Patient's question:
Expert, hello! My baby is four and a half months old. These days, he vomits after eating milk. Could you please help me figure out what the reason is? Thank you! Additional question: It's mainly spitting up, accompanied by nausea. Please reply!Doctor's answer:
Hello: Vomiting is one of the common symptoms in children. It can be caused by digestive system diseases or seen in various diseases of the entire body and its organs. It can be a single symptom or one of the complex symptoms of multiple serious diseases. What causes vomiting in children? (1) Digestive system diseases. 1. Congenital. 2. Acquired. 3. Infectious. (2) Extra-gastrointestinal diseases. 1. Intracranial diseases: various meningitis, encephalitis, brain abscess, brain tumors, cerebral edema, brain trauma, intracranial hemorrhage, kernicterus, etc. 2. Respiratory diseases: upper respiratory infection, pharyngitis, tonsillitis, bronchitis, pneumonia, etc. 3. Cardiovascular and renal diseases: myocarditis, pericarditis, heart failure, renal hypertensive encephalopathy, pyelonephritis, pyelocaliectasis, urinary tract stones, renal insufficiency, etc. 4. Endocrine and metabolic diseases: adrenal cortical insufficiency, hyperparathyroidism, metabolic acidosis, hyponatremia and hypernatremia, hypokalemia, diabetic ketoacidosis, phenylketonuria, galactosemia, etc. 5. Others. What are the symptoms of vomiting in children? Vomiting methods "① Gastroesophageal reflux. ② General vomiting: This type of vomiting is often accompanied by nausea, and the amount of vomit varies. ③ Projectile vomiting. Vomiting accompanied by fever, headache, and positive neurological signs suggests intracranial infection. Vomiting accompanied by fever, nausea, and upper abdominal discomfort should be noted for viral hepatitis. Vomiting accompanied by fever, abdominal pain, and diarrhea should be considered for gastrointestinal infection. Vomiting accompanied by bloody stools may be due to dysentery, intussusception, necrotizing enteritis, Meckel's diverticulitis, or allergic purpura. What tests are needed for vomiting in children? On the basis of a comprehensive physical examination, special attention should be paid to abdominal signs and neurological examination, and fundus examination and digital rectal examination may be performed if necessary. Auxiliary tests 1. Stool and urine routine tests and other examinations. 2. X-ray examination, CT or MRI. How to treat it (1) Etiological treatment. (2) Symptomatic treatment. 1. Severe vomiting requires fasting for 4 hours. Except for gastric perforation, normal saline or 1-2% sodium bicarbonate solution can be used for gastric lavage. Pay attention to lateral decubitus to prevent vomit from being aspirated into the trachea. 2. After vomiting stops or decreases, small amounts of thick, warm, easily digestible food or liquid diets such as rice soup can be given. 3. For dehydration or electrolyte disorders, fluid and electrolytes should be supplemented promptly as needed. If there is peripheral circulatory failure, it should be treated according to circulatory failure. 4. Frequent vomiting requires antiemetics and sedatives, such as luminal, somnolent, and domperidone suppositories, etc. Metoclopramide should be used with caution. 5. Spasmolytic drugs, such as belladonna mixture, atropine, 654-2, propantheline, and 1-2% procaine (1-2ml/age/time) can also be selected according to the condition. But note that improper use can mask symptoms and hinder diagnosis. 6. For intracranial hypertension and cerebral edema, dehydrating agents such as mannitol and hypertonic glucose solution can be used for treatment. 7. Acupuncture often selects acupoints such as Neiguan, Zhongwan, and Zusanli.