In our previous discussions about the digestive system and how it works, we talked about what happens right from the mouth through the esophagus to the stomach and beyond that, into the small intestine and the large intestine until the waste is passed out through the anus. If any problem develops anywhere along this long journey, the intestines or the body as a whole can respond with feelings of nausea. The usual symptoms will typically develop inside the stomach or in the upper abdominal area because that is where the bulk of the digestion takes place. Sometimes, the strong reaction provoked through any of the processes is enough to cause a forceful emptying of the stomach which is known as vomiting. In certain cases, the nature of the problem causing this disturbance can be identified by the colour of the vomit.

A bright yellow vomit indicates that there is a problem somewhere in the small intestine while a dark-green vomit would point towards a problem in the duodenum; the first part of the small intestine. When the vomit is dark with small particles that resemble coffee grains, it is clear that the vomit is mixed with some blood, whereas, if it looks dull brown and smells a lot, the inference would be that it has come all the way from the large intestine. These often help to direct the attending doctors towards the point of interest with regards to each patient. This kind of information is crucial in helping to formulate an action plan for the management of each condition right from what type of investigations to carry out and how to treat the condition. Those investigations will, in turn, help determine if a case can be treated with the imposition of some rest on the stomach by stopping all kinds of feeding and drinking, or if it will require the administration of antibiotics or if the patient should be prepared for the necessary operation. It is the ability to deduce where such a problem lies and what has caused it that helps formulate an action plan to help deal with it. But this essay is about nausea and not vomiting, so we will do well to focus on that for the purpose of this article so that we avoid any confusion as well.

One common mechanism that brings nausea is intolerance to certain food items which would indicate that the body has some difficulty with digesting such food. Eating or drinking that kind of food will often cause nausea within a few hours of consuming them and some of these foods contain lactose, such as milk and other dairy products. Others are food items that cause intestinal gas to build up such as beans and cabbage. The other factor pertains to food allergies which can present with nausea as one of the symptoms. This is due to the presence of certain proteins in that food which the body incorrectly identifies as a threat thus setting off an immune response. Such nausea can be caused within a few minutes of consuming the food. This is typically accompanied by other symptoms such as swelling of the lips or face, severe itching or difficulties with breathing or swallowing. These are dire emergencies and would be fatal without immediate medical attention. Another common cause of nausea is in the early stages of pregnancy, when the sight of food, odours of any kind and eating of most kinds of food would cause nausea especially in the mornings. While the precise mechanisms of these changes are not known, it is speculated to be due to the raised hormone levels which cause changes to the digestive system. An elevated sense of smell due to some of these changes could then make nausea worse.

Food contamination leading to food poisoning is another combination that often causes nausea. When food is not properly cooked or is stored inappropriately, such food could be contaminated by bacteria, and this can induce feelings of nausea within a few hours of eating. Occasionally, such food contamination is caused by viruses and such viral infections of the intestinal tract often cause symptoms called stomach flu. One prominent feature of this diagnosis is nausea. This happens because these viruses are highly contagious, and like the bacteria would cause inflammation of the lining of the stomach and intestines. Such inflammation will often lead to the development of nausea, chills, fever, abdominal cramps, diarrhoea and vomiting. Besides, when a part of the intestinal system is no longer functioning properly, nausea can be the result. Such a circumstance is seen in gastroesophageal reflux disease. In this condition, the ring of muscle at the lower end of the esophagus, between it and the stomach, becomes unduly lax so that the acid contents of the stomach escape upwards into the esophagus. The results are heartburn as this sensation occurs almost throughout the length of the esophagus and would also lead to nausea.

Lastly, during the digestion of fat, bile plays a prominent role. If bile flow is interrupted in the presence of consuming a meal high in fat, there is a failure of fat digestion and nausea can result. In some cases, the development of nausea after eating could be a warning sign of an impending heart attack; we have also previously discussed this fact. Migraine can also cause nausea after eating, and can also be associated with intense stomach pain, nausea and vomiting. Other causes of nausea would be such things as motion sickness which would be a factor in the road, water or air travel. Usually, such events are aggravated by eating or drinking and the addition of any kind of mechanized movement would compound all the issues. Certain medications could also be responsible for causing nausea such as antibiotics like metronidazole, popularly known as Flagyl, which people use or rather, abuse for all sorts of intestinal ailments. The same is true of cancer treatment medicines. But among these, the most curious cause of nausea is found in people who suffer from anorexia nervosa where eating is often accompanied by feelings of guilt leading sometimes to nausea and vomiting. Together with bulimia, anxiety, and depression, this condition commonly afflicts young women and girls and can be difficult to treat because of its mostly psychological basis.

Questions and answers

Dear doctor, compliments of the season to you. I need your candid opinion, please. I am 66 years old and have been having erectile dysfunction. So, can I use those Zee Virtual products that they used to advertise in the Sunday PUNCH? Do you think they are good for me? I have tried some other drugs, but they tend to make my blood pressure go up among other things. Also, in an attempt to control the high blood pressure, I use amlodipine but that usually results in further erectile dysfunction. On the whole, what do I have to do? Is there any drug(s) that can balance both situations? 0803xxxxxxx

The advice that is appropriate is that you do not attempt to use any more medications until you have seen the physician who is managing your high blood pressure and received further advice about your erectile dysfunction from a urologist. As we do not have the benefit of your medical history other than what you have divulged here, that would be the best course of action. Do not engage in self-medication, please.

