TOC  | D-Dx    

Nausea and Vomiting Differential  -  Outlines in Clinical Medicine on Physicians' Online 2001

Types of Disease : Normal gastric emptying & Abnormal gastric emptying

A. Normal Gastric Emptying

1. Food Poisoning: Staphylococcal , B. cereus Toxin , Other toxins including salmonella, clostridial
2. Gastroenteritis: Viral , Bacterial , Protozoal
3. Upper GI Bleed (usually with "coffee-ground" emesis)
4. Acid overproduction (Caffeine, NSAIDS, Gastrinoma, Zollinger-Ellisson Syndrome)
   a.Gastric Ulceration
   b.Peptic Ulcer Disease
5. Gastric insult (eg. Nasogastric tube)
6. Upper GI obstruction (Small Bowel Obstruction)
7. Proximal Lower GI obstruction, especially with incompetent ileocecal valve
8. Esophageal abnormalities (such as Zenker's Diverticulum, achalasia)
9. Vascular (Migraine)
10. CNS: Increased ICP: a. Infection   b.Trauma   c.Mass: tumor, abscess, cyst
11. Psychological: a.Anorexia   b.Bulimia   c.Obsessive-Compulsive Disorder

B. Abnormal Gastric Emptying

1. Pancreatitis
2. Pregnancy (Morning Sickness)
3. Ruptured Ectopic Pregnancy
4. Diabetes and Diabetic Ketoacidosis
5. Drug overdoses and hypersensitivity reactions
6. Emetogenic Drugs: a.Chemotherapies   b.Erythromycin (especially high doses)   c.Codeine and other opiates
7. Serious Infections: a.Sepsis   b.Pyelonephritis
8. Scleroderma
9. Neuropathies

C. Congenital Malformations

1. Pyloric Stenosis
2. Intestinal Atresia
3. Sliding Hernia (Hiatal)
4. Intussusception

04182001