown that stimulation of the area postrema by a wide variety of drugs as well as bacterial toxins, radiation, and physiologic conditions, induces vomiting.

Certain nerve pathways (called afferent neural pathways) induce vomiting when triggered by motion, ear infections or tumors, Ménière’s disease (a disease characterized by recurrent vertigo), odors, visual stimulation, pain, and bad tastes.

Still other nerve pathways (peripheral afferent neural pathways) induce vomiting in response to stomach irritants, distension of the intestines and bile ducts, abdominal inflammation, and myocardial infarction (heart attack).

The physical act of vomiting is controlled by multiple sites of the brain stem. When activated, these structures send signals to the throat, diaphragm, and abdominal muscles.

These signals result in the simultaneous contraction of these muscles, which brings the stomach contents up through the esophagus (the tube between the stomach and the throat) and out the mouth.

During vomiting, breathing is inhibited, except for short breaths between discharges. Bradycardia (decrease in the heart rate) and changes in blood pressure may occur during retching and vomiting.

Causes and symptoms

Vomiting can be caused by many different things. Vomiting that lasts only one or two days is usually caused by infection, a reaction to medication, a toxin, uremia (accumulation of protein breakdown products in the bloodstream), and diabetic ketoacidosis (accumulation of toxins resulting from uncontrolled diabetes).

Vomiting that lasts longer than one week can be caused by a long-term medical or psychiatric condition. Causes of vomiting include:

• Medications. Drugs are the most common cause of vomiting, especially during the first days of use. Drugs can induce vomiting by stimulation of the area postrema or by direct stimulation of peripheral nerve pathways. Medications that commonly cause vomiting include cancer drugs, pain relievers (especially opioids), heart medications, diuretics, hormones, antibiotics, antiasthmatics, gastrointestinal drugs, and medications that act on the brain.
• Infections. Infections of the gastrointestinal system or whole body can cause vomiting. Gastrointestinal infections are more common in infants, toddlers, and young adults (20–29 years old) who usually get 1.2 infections each year. Infections that can cause vomiting include bacterial, viral, and parasitic gastrointestinal infections, severe acute respiratory syndrome (SARS), otitis media (ear infection), meningitis (infection of the membrane that surrounds the brain and spinal cord), and hepatitis (infection of the liver).
• Gastrointestinal and abdominal disorders. Disorders of the gastrointestinal system that can produce vomiting include blockage of the stomach or small intestine, motility disorders (muscles in the esophagus become discoordinated or weak, causing difficulty swallowing, regurgitation, and sometimes pain), indigestion, radiation therapy-induced changes, Crohn’s disease (chronic recurrent inflammation of the intestines), peptic ulcer, worm infestations, or inflammation of the appendix, gall bladder, or pancreas.
• Nervous system disorders. Cancers, infarction (an area of dead tissue caused by an obstruction in the artery supplying the area), bleeding (hemorrhage), birth defects, ear disorders, motion sickness, weightlessness, ear tumors, Ménière’s disease, unpleasant memories, psychogenic (caused by mental factors) issues, and bad tastes or smells can all cause vomiting.
• Hormones and physiological conditions. Hormonal and metabolic (physical and chemical processes of the body) conditions that can cause vomiting include: parathyroidism, diabetic ketoacidosis, hyperthyroidism (condition caused by excessive ingestion or production of thyroid hormone), Addison’s disease, uremia, and pregnancy. Pregnancy is the most common cause of vomiting associated with the hormonal system. Vomiting associated with pregnancy is often called morning sickness.
• Postoperation. Anesthesia and pain medications can cause nausea and vomiting, which are complications associated with 17–39% of surgeries.
• Cyclic vomiting syndrome (CVS). This rare disorder occurs in children usually beginning at age five years, although it also occurs in adults. It is characterized by, on average, eight attacks of vomiting lasting for 20 hours each year. Although the exact cause is unknown, there seems to be a relationship between cyclic vomiting and migraine headaches.
• Poisons. Arsenic and other heavy metals, weed killers and household cleaning agents, and many other substances may cause vomiting if inhaled or swallowed.
• Miscellaneous causes. Excessive alcohol consumption causes vomiting by acting both on the gastrointestinal tract and the brain.

