Posted on Thursday, February 1, 2007
VOMITING, REGURGITATION, AND DYSPHAGIA
Vomiting refers to a forceful ejection of gastric and occasionally proximal small intestinal contents through the mouth. The vomiting act involves three stages: nausea, retching, and vomiting. Nausea is recognized as a premonitory sign and is clinically manifested by a state of depression, salivation, licking of the lips, and increased swallowing motions. Retching is a preparatory manoeuvre during which forceful respiratory movements overcome natural anti-reflux characteristics of the abdominal oesophagus and cardia. Vomiting then occurs as the high intra-abdominal pressure expels gastric contents through a relaxed cardia. It is essential to make a clear differentiation between regurgitation and vomiting at the outset. Regurgitation is defined as passive, retrograde movement of ingested material.
CLINICAL FEATURES OF VOMITING
Vomiting may be the first indication of intestinal obstruction, renal failure, pancreatitis, addisonian crisis, drug toxicity, neoplasia, and others. A complete historical review with emphasis on all body systems is essential for determining a realistic and effective initial work-up plan and treatment protocol. All too often concentration on only the gastrointestinal tract leads to a misdiagnosis and inappropriate treatment.
Duration of Signs and Systems Review. It should be determined whether any non steroidal anti-inflammatory drugs have been used. Gastric and intestinal erosions and potentially serious ulceration may develop in conjunction with their use. Chemotherapeutic agents, erythromycin and tetracycline, and cardiac glycosides may cause vomiting. Specific information regarding diet, vaccinations, travel history, and environment is obtained in all cases.
Time Relation to Eating. Vomiting shortly after eating most commonly suggests dietary indiscretion or food intolerance, overeating, stress or excitement, gastritis, or a hiatal disorder. Vomiting of undigested or partially digested food more than 6 to 7 hours after eating usually indicates a gastric motility disorder or gastric outlet obstruction. Causes include foreign bodies, hypertrophic gastritis, pyloric mucosal hypertrophy, and antral or pyloric neoplasia or polyps.
Content of the Vomit. Bile is often present when vomiting is due to inflammatory bowel disease, bile reflux syndromes, idiopathic or secondary gastric hypomotility, intestinal foreign bodies, and pancreatitis. Large clots of blood or "coffee grounds" usually indicate a significant degree of erosion or ulceration. A faecal odour suggests intestinal obstruction.
Intermittent Chronic Vomiting. The clinician should strongly consider chronic gastritis, inflammatory bowel disease, irritable bowel syndrome, and gastric motility disorders as leading differential diagnoses. It is a common clinical sign of inflammatory bowel disease in both dogs and cats.
The mucous membranes are evaluated for evidence of blood loss, dehydration, sepsis, shock, and jaundice. An oral examination may reveal a foreign body that may extend to the stomach or intestine. The cervical region should be palpated for thyroid nodules. A careful assessment is made for abdominal pain, either generalized or more localized. Other factors to evaluate include abnormal organ size, small or large kidneys, presence of a mass, degree of gastric distension, and altered bowel sounds. Bowel sounds are often absent in peritonitis and increased in acute inflammatory disorders. A rectal examination is always done to evaluate mucosal texture, stool characteristics, melena, foreign material and to obtain a fresh sample for parasite examination.
These OESOPHAGUS REFLUX ARE SUGGESTED TREATMENTS for Canines.
AN # 189 OESOPHAGUS REFLUX Set 2 $77.00
1. Reflux heal (liquid medicine given on top of head)
2. Scar Tissue Heal
Both natural remedies will assist in healing, with either scar tissue or lacerations (acute/chronic). Stops reflux, oesophagus spasms or stricture.
This remedy will assist healing quickly and surgery is not necessary at all. Liquid diet is also suggested while starting off.
Full instructions and further advice will be given.