Regurgitation vs. Vomiting Flashcards
What things in history would indicate regurgitation?
Passive event, no abdominal effort, undigested food, Possibly painful, No prodromal nausea, May be hypersalivating, dysphagia, nasal discharge. Related to eating food.
What things in the history would indicate vomiting?
Abdominal effort, prodromal nausea, usually digested food, no swallowing pain, may be not related to eating.
What are the three most common causes of regurgitation?
Mega-oesophagus, Oesophagitis, Oesophageal foreign body.
What are the common causes of mega-oesophagus?
Idiopathic, Myasthenia gravis, thymoma, hypoadrenocorticism.
What can cause oesophagitis?
Chemical injury, gastrooeoesphageal reflux (esp. in anaesthesia), Oesophageal FB (EMERGENCY!)
How should oesophagitis be treated?
Remove FB if there is one, small meals with high protein and low fat, Sulcralfate ‘bandage’, Inhibit gastric secretion (proton pump inhibitor)
How should an oesophageal FB be diagnosed? Where are the most common place for things to lodge?
Needs endoscopy and is an EMERGENCY! Most common places to lodge are the thoracic inlet, base of heart and hiatus.
How should regurgitation be investigated?
Usually using diagnostic imaging - plain/contrast radiographs. May use lung auscultation to check for aspiration pneumonia.
How should causes of vomiting be refined? What categories can it be put into?
Primary GI or secondary GI.
Chronic (>2-3 weeks) or acute (just primary GI)
Can you think of any primary GI causes that are would cause acute vomiting?
Dietary (intolerance etc), Infection (parvo), Obstruction (Neoplasia, FB), Motility disorders.
Can you think of any primary GI causes that are would cause chronic vomiting?
Neoplasia, Inflammatory conditions (e.g. IBD, Ulceration)
Can you think of any secondary GI causes of vomiting?
Hepatic disease, Addisons disease, Drugs, Pancreatitis, Toxins.
How should vomiting be investigated to reach a diagnosis?
Blood work (haem/biochem) to identify organ disease, Urinalysis (evaluate kidney), Imaging (radiographs -obstruction, US), Endoscopy
How would you treat chronic and acute vomiting?
Chronic - treat underlying cause.
Acute - fasting, treat symptomatically.
If you diagnosed a dog with mega-oesophagus, how would you treat? What would you suggest to the owner?
Treat any underlying disease, suggest elevated food/water, hold vertical after feeding, experiment with food consistency (liquid slides easier but may aspirate, solid harder to swallow but harder to inhale)
