Vomiting in a child without fever and without diarrhea
Vomiting in a child without fever and diarrhea occurs quite often. Naturally, this condition causes serious concern for parents, since they often cannot find an explanation for what is happening. Vomiting for no apparent reason can occur in both toddlers and older children.
It should be noted that this condition does not always characterize any serious illness or disorder in the child's body. However, only a doctor can determine this.
The absence of temperature in a child against the background of vomiting should not lull the parents' vigilance. After all, nausea and vomiting are not signs of health, and normally they do not occur. It is worth remembering that vomiting in itself is not a disease - it is always a symptom. Therefore, every adult should be guided by what can provoke a similar condition in a child.
Content:
- Causes of vomiting without fever and diarrhea
- Vomiting without fever and diarrhea: what to do?
- How to treat vomiting in a child without fever?
Causes of vomiting without fever and diarrhea
The reasons for vomiting without fever and diarrhea in a child may be as follows:
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Gastroesophageal reflux. This condition is a reverse reflux of gastric contents into the esophagus. In this case, the vomit will not be abundant, often a sour smell comes from them. Vomiting will be repeated after each meal. Reflux is accompanied by the following symptoms: the child is restless, does not gain weight well, often hiccups, and suffocation attacks are possible. Also for children with gastroesophageal reflux salivation and morning cough are characteristic. If the pathology is not eliminated in time, then heartburn, belching, bouts of shortness of breath, night snoring, dysphagia will join in the future, tooth enamel will suffer.
Parents should remember that reflux is a normal physiological phenomenon in children under three months old and is often accompanied by vomiting and regurgitation. This is due to the underdevelopment of the distal esophagus and the small volume of the stomach. Over time, regurgitation will occur less and less, and then should stop altogether.
Nevertheless, gastroesophageal reflux can be the cause of serious pathologies, including: failure of the gastroesophageal junction, stomach diseases, inability of the esophagus to cleanse itself.
- Pylorospasm or pyloric spasm. Pylorospasm is a disease that makes itself felt with spasm of the pyloric stomach, which leads to problems with its emptying. As a result, the child periodically vomits. It is not abundant and is observed from the first days of life. It has been established that girls are more likely to suffer from the disease. With pylorospasm, children gain weight worse, are more restless, and problems with stool are rare.
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Pyloric stenosis. Pyloric stenosis is a condition that refers to congenital malformations of the muscle layer of the stomach and manifests itself in profuse vomiting. It occurs 20 minutes after feeding the baby. Vomit is free of impurities and consists of undigested breast milk. Manifests a pathological condition as early as 2-3 days of a baby's life. As with pylorospasm, female infants are more likely to suffer from pyloric stenosis. In addition to vomiting, there is a sinking fontanelle and weight loss, which is very dangerous for infants.
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Intestinal intussusception. Intestinal intussusception is a variant of intestinal obstruction and consists in the introduction of a section of the intestine into the lumen of a nearby segment. The disease occurs in 90% of cases in infants, it is detected mainly at 5-7 months, although it can develop in older children. Most often, male infants suffer from intestinal intussusception.
The causes of intestinal intussusception are past viral intestinal infections (most often rotavirus and adenovirus infections), hereditary predisposition, improper feeding, colitis, tumors, intestinal allergies, etc.
In addition to vomiting, this pathological condition is manifested by severe paroxysmal pain. Children draw their legs to their stomachs, cry and scream. The skin turns pale, cold sweat appears. Babies give up the nipple and breast. The attacks start and end abruptly and last about five minutes.
As for the vomit, they contain an admixture of bile. Vomiting occurs shortly after a painful attack. There is no diarrhea, but the stool may contain streaks of blood and resemble raspberry jelly in consistency.
