A Visit From Ralph

As many of you know, I spent two days sick this week with a stomach virus.  I hope never to be so sick again!

Hanging out on the couch gave me a lot of opportunity to think, and I decided to write about, um, “plumbing issues.”  There are lots of ways your internal intestinal plumbing can go awry, but vomiting is probably the most uncomfortable problem.

The GI tract itself can have motility issues for many reasons.  The most common reason is probably the one I had:  an intestinal infection, either viral or bacterial.  Rotavirus, Norovirus (the Cruise Ship Virus), Adenovirus, several causes of food poisoning and the C. diff bacterial infection all can cause vomiting with or without diarrhea.

Gastrointestinal reflux (called reflux or GERD) is a disorder where acidic stomach contents splash up into the esophagus.  This can cause nausea and vomiting as well as sore throats, a bitter taste in the mouth, bad breath, and asthma flares.

The bowels themselves can get blocked for many reasons.  Those who have had surgery in the abdomen can get scar tissue called adhesions that can crimp off the bowel, particularly the small intestine, and cause an obstruction.  More serious bowel obstructions can be caused by tumors, and severe constipation can block the intestines too.

After surgery, anesthesia and pain medication can make the bowel “go to sleep,” a condition called an ileus, which causes nausea and vomiting.  Other conditions like pancreatitis, appendicitis and kidney infections can cause an ileus too.

Vomiting can be caused by toxins as well.  Anybody who has had a hangover knows what that feels like 🙂  Alcohol is metabolized by the liver to byproducts that cause headache, diarrhea, nausea and vomiting.  Many medications have side effects of nausea and vomiting.  Some illnesses such as hepatitis and kidney disease can cause nausea and vomiting by promoting the buildup of toxic substances in the body.  Drug withdrawal (especially from narcotic pain medication) can do it too.

Problems in the nervous system also cause nausea and vomiting.  The most common is motion sickness!  This happens when the brain is getting conflicting signals from the ears and the eyes.  The resulting confusion is expressed as nausea and can be fixed if addressed promptly by making sure the brain gets signals that make sense.  If you’re on a boat or in a car or plane, look out at the horizon so your eyes can see that you’re moving.  The nausea should subside.  Vertigo is similar in that usually one inner ear goes wonky (because of a fluid imbalance or infection) and gives the brain signals that differ from those of the other inner ear.  This causes the sensation of movement, nausea and (if severe) vomiting.

More rare but more sinister causes of nausea and vomiting include brain tumors and meningitis.  They are usually accompanied by other symptoms such as headache, fever, vision changes, and trouble with balance.

This is by no means an exhaustive list of all the causes of nausea and vomiting, and I’m pretty confident I know what caused my recent run-in with them, but I figured I’d put all my time scowling at my stomach to good use and share my thoughts with you.

PS – I’ll be glad to get back to normal this week, get back to work and stop thinking about my innards!

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