Nausea is often associated with vomiting. Vomiting may be preceded by retching, in which the muscles contract as for vomiting but without the discharge of stomach contents.

The patient may hyperventilate (breathe rapidly and deeply) and salivate before vomiting begins. Patients should consult a physician immediately if there is blood in the vomitus (expelled stomach contents).

Other symptoms associated with vomiting depend upon the cause. Gastrointestinal infection would also cause fever, muscle pain, and diarrhea.

Patients with peptic ulcer, intestinal blockage, cholecystitis or pancreatitis (inflammation of the gall bladder or pancreas) would experience abdominal pain. Meningitis symptoms include neck stiffness, headache, vision changes, and changes in mental processes.

Diagnosis

Vomiting may be diagnosed by an internal medicine specialist or a gastroenterologist. A detailed medical history will be taken and will include specifics about the vomiting including frequency, a description of the vomitus, duration, how soon after meals vomiting occurs, and any other symptoms.

The history alone can help the physician to narrow down the cause to a few choices. The patient’s abdomen will be palpated (felt with the hands) to detect any abnormalities. Vital signs will be taken to identify any abnormalities in heart rate, blood pressure, or temperature.

Although the medical history and physical exam is usually sufficient to determine the cause of vomiting, certain laboratory tests may also be performed.

Blood tests may be performed to check for dehydration (decreased water), anemia (decreased number of red blood cells or iron-poor blood), and electrolyte (blood chemicals) imbalances, as well as specific tests to confirm the suspected diagnosis.

In some cases, more advanced testing may be required. These include x rays, endoscopy (a thin, wandlike camera used to visualize internal organs), magnetic resonance imaging (MRI), ultrasound (using sound waves to visualize internal organs), and computed tomography (CT) scanning. In addition, there are tests that measure stomach emptying and the pressure and motility of the stomach and intestine.

Treatment

Alternative treatments can be effective in treating vomiting, but not the underlying cause. A physician should be consulted if vomiting is recurrent and/or lasts for more than a few days.

Dietary changes

The best dietary approach is to eat foods that can be quickly cleared from the stomach. Foods that are high in fat are slow to digest and place the patient at risk for additional vomiting.

Ingestion of a low-fat, predominately liquid diet taken in frequent small meals can help relieve vomiting. Dry soda crackers are a good choice when nausea sets in. After vomiting, the patient should not eat for one hour, after which small servings of broth, bread, or flat soda may be taken.

It is important to replenish the fluids lost by vomiting. Juice therapists recommend drinking a juice made from fresh ginger, apples, and carrots. Supplementation with vitamin B6 was found to reduce the symptoms of morning sickness in pregnant women.

Herbals

The herbs that are effective in relieving nausea and vomiting include:

• apple tree (Pyrus malus) bark tea
• bergamot (Monarda citriodora) tea
• black horehound (Ballota nigra) infusion
• codonopsis (Codonopsis pilosula) decoction
• galangal (Alpinia officinarum) infusion
• ginger (Zingiber officinale) infusion or crystallized
• lemongrass (Cymbogen citratus) oil or tea
• nutmeg (Myristica fragrans) capsules
• turmeric (Curcuma longa) infusion

Chinese medicine

Practitioners of traditional Chinese medicine use acupuncture, ear acupuncture, herbals, and patent medicines in the treatment of vomiting.

The following herbals may be made into soups, which are sipped frequently: Lu Gen (Rhizoma phragmitis); Zhu Ru (Caulis bambusae in taeniis), Bai Mao Gen (Rhizoma imperatae), and Pi Pa Ye (Folium eriobotryae); and Huo Xiang (Herba agastachis) and Pei Lan (Herba eupatorii).

Placing a drop of Sheng Jiang (Rhizoma zingiberis recens) on the tongue can check vomiting. Patent medicines used to treat vomiting include: Huo Xiang Zheng Qi Wan (Agastache Pill to Rectify Qi),Yu Shu Dan (Jade Pivot Pill), Zuo Jin Wan (Left Metal Pill), and Bao He Wan (Preserve Harmony Pill).