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Alimentary gastritis. Gastritis is an inflammation of the superficial layer of the stomach. Children during an exacerbation of the disease experience severe pain in the epigastric region, nausea and vomiting, and dry mouth. The tongue is covered with a white bloom, salivation increases, belching and hiccups appear. Without vomiting and fever, alimentary gastritis occurs in children. Its causes lie in nutrition that is inappropriate for the age of the child. Most often, pathology develops when eating spicy, fried, fatty, very hot or rough food. Overeating is dangerous. As a result, food that has entered the stomach is not completely broken down and irritates the intestinal mucosa. The digestion process slows down, inflammation occurs, which provokes vomiting.
Another dangerous form of gastritis, provoking severe vomiting with blood impurities, is gastritis against the background of chemical burns (when swallowing acids, alkalis and other caustic, poisonous substances). This condition requires urgent medical attention, as it poses a direct threat to the child's life.
- Acute gastroduodenitis. Acute gastroduodenitis is an inflammation of the distal stomach and duodenum. Symptoms of the disease are similar to those of alimentary gastritis. But besides vomiting and nausea, bitter belching, headaches, and sleep disturbances are added. Body temperature usually remains normal. As for the stool, it is unstable - prolonged constipation will be replaced by diarrhea. In children with gastroduodenitis, appetite is noticeably impaired, and therefore they lose weight. It has been established that duodenitis in childhood is often accompanied by vegetative-vascular dystonia.
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Diseases of the pancreas. The most common disease of the pancreas in children that provokes severe vomiting without fever and without diarrhea is pancreatitis. The child has repeated vomiting, severe pain in the epigastric region, loss of appetite, flatulence (diarrhea does not always develop). As for body temperature, as a rule, it remains either within normal limits or rises to 37 ° C. The skin becomes paler than usual, a white coating appears on the tongue.
Separately, it should be said about the nature of vomiting in acute pancreatitis. If at first it consists of gastric contents, then subsequently the contents of the duodenum (bile) appear in the vomit. The volume of vomiting is most often significant, which threatens dehydration.
The causes of pancreatitis in childhood are manifold. Acute inflammation of the pancreas can develop when the diet is disturbed, when overeating, when carbonated drinks, fast food, spicy foods, chips, etc. are included in the menu. Pancreatitis often develops against the background of a toxic-allergic reaction. An allergen can be not only food, but also drugs. Sometimes pancreatitis is a consequence of other diseases of the gastrointestinal tract and the body as a whole.
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Diseases of the gallbladder. Biliary dyskinesia in children is the most common gallbladder pathology leading to vomiting. In addition, diseases such as cholecystitis can provoke it. Parents should take into account that pathologies such as cholangitis and gallstone disease are always accompanied by vomiting without diarrhea, but during the exacerbation stage, the child's body temperature will rise.
Vomiting in a child without fever and diarrhea For biliary dyskinesia, symptoms such as pain in the right hypochondrium, vomiting, bitterness in the mouth, nausea, loss of appetite, general weakness, headaches are characteristic. Loose stools may occur, but severe diarrhea is usually absent.
Vomiting is an indispensable companion of a disease such as cholecystitis (inflammation of the gallbladder). In addition, the child complains of decreased appetite, abdominal pain and constipation. As for body temperature, it will remain at subfebrile levels for a long time. Cholecystitis is provoked by pathogenic microorganisms (various bacteria) and parasites. Inflammation may develop against the background of existing diseases of the gastrointestinal tract (duodenitis, gastritis, appendicitis), against the background of appendicitis, scarlet fever, flu, etc. Naturally, malnutrition of the child negatively affects the state of the gallbladder.
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Diseases of the central nervous system. Diseases affecting the central nervous system are very often accompanied by persistent vomiting, which is not associated with food intake. Typically, cerebral vomiting occurs at the peak of the headache and does not bring relief to the child.
