Vomiting without fever and diarrhea in a child

Vomiting without fever and diarrhea in a child is not a diagnosis or disease. At the same time, vomiting is an alarming symptom indicating a number of uncomfortable physiological conditions at a minimum, and at a maximum - a disease requiring diagnosis and treatment.

Epidemiology

Epidemiology of vomiting without fever and diarrhea in a child is epidemiological information about the root cause of the gag reflex. Let us remember that vomiting itself is not a disease - it is just a clinical manifestation of a reflex response from the baby's body to a trigger (trigger mechanism).

Let us consider the epidemiology of the most frequently encountered diseases in the list of etiological factors of vomiting.

1. Regurgitation as a functional reflex, often requiring no treatment. Vomiting without fever and diarrhea in infants is a common phenomenon associated with the anatomical specifics of the baby's body. In the early period of infancy, the cardia of the stomach is practically undeveloped, the stomach has not yet "found" its position in the body, being located vertically. As the child grows, regurgitation decreases, but the gag reflex may persist and be accompanied by pale skin, increased salivation. Also, vomiting without an increase in body temperature in young children is caused by an immature nervous system, when, for example, neuromuscular fibers, structures in the digestive tract have not yet matured, their functioning is imperfect. Thus, passive eruption of oral masses in a baby can be considered a transient phenomenon and, in an epidemiological sense, safe. Pyloric stenosis as a congenital pathology of the gastric sphincter deserves special attention. It is mainly diagnosed in newborn first-born boys - 4 times more often than in girls. Thickening of the pyloric walls is clinically manifested literally from the first days of birth in the form of vomiting after taking breast milk or artificial mixtures. Frequent vomiting is typical for the first 4 weeks, then the reflex rejection of food decreases, but the process itself remains. Vomiting occurs actively, the eruption is a strong stream. The baby's body weight, as a rule, does not change, the only thing that parents notice is constipation and rare urination.
2. Gastrointestinal diseases of non-infectious etiology, such as gastritis. Vomiting without fever and diarrhea in a child may be a consequence of developing or long-standing, sluggish non-specific inflammation of the stomach. This is not a separate, isolated condition of atrophic tissue. The stomach is anatomically connected with nearby organs and systems, including the nervous or endocrine system. Therefore, factors that provoke gastritis can be both external and exogenous. Epidemiology, the prevalence of diseases of the digestive system in children provides eloquent facts:
   • In the list of all diseases diagnosed in children from birth to 16 years of age, gastritis ranks 5th (all gastrointestinal diseases - 4th place).
   • Since 2005, the number of confirmed diagnoses of GERD (gastroesophageal reflux disease), CGD (chronic gastroduodenitis) in children has increased by 30%.
   • Among all diseases associated with digestion in children, chronic gastroduodenitis is the leader.
   • In children, so-called secondary chronic gastritis is most often diagnosed; one of the signs of this disease is vomiting without fever and diarrhea.
   • The onset of an exacerbation of CGD (chronic gastroduodenitis) coincides with a sharp change in daily routine and nutrition, nervous tension, for example, a child entering school.
   • Most often, girls suffer from gastritis until the end of puberty, after which the rates between boys and girls equalize.
   • In a child, chronic gastritis is rarely an isolated nosology; in 85% of cases it is “accompanied” by diseases of the duodenum, dysfunction of the gallbladder, and pancreas.
   • Chronic gastritis (CG) in children, caused by Helicobacter pylori, statistically increases with age: children under 10 years old - 20%, under 15 years old - 40-45%, children over 15 years old - 55-60%.

The following information is also available on the frequency and statistics of vomiting in children:

1. As the child grows older, attacks of vomiting and nausea decrease; neurological factors of vomiting are typical for teenagers aged 12-14 years.
2. Girls are most susceptible to the gag reflex.
3. Vomiting without fever and diarrhea in a child may be associated with motion sickness syndrome; more than 40% of children have this syndrome. This is explained by high sensitivity, vulnerability of the vestibular apparatus and "fixation" of the gag reflex (reflex arc).
4. Most often, vomiting is observed in emotional, excitable children.
5. Children with metabolic disorders and excess weight suffer from vomiting twice as often.