Dear doctor, I am thanking you for your insightful and well-educative articles. May the Lord continue to bless and prosper you. Amen. I would like to refer you to your article on low back pain 1 & 2 in the October edition of your column. I have been experiencing low back pain since Friday, December 23, 2022, which has made it impossible for me to stand up properly, pray, bend down or even sit down. And my hospital will not attend to me until my appointment day which is the end of next month. Please I would like you to proffer a possible solution for me before my next appointment to ease the pain. Thank you. Kind regards. This email address is being protected from spambots. You need JavaScript enabled to view it. 

Thank you very much for your kind words and prayers. They are appreciated greatly. But which kind of hospital is that which gives you such a long appointment for severe pain such as yours? The back pain you have is of a recent onset according to the history you gave above and so you should be given an earlier appointment or in the alternative, present in the emergency room of that hospital since you can barely move about on your own. Something must have provoked it and so the first place to start with the management is to carefully control your movements and use simple medications such as paracetamol or ibuprofen for pain relief. Both of those medicines can even be combined for quicker relief. Heat massage to the painful area can also be helpful.

Dear doctor, recently, my wife has been complaining of dull pain in her lower abdomen and we went to do a scan at a private setting in the Oshodi area of Lagos. The report of the scan said moderate fluid collection in the POD. A suspected case of PID. HVS for m/c/s advised. What is the meaning of all these terms and what should we do now? Thank you. This email address is being protected from spambots. You need JavaScript enabled to view it.

You should have taken your wife to see a doctor for a proper examination before you invested money in an abdominal ultrasound. You would then simply have taken this report back to the doctor for interpretation and treatment. However, POD refers to a certain pocket between the uterus and the rectum in the female and is known as the Pouch of Douglas. Fluids can collect there for certain reasons, including infections. PID means Pelvic Inflammatory Disease which we have discussed before on this page. HVS means High Vaginal Swab which the sonologist is now recommending as a further test that needs to be carried out and it means microscopy, culture and sensitivity (m/c/s) or less formally, simply known as a swab for culture. When you have done this, the organism responsible for this infection will be isolated and the antibiotics effective against such organisms will be made clear.

Dear doctor, recently, I suffered severe chest pain that came on suddenly in the early evening. I am 30 years old and work in a microfinance bank in Benin City, Edo State and have also struggled recently with a host of marital problems. The pain was so sharp and piercing that I was afraid I was going to die. What could have caused this kind of thing? 0703xxxxxxx

Sudden onset of acute anxiety and panic attacks can lead to feelings such as these and you would do yourself a ton of good if you took some time off work to just relax. However, it is also possible that there is an underlying heart problem such as angina, though an unlikely problem at your age. On the whole, it is useful to consider visiting a hospital for a proper examination of your chest so that X-rays can be requested and an ECG (electrocardiogram) as well.

Dear doctor, I have a 10-day-old baby delivered through caesarean section and during routine screening, before we were discharged home, I was told that my baby has G6PD deficiency. I am not clear with the explanation the doctors gave me. What does it mean to have this condition? Thank you, sir. 0803xxxxxxx

G6PD is an inherited condition that indicates that a certain enzyme called Glucose-6-Phosphate Dehydrogenase is lacking in the body. What this means is that the enzyme that is so named is not available in sufficient concentration to ensure that your baby’s red blood cells work properly. As a result of this, the red blood cells can get destroyed faster than they can be replaced. Certain types of medications and even foods are, therefore, discouraged from being used by such people. Your baby, for example, will need to avoid the use of sulphur-containing drugs and avoid any contact with camphor. The same is true for certain types of food like lentils and certain types of beans. If they are exposed to any of these products, the consequences would be haemolytic anaemia and in severe situations, jaundice would develop. Other than that, most people with this condition live normal lives.

Dear doctor, thank you for the good work you are doing for the populace. We appreciate you. God will bless you very much. Amen. My question is this: why do doctors not advise patients in hopeless situations that their condition is hopeless, and they should go back home instead of wasting money on treatment that will not change anything? Thank you. 0803xxxxxxx

Thank you very much for your prayers. You have asked a profound question. The problem in our society is that many people refuse to accept the inevitability of death. They are usually informed when there is nothing further the hospital can do. Such information is diplomatically delivered to avoid emotional scenes occurring. Many times, even when the facts are laid bare before relatives, they fail to understand what is being communicated. In the end, they do not only leave their loved ones in the hospital preferring to spend their money but would also bring in the faith healers to do what they believe will turn the health status around. When relatives are told that “we will do our best, but you go and pray,” they are being informed that medically no further hope exists.

Dear doctor, please what is the best treatment for diarrhoea, especially the type that happens after eating party food? Thank you, sir. 0805xxxxxxx

Thank you for your question. Many people use many different things to treat diarrhoea but in truth, many cases do not even require treatment as such being that they are described as self-limiting in that position. The meaning, therefore, is that such an episode of diarrhoea will ultimately stop on its own without the use of antibiotics or active treatment. Rehydration with fluids and replacement of the lost salts, even with salt and sugar will suffice during that period. Therefore, the treatment of diarrhoea depends on the cause and antibiotics should only be used if it is likely to be the result of an infection.

source: healthwise.punchng.com