The most common diseases of the central nervous system in infancy, accompanied by vomiting, are cerebral ischemia and hydrocephalus. In children over a year old, these are brain tumors and increased intracranial pressure. With pathologies of the central nervous system, vomiting is rarely the only symptom of the disease. Most often, there are signs such as: headaches, coordination disorders, visual disturbances, dizziness. Other neurological disorders that provoke vomiting include meningitis, encephalitis, and epilepsy.
- The ingress of a foreign body into the digestive tract. Ingestion of a foreign body provokes vomiting a few minutes after the incident. The nature of the vomit depends on what is in the child's stomach. If there is damage to the walls of the esophagus or the mucous membrane of the stomach itself, then blood will be present in the vomit. Other symptoms indicating that a foreign body has entered the digestive system are: difficulty breathing, profuse salivation, increased anxiety of the child, severe cough.
- Food poisoning, indigestion. Vomiting with food poisoning is a fairly common occurrence. In this case, an increase in body temperature does not occur, but diarrhea is possible. Although mild intoxication often goes away with a single vomiting and without any changes in the stool. For example, when it comes to indigestion, overeating or taking the wrong medication.
- Traumatic brain injury. Most often, vomiting is accompanied by concussion and contusion. In addition, amnesia, headaches, weakness, sweating, and sleep disturbances are possible.
- Acetonemic crisis. Acetonemic crisis is a whole complex of symptoms, which is caused by the accumulation of ketone bodies in the child's blood. Vomiting during a crisis is indomitable, repeated. It arises as a reaction to an attempt to water or feed a child. Against the background of vomiting, symptoms of poisoning and dehydration rapidly increase. The skin becomes pale, a blush appears on the baby's cheeks, and muscle weakness increases. The causes of the crisis are varied, they can be hidden in the child's malnutrition (the predominance in the menu of dishes saturated with ketogenic amino acids and fatty acids), in enzymatic liver failure, in the characteristics of metabolism.
- Psychogenic vomiting. Psychogenic vomiting occurs in a child after the age of three years. The provoking factors are: strong anxiety, fear, overexcitement and other emotional upheavals. Sometimes psychogenic vomiting is a way to attract attention, which is typical for children without parental care.
- Introduction of complementary foods. Vomiting for the introduction of complementary foods is most often one-time. It may be accompanied by bloating and rumbling in the abdomen, flatulence. Diarrhea sometimes develops.
- Acute appendicitis. Vomiting often occurs with acute appendicitis, as the initial symptom of this pathology. At the same time, abdominal pains appear (their localization is different), the pulse quickens. After a few hours, the body temperature will rise, and other dyspeptic disorders will appear.
Vomiting without fever and diarrhea: what to do?
If a child has vomiting, which is not accompanied by an increase in body temperature and diarrhea, then parents should be alert and show maximum attention to their baby. In the event that vomiting is repeated, and its cause cannot be determined, qualified medical assistance is needed.
Parents themselves can take the following steps:
- Provide the child with rest and bed rest. It is important to ensure that his head remains elevated and in an elevated position. This will avoid the entry of vomit into the respiratory system.
- You should not try to feed your baby if he is vomiting.
- When vomiting occurs during a meal, you need to stop this process and hold the child in an upright position for some time.
- If the attacks have stopped, then liquid food can be offered no earlier than two hours later.
- After the end of vomiting, you need to remove all food debris from the mouth. If the child is an adult, then he can rinse his mouth independently.
- To prevent dehydration, it is necessary to offer the child to drink water in small sips. It can be alternated with rehydration drugs (Rehydron).
Do not give your child any antiemetics on your own. Call an ambulance immediately if there are streaks of blood in the vomit, or if they are brown. Also, the arrival of specialists is required when the child's body temperature rises, with abdominal pain or constipation, or loss of consciousness.
How to treat vomiting in a child without fever?
Vomiting in a child without fever should be treated based on the reason that provoked this symptom:
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Treatment of gastroesophageal reflux. If the parent believes that the child is spitting up more than it should be, or it continues for a long time, then it is imperative to pay attention to this fact of the pediatrician and pediatric gastroenterologist. Most often it is possible to get rid of the problem by switching to a thicker food, adjusting the frequency and volume of feeding.
