Nausea and Vomiting Related to Non-esophageal and Non-Gastric Diseases of the Gastrointestinal Tract

We describe a case of intestinal obstruction caused by a small bowel adenocarcinoma misdiagnosed as psychogenic disorder. A woman in her 40s was admitted to Nagoya City University Hospital with fatigue, anorexia, nausea and vomiting. CT, oesophagogastroduodenoscopy and colonoscopy revealed no signs of organic abnormality in her gastrointestinal tract. As the patient had previously been diagnosed with and treated for depression, her symptoms were suspected to be due to psychogenic disorder. Therefore, she was diagnosed with severe depression and was administered antidepressant agents. Despite intense psychiatric treatment, her symptoms worsened and she was later diagnosed with ileus due to adenocarcinoma in the jejunum. After drainage by insertion of a transnasal decompression tube, a partial jejunum resection was performed. After the resection, the patient’s symptoms including fatigue and depression resolved without the use of antidepressant agents.

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Nausea and vomiting

10.1093/med/9780198821328.003.0053 ◽

2021 ◽

pp. 534-544

Author(s):

Saskie Dorman

Keyword(s):

Palliative Care ◽

Social Interaction ◽

Gastrointestinal Tract ◽

Area Postrema ◽

Nausea And Vomiting ◽

Psychological State ◽

Solitary Tract ◽

Hyoscine Hydrobromide ◽

Neurokinin Antagonists ◽

Metabolic Treatment

Nausea and vomiting are common, distressing symptoms, with significant impacts on physical functioning, psychological state, and social interaction. There are numerous causes including gastrointestinal, metabolic, treatment-related, vestibular, cranial, and psychological causes. Vomiting is mediated through pathways involving the nucleus of the solitary tract in the brainstem, with inputs from the gastrointestinal tract, viscera, vestibular system, area postrema, and higher centres. Nausea involves more complex connections between gut and brain. The roles of non-pharmacological strategies and medications (including levomepromazine, olanzapine, haloperidol, metoclopramide, domperidone, hyoscine hydrobromide, serotonin (5-HT3) antagonists, neurokinin antagonists, and others) are discussed. Emerging evidence in palliative care will facilitate optimum treatment.

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Early oral protein-containing diets following elective lower gastrointestinal tract surgery in adults: A meta-analysis of randomized clinical trials.

10.21203/rs.3.rs-29449/v2 ◽

2021 ◽

Author(s):

Hong PU ◽

Philippa T. Heighes ◽

Fiona Simpson ◽

Yaoli WANG ◽

Zeping LIANG ◽

...

Keyword(s):

Clinical Trials ◽

Gastrointestinal Tract ◽

Postoperative Complications ◽

Postoperative Nausea ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Postoperative Nausea And Vomiting ◽

Surgical Site Infections ◽

Nausea And Vomiting ◽

Lower Gastrointestinal Tract

Abstract Background: Although current guidelines make consensus recommendations for the early resumption of oral intake after surgery, a recent comprehensive meta-analysis failed to identify any patient-centred benefits. We hypothesized this finding was attributable to pooling studies providing effective protein-containing diets with ineffective non-protein liquid diets. Therefore, the aim of this paper was to investigate the safety and efficacy of early oral protein-containing diets versus later (traditional) feeding after elective lower gastrointestinal tract surgery in adults.Methods: PubMed, Embase and the China National Knowledge Infrastructure databases were searched from inception until 1 August 2019. Reference lists of retrieved studies were hand searched to identify randomized clinical trials reporting mortality. No language restrictions were applied. Study selection, risk of bias appraisal and data abstraction were undertaken independently by two authors. Disagreements were settled by obtaining an opinion of a third author. Majority decisions prevailed. After assessment of underlying assumptions, a fixed-effects method was used for analysis. The primary outcome was mortality. Secondary outcomes included surgical site infections, postoperative nausea and vomiting, serious postoperative complications and other key measures of safety and efficacy.Results: Eight randomized clinical trials recruiting 657 patients were included. Compared with later (traditional) feeding, commencing an early oral protein-containing diet resulted in a statistically significant reduction in mortality (Odds Ratio [OR] 0.31, P=0.02, I2=0%). An early oral protein-containing diet also significantly reduced surgical site infections (OR 0.39, P=0.002, I2=32%), postoperative nausea and vomiting (OR 0.62, P=0.04, I2=37%), serious postoperative complications (OR 0.60, P=0.01, I2=25%) and significantly improved other major outcomes. No harms attributable to an early oral protein-containing diet were identified.Conclusions: The results of this systematic review can be used to upgrade current guideline statements to a Grade A recommendation supporting an oral protein-containing diet commenced before the end of postoperative day 1 after elective lower gastrointestinal surgery in adults.

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Neutropenia induced by paraquat poisoning

Human & Experimental Toxicology ◽

10.1191/096032701718620891 ◽

2001 ◽

Vol 20 (11) ◽

pp. 597-599 ◽

Cited By ~ 2

Author(s):

N Papanikolaou ◽

G Paspatis ◽

A Dermitzakis ◽

E Tzortzakakis ◽

E Charalambous ◽

...

Keyword(s):

Case Report ◽

Gastrointestinal Tract ◽

Nausea And Vomiting ◽

Agricultural Area ◽

Paraquat Poisoning ◽

Life Threatening ◽

Wine Glass ◽

Kidney Liver

Paraquat is a synthetic, nonselective, contact herbicide, which causes injury to tissues following contact. When ingested in sufficient amounts, paraquat has life-threatening effects on the gastrointestinal tract, lungs, kidney, liver, heart and other organs. This is a case report of a 15-year-old girl from an agricultural area who was admitted to hospital for treatment. She presented with dis comfort, nausea and vomiting. She had drunk a small wine glass full of paraquat. After 18 days in the hospital, the girl developed neutropenia. This is the first reported case of paraquat poisoning-induced neutropenia.

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Habitat Association of Klebsiella Species

Infection Control ◽

10.1017/s0195941700062603 ◽

1985 ◽

Vol 6 (2) ◽

pp. 52-58 ◽

Cited By ~ 111

Author(s):

Susan T. Bagley

Keyword(s):

Drinking Water ◽

Gastrointestinal Tract ◽

Surface Waters ◽

Industrial Effluents ◽

Opportunistic Pathogen ◽

Habitat Associations ◽

Habitat Association ◽

Klebsiella Species ◽

Almost All ◽

Polluted Waters

AbstractThe genus Klebsiella is seemingly ubiquitous in terms of its habitat associations. Klebsiella is a common opportunistic pathogen for humans and other animals, as well as being resident or transient flora (particularly in the gastrointestinal tract). Other habitats include sewage, drinking water, soils, surface waters, industrial effluents, and vegetation. Until recently, almost all these Klebsiella have been identified as one species, ie, K. pneumoniae. However, phenotypic and genotypic studies have shown that “K. pneumoniae” actually consists of at least four species, all with distinct characteristics and habitats. General habitat associations of Klebsiella species are as follows: K. pneumoniae—humans, animals, sewage, and polluted waters and soils; K. oxytoca—frequent association with most habitats; K. terrigena— unpolluted surface waters and soils, drinking water, and vegetation; K. planticola—sewage, polluted surface waters, soils, and vegetation; and K. ozaenae/K. rhinoscleromatis—infrequently detected (primarily with humans).

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