Intractable vomiting is repeated vomiting that resists treatment, with causes including pregnancy, hormonal imbalances, infections, and brain injury. Treatment involves supportive care, medication, and surgery, with risks including dehydration and hiatal hernia. Cyclic vomiting syndrome is a condition where patients have periodic episodes of persistent vomiting.
Intractable vomiting is repeated vomiting that resists medical treatment. People can develop this symptom for a variety of reasons, and treatment focuses on providing supportive care to keep the patient as comfortable as possible until the cause can be resolved. There are some risks associated with intractable vomiting, including dehydration and the possibility of a hiatal hernia, where part of the stomach slips through the diaphragm and into the upper chest. Treatment of intractable vomiting can be supervised by a general practitioner or specialist, depending on the cause.
In people with intractable vomiting, repeated bouts of vomiting occur and may be accompanied by loss of appetite, headache, nausea without vomiting, and general discomfort. Vomiting does not resolve and antiemetic drugs may not suppress it. Patients may also feel weak or lightheaded from straining associated with vomiting and may develop complications such as sore throat and tooth damage.
Pregnancy can sometimes cause intractable vomiting, as can some hormonal imbalances. Other causes include certain infections, pyloric obstruction, brain injury, and drug reactions. When a patient has intractable vomiting, a doctor may need to conduct some tests to determine the cause in order to provide the most appropriate treatment. Treatments may include surgery and medications. Because prolonged intractable vomiting can make the patient weak, there may be greater risks with surgical procedures, and the patient should be monitored closely during surgery for signs of complications.
People who have repeatedly vomited over the course of several days are at risk of dehydration due to fluid loss. A doctor can provide intravenous fluids to the patient and may recommend taking clear, bland liquids. Patients will also be checked for other signs of complications and additional supportive care may be provided to address these issues. Care can be provided in a hospital setting during episodes of acute vomiting, with the patient returning home once stabilised.
In a condition known as cyclic vomiting syndrome that usually begins in childhood, patients have periodic episodes of repeated persistent vomiting that can last for hours, days, or weeks. Sometimes there is a clear trigger and in other cases there is no known cause. Between episodes, the patient may be quite healthy and active. This condition sometimes resolves as people enter adulthood, while in other cases, episodes of cyclic vomiting can continue and can become disabling as the patient may have to skip work and make lifestyle changes to manage the vomiting .
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