Epidemiological studies of factors causing vomiting are numerous, and it is not possible to summarize them within the framework of this article. In general, we note that the functional vomiting reflex without other accompanying clinical symptoms is most typical for small children.

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Causes vomiting without fever and diarrhea in a child

The causes of vomiting without fever and diarrhea in a child can be divided into three categories:

1. Functional, associated with temporary physiological processes in the body.
2. Psychogenic.
3. Vomiting associated with the underlying disease that is the underlying cause of the reflex.

Let us immediately stipulate that serious illnesses that threaten the life of a child, accompanied by vomiting, as a rule, have standard clinical manifestations in the form of elevated body temperature or diarrhea. A gag reflex without other symptoms very rarely indicates a pathological state of health of a child, the only exceptions may be TBI (traumatic brain injury), cardiac problems and diabetes.

The most common factors that provoke the gag reflex are a fairly large list of physiologically transient conditions, including the nervous and gastrointestinal systems. The causes of vomiting without fever and diarrhea in a child are due to many signs and clinical manifestations. Often, before vomiting, children experience nausea as a harbinger of the actual gag reflex and subsequent symptoms.

Vomiting without fever and diarrhea in a child can be a reflex that originates both in the psycho-emotional sphere and in the systems and organs of the baby. The most common cause, which does not relate to pathological conditions, is a transient, temporary irritation of the mucous tissue of the pharynx, in second place is a fairly large list of uncomfortable or pathological conditions of the gastrointestinal tract, it also happens that the causes of vomiting are hidden in pain syndrome (the reflex center comes from special parts of the brain).

Clinically, the causes of vomiting without additional symptoms - fever and diarrhea, can be divided into three large categories:

1. Psychogenic vomiting caused by structural irritation or pathological damage to the CNS (central nervous system)
2. Vomiting as a reflex during irritation or disease of the gastrointestinal tract (GIT)
3. Gag reflex caused by hematotoxic causes (poisoning with drugs, toxic substances)

Causes of vomiting without fever and diarrhea in a child as a primary symptom requiring clarification of the diagnosis, appointment of the first stage of treatment and dynamic observation of the clinical picture.

Diseases, pathologies and transient conditions of the gastrointestinal tract	Neurological disorders, CNS diseases	Psychogenic causes of vomiting
Congenital gastrointestinal pathologies (pyloric stenosis, diverticulum, esophageal obstruction)	Traumatic brain injury	Stress, fear, provoking a psychogenic gag reflex
Maltration syndrome	Labyrinthopathy or Meniere's disease	Associative, reactive vomiting (reaction to uncomfortable associations, for example, to a smell, to the appearance of an object)
Foreign body in the esophagus	Hemicrania (migraine)	Strong affective arousal (vomiting as a compensatory reaction)
Functional dyspepsia	Hypoxia	Anorexia
Reflux disease (GERD)	Meningitis, epilepsy	Vomiting as an early symptom of mental disorder
Cardiospasm associated with esophageal dysfunction (motility disorder)	A sharp increase in intracranial pressure	Rumination – vomiting as a way to attract attention to oneself when a loved one caring for the child is not paying enough attention

Let us note once again that vomiting without fever and diarrhea in a child is almost never a symptom of infectious intervention. Bacteria, parasites or viruses, as a rule, provoke both an increase in body temperature and diarrhea. An exception may be infectious diseases of the urinary, bronchopulmonary system in a chronic, advanced form, which proceed sluggishly in the clinical sense, without characteristic signs. Quite rarely, the causes of vomiting without fever and diarrhea can be due to such pathologies:

• Cardiovascular diseases.
• Diabetes.
• Rotavirus infection in a sluggish form.
• Lactic acidosis.
• CVR - cyclic vomiting syndrome against the background of migraine.