If the problem lies deeper, then a drug correction of gastroesophageal reflux is prescribed with the use of drugs that block the production of hydrochloric acid. It is possible to take antacids, adsorbents, as drugs that suppress gastric secretion. To stimulate the motor-evacuation function of the digestive tract, prokinetics are recommended.
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Treating the pyloric spasm. The spasm of the gatekeeper is corrected by prescribing a special diet to the child (alkaline drink, thick cereals) and antispasmodic drugs. The amount of food that a child receives should be appropriate for his age; it is recommended to offer children alkaline mineral water before feeding. After feeding, you should not lay the baby down; you need to keep him upright for at least an hour.
Physiotherapeutic treatment is effective, which includes electrophoresis with novocaine on the epigastric region, application of ozokerite and paraffin. The prognosis for recovery is most often favorable, and vomiting stops already from the first days from the start of treatment. In severe cases, surgical intervention is indicated.
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Treatment of gastritis in children. A gastroenterologist is involved in the detection and treatment of gastritis. Children in the acute period are shown bed rest, refusal of food for up to 12 hours. If necessary, gastric lavage is performed. The child should drink plenty of fluids, but in small portions, so as not to provoke vomiting. To stop it, prokinetic drugs are used - these are Motilium and Cerucal. To relieve pain, antispasmodics are prescribed - No-shpu, Papaverine and antacids - Maalox, Almagel.
After 12 hours, the child is offered age-appropriate food, most often low-fat broths, jelly, slimy cereals. Gradually, the menu is expanding, the table becomes common, but fried, spicy, smoked dishes, as well as coarse food are prohibited. It is important that a child with gastritis has been registered with a pediatric gastroenterologist for at least 3 years. With adequate and timely treatment, the prognosis for recovery is favorable.
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Treatment of gastroduodenitis. The basic treatment of gastroduodenitis in childhood is adherence to a diet. Meals should be fractional, the number of meals per day should be at least five. Food is either boiled or steamed. Meat and strong vegetable broths, oily fish dishes, mushrooms, as well as all canned and smoked products are strictly prohibited. During an exacerbation of the disease, the child is shown bed rest with complete physical and psychological rest.
As for drug therapy, it is carried out depending on the cause of the disease. So, with increased acidity, Vikalin, Almagel are prescribed. Antisecretory drugs are Omeprazole, Ranitidine. Medicines such as Cerucal and Motilium help to get rid of the reflux of gastric contents into the esophagus. It is possible to carry out anti-Helicobacter pylori therapy in which an antibiotic is prescribed in combination with bismuth preparations. For example, De-nol and Amoxicillin with Metronidazole. Children with chronic gastroduodenitis need sanatorium treatment at specialized resorts.
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Treatment of acute pancreatitis. During the acute phase of the illness, the child must be in a medical facility. He is shown strict bed rest and fasting for 12 hours. At this time, a glucose solution is parenterally administered and alkaline mineral water is given. Depending on the patient's condition, it is possible to administer proteolytic enzymes, rheopolyglucin, plasma. Also, the child is prescribed painkillers and antispasmodics, pancreatic enzyme preparations (Creon, Pancreatin), antisecretory drugs (Pirenzepine, Famotidine).
If it is not possible to stop vomiting, then the child is injected intramuscularly with metoclopramide in an age-appropriate dosage. In early childhood, the drug is used with extreme caution because of the risk of developing dyskinetic syndrome. The rest of the treatment (taking antibiotics, antihistamines) is carried out according to indications. After the elimination of the acute phase of the disease, the child is offered food according to a special dietary scheme.