Homeopathy

Homeopathic remedies are chosen based upon the specific set of symptoms displayed by the patient. Ipecac is chosen for strong nausea and vomiting. Bismuth or Phosphorous is indicated when vomiting is caused primarily by liquids.

Nux vomica is recommended when vomiting is caused by emotional stress and for patients with heartburn, nausea, and retching. Tabacum is indicated for vomiting caused by motion. Veratrum album is indicated for the patient with nausea, vomiting, and diarrhea.

Arsenicum is recommended for the patient with violent vomiting, diarrhea, abdominal pain, exhaustion, restlessness, and thirst. Bryonia is recommended for gastroenteritis (inflammation of the lining of the gastrointestinal system).

Ayurveda

Ayurvedic practitioners believe that vomiting is caused by high pitta in the stomach. Remedies for vomiting are:

• yogurt containing cardamon and honey
• warm milk containing cardamon and nutmeg
• tea prepared from cumin seeds and nutmeg
• fresh pineapple juice (1 cup with a pinch of ginger and black pepper and 0.5 tsp sugar) three times during a day of fasting
• water containing 10 drops lime juice, 0.5 tsp sugar, and 0.25 tsp baking soda
• cardamon seeds (chewed)
• ginger juice and onion juice (1 tsp each)
• water containing rose petal powder (0.5 tsp), sandalwood powder (0.25 tsp), rock candy powder (0.5 tsp), and lime juice (10 drops)

Other treatments

Various other treatments for vomiting include:

• Aromatherapy. The essential oil of peppermint is a traditional cure for vomiting.
• Acupressure. The acupressure points P5 and P6 located on the inner forearms are effective in treating vomiting. A wristband (Sea-Band) has been proven to be effective in reducing nausea and vomiting.
• Acupuncture. A National Institutes of Health consensus panel found that acupuncture is an effective treatment for chemotherapy and postoperative vomiting. A few people, however, experience nausea as a side effect of acupuncture.
• Behavioral interventions. Behavioral therapies such as desensitization, distraction, imagery, relaxation, and self-hypnosis have been shown to be effective in treating chemotherapy-induced vomiting.
• Hydrotherapy. Stomach upsets may be treated by drinking a glass of water containing activated charcoal powder.
• Reflexology. The reflex points solar plexus, chest, lung, diaphragm, esophagus, liver, stomach, gallbladder and thyroid, and pituitary and adrenal gland on the feet may help treat vomiting.
• Transcutaneous electrical nerve stimulation (TENS, which is a treatment where a mild electrical current is passed through electrodes on the skin to stimulate nerves and block pain signals). TENS can be effective in reducing postoperative vomiting.

Allopathic treatment

Treatment of vomiting depends upon the cause and severity but may include dietary changes, medications, and surgery. Replacement of lost fluids is an important component of treatment.

Hospitalization may be required in some cases. Surgery may be needed to treat inflammatory conditions (such as cholecystitis) and physical abnormalities (such as blockage).

Medications used to treat vomiting are called antiemetics. Scopolamine, dimenhydrinate (Dramamine), and hyoscine are used to treat motion sickness; promethazine (Mepergan, Phenergan) is used to treat postoperative nausea; meclizine (Antivert, Bonine) is used to treat inner ear inflammation; and prochlorperazine (Compazine) is used for gastroenteritis, postoperative toxins, radiation, medications, and other causes of vomiting. Other medications that target the underlying cause of the vomiting may be used.

Newer drugs that have been developed to treat postoperative or postchemotherapy nausea and vomiting include ondansetron (Zofran) and granisetron (Kytril). Another treatment that has been found to lower the risk of nausea after surgery is intravenous administration of supplemental fluid before the operation.

Expected results

Most cases of vomiting resolve spontaneously. Complications of vomiting include dehydration, malnutrition, weight loss, and abnormalities of blood chemicals (including electrolytes, pH, and potassium). Vomiting by unconscious patients can lead to aspiration (inhalation of stomach contents), which can affect the lungs.

Prevention

Antiemetic drugs are effective at preventing vomiting. Some alternative treatments are effective at reducing nausea, which may prevent vomiting.