Vomiting without fever and diarrhea is conventionally divided into age categories. For example, a psychogenic vomiting reflex is more common in adolescents or children over 6-7 years old. During puberty, nervous vomiting is observed in adolescents aged 12-14, and this condition passes as they grow older. Just as the psychogenic vomiting reflex disappears with age, motion sickness syndrome - kinetosis.

In infancy, vomiting without fever and diarrhea is typical for babies in the first month of life. The so-called regurgitation is a kind of contraction of the gastrointestinal tract when the cardiac sphincter is open. Vomiting in infants has functional causes and is most often caused by either swallowing air or a violation of the feeding regime. Such vomiting stops at 6-7 months.

Particular attention should be paid to acetonemic vomiting. The condition has characteristic signs:

• Vomiting is preceded by nausea.
• A specific smell of acetone can be felt from the child’s mouth.
• The baby is lethargic, weak, and complains of a headache.
• The child quickly becomes dehydrated.
• Vomiting intensifies and becomes uncontrollable and profuse.

Acetonemia is diagnosed at any age, but according to statistics, it is most often diagnosed in children under 9-10 years old. At the first clinical signs, and most often this is a characteristic odor, you need to contact your pediatrician, in case of severe vomiting - call an ambulance.

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Risk factors

Vomiting without fever and diarrhea in a child in most cases has functional causes. However, risk factors should be taken into account and attention should be paid to the following symptoms:

• vomiting in a child is accompanied by weakness and drowsiness
• the gag reflex is repeated more than 3 times a day
• In addition to vomiting, the child has a stomach ache
• repeated vomiting subsequently results in a rise in temperature
• the child's urination frequency decreases
• vomiting occurs after a bruise, fall, it is especially dangerous if the blow was to the head
• the baby flatly refuses to drink
• the gag reflex occurs without any apparent objective reasons

If any of the above symptoms occur, the child requires qualified medical assistance.

Risk factors to look out for if vomiting without fever and diarrhea in a child does not stop within 1-2 hours:

Symptoms	A probable cause that a doctor will confirm or rule out	What should parents do?
The child's vomit takes on a specific color shade - greenish or with an admixture of blood, the baby may have a stomach ache	An acute form of intestinal disease, such as intestinal obstruction	Call an ambulance immediately
Vomiting without fever and diarrhea is caused by a child falling. The gag reflex is accompanied by weakness and drowsiness	TBI - traumatic brain injury Concussion	It is necessary to call an ambulance
Vomiting is accompanied by severe headache, drowsiness. The child is irritated by daylight, sounds	CNS related disease. Meningitis	Urgent hospitalization is required
In addition to vomiting, the child has acute pain in the back and groin. The pain radiates and moves	Renal colic is possible against the background of pyelonephritis	Call a doctor, in case of acute pain and uncontrollable vomiting - call an ambulance

What else should you pay attention to? What are the risk factors for vomiting?

1. Repeated, persistent vomiting is a serious symptom that requires medical attention.
2. After one or two episodes of vomiting, the child's body temperature rises.
3. Vomit has a specific smell - putrid or like acetone.
4. After the vomiting stops, the child begins to have diarrhea.
5. Vomiting is accompanied by involuntary attacks of muscle contraction and convulsions.
6. If the child is given something to drink, the vomiting increases.

In general, risk factors for gag reflex are two conditions:

• Dehydration
• Risk of vomit entering the respiratory system

Infants under one year of age are most at risk in this regard.