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Treatment of gallbladder diseases. Dyskinesia of the biliary tract is treated with a diet restricting fatty, fried, sweet, spicy foods. Shown fractional nutrition, inclusion of fermented milk drinks in the diet. Depending on the cause of the disease, cholespasmolytics (Allochol, Cholenzym, Flamin), sedatives (Persen, Novopassit, Fitosbori), choleretic drugs - Xylitol, Magnesium sulfate, Sorbitol can be prescribed. Such physiotherapeutic methods as Bernard's currents, galvanization, electrophoresis are effective.
Vomiting in a child without fever and diarrhea Treatment of cholecystitis of an infectious nature is reduced to the appointment of antibiotics (Erythromycin, Penicillin, Levomycetin). To get rid of parasites, Aminoquinol, Furazolidone are prescribed. In addition, the scheme of complex therapy includes the appointment of choleretic drugs, dietary nutrition, and the passage of physiotherapeutic procedures.
- Treatment of diseases of the central nervous system. Treatment of pathologies of the central nervous system is a very difficult task. Typically, therapy is within the purview of a neurologist. It, depending on the reason, is carried out either in a hospital or at home. Prescribed drug correction with the use of drugs that improve cerebral circulation, nootropics, etc. Brain tumors and severe hydrocephalus are treated with surgical intervention.
- Ingestion of a foreign body. The swallowing of a foreign body by a child requires immediate adult assistance. A wait-and-see tactic can be used only if it is reliably known what exactly the child swallowed, if this object is small and will not harm him. However, it is important to track the exit of a foreign body through the intestines. In all other cases, you must call an ambulance. Surgery may be required. It is worth taking into account that no matter how safe the situation with swallowing a foreign body may seem to parents, consultation with a specialist is required.
- Traumatic brain injury treatment. After a child receives a traumatic brain injury, examination by a specialist should be immediate. An assessment of the child's condition, even if he did not lose consciousness, should be carried out only by a doctor. With a mild traumatic brain injury, which includes only a concussion, the patient is shown bed rest, psychoemotional rest, applying cold to the head, inhalation of oxygen. For the prevention of cerebral edema, diuretic drugs (Diacarb, Furosemide), sedatives (Valerian, Phenobarbital), nootropics and vitamins are prescribed.
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Indigestion and poisoning. In case of mild indigestion or food poisoning, it is necessary to provide the child with plenty of drink. It is possible to take enterosorbents - Smecta, Activated carbon, Enterosgel, etc. To abstain from food is for 6-12 hours. If vomiting stops, then for the first few days, the child is recommended a sparing diet (fermented milk products, slimy soups, crackers, etc.).
If vomiting becomes persistent and diarrhea joins, then it is necessary to seek medical help, prescribe drugs for rehydration (Oralit, Rehydron), polyenzymes (Panzinorm, Festal, Mezim-Forte). As for antimicrobial therapy, it is carried out under strict medical supervision.
- Treatment of acetone syndrome. Treatment of an acetone crisis is carried out in a hospital. The child is shown a strict diet with the maximum restriction of fat, with plenty of portions of drinking. Enemas with sodium bicarbonate solution, oral rehydration with alkaline mineral water and Rehydron are prescribed. With persistent vomiting, antiemetics, antispasmodics, and sedatives are administered. Children with acetone syndrome are registered with a pediatric endocrinologist.
- If a child develops psychogenic vomiting, then he needs the help of a psychotherapist who must find out the reasons for its occurrence.
- When vomiting occurs in response to the introduction of a new product, then it should be abandoned for a while. Perhaps, after a few months, the same product will no longer cause such a reaction, since the child's digestive system will become more perfect.
- Treatment of pyloric stenosis, intestinal intussusception, acute appendicitis and congenital diverticulum of the esophagus is only operative.
Author of the article: Alekseeva Maria Yurievna | Therapist
Education: From 2010 to 2016 Practitioner of the therapeutic hospital of the central medical-sanitary unit No. 21, city of elektrostal. Since 2016 she has been working in the diagnostic center No. 3.