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Pathogenesis

Pathogenesis or description of how a condition or disease begins and develops in relation to the gag reflex is an explanation of the physiological processes that trigger vomiting. Vomiting is a specific reflex that is triggered by a spasm of the sphincter between the stomach itself and the duodenal bulb. The pylorus or sphincter contracts constantly, controlling the movement of food through the gastrointestinal tract. Vomiting without fever and diarrhea in children, not caused by serious pathology, occurs as follows:

• Before vomiting, there are almost always signs of nausea, heaviness in the middle of the abdomen, and increased salivation.
• Vomiting begins with a deep, heavy breath, which seeks to compensate for the spasm of the sphincter.
• During inhalation, the epiglottis closes, isolating the respiratory system from possible eruption of masses.
• The gatekeeper spasms, and at the same time the muscle tissue of the fundus of the stomach relaxes. This is how the vomit is able to move upward.
• The lower esophageal sphincter opens, the abdominal muscles tense, the diaphragm contracts strongly - thus, the intra-abdominal pressure increases.
• The vomit moves upward toward the oral cavity and is expelled through the mouth, less often through the nose.
• Vomiting is always accompanied by strong salivation due to the fact that the glandulae salivariae (salivary glands), facial and pharyngeal nerves are located very close to the center that triggers the gag reflex (in the medulla oblongata).

The pathogenesis of vomiting without fever and diarrhea in a child is associated with two centers of the medulla oblongata (medulla oblongata):

1. Descending zone of the reticular formation.
2. The chemoreceptor zone that initiates the process. Located in the fossa rhomboidea (the diamond-shaped fossa at the bottom of the fourth ventricle).

According to pathogenetic mechanisms, the process of vomiting is also divided into two paths:

1. The stimuli for the gag reflex come from the nerve endings of the gastrointestinal tract or biliary tract, and the impulse can also come from the vestibular apparatus (cortical centers) or from the hypothalamus, thalamus dorsalis.
2. The chemoreceptor zone (CTZ) initiates vomiting as a trigger, from where the impulse goes directly to the vomiting center (VC). The cause of stimulation may be a lack of oxygen (hypoxia), taking certain medications, or diabetic carbohydrate metabolism disorder (ketoacidosis).

The pathogenesis of vomiting as a process was studied quite a long time ago, back in 1953. The studies of scientists Borison and Wang describe in detail the mechanism of the reflex occurrence – from stimulation to motor response. Since then, the pathogenesis of vomitus (vomiting) is based on these scientific works.

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Symptoms vomiting without fever and diarrhea in a child

Symptoms of vomiting and nausea can be varied. Vomiting without fever and diarrhea in a child is a kind of protective reflex that helps remove from the body what interferes with normal life. By irritating the vomiting center, provoking factors, as a rule, have the following symptoms:

• Paleness of the skin.
• Increased salivation.
• Lethargy, weakness.
• Nausea, sometimes very long lasting.
• Involuntary swallowing movements.
• Your heart rate may increase.
• Breathing is intermittent or, on the contrary, deep and slow.
• Sweating increases.

Vomiting without fever and diarrhea is most typical for infants; this process is called regurgitation. Symptoms:

• Vomiting occurs without prior nausea.
• The baby's tummy quickly tenses up and becomes hard.
• The skin of the face may change color towards paler.
• The baby's general condition does not suffer, regurgitation is not a disease.

You should pay attention to the symptoms of too frequent regurgitation not related to food intake:

• The baby's face takes on a bluish tint.
• The child becomes restless and often cries for no apparent reason.
• The baby's body temperature drops, and the legs and arms become cold to the touch.
• Regurgitation is more like repeated vomiting, which threatens dehydration.

Also, the symptoms of vomiting without fever and diarrhea in a child can be conditionally divided into three categories in accordance with the etiological factors:

1. Functional vomiting, regurgitation. The ejected mass is released without obvious strain, effort and changes in the baby's health.
2. A gag reflex caused by diseases, pathological conditions of the brain (central origin of the provoking factor). Vomiting occurs without nausea, but is accompanied by a headache. After the vomit is ejected, the child's condition does not improve.
3. Vomiting of visceral origin is almost always accompanied by nausea. Irritation of the nerve endings of the digestive tract provokes a painful symptom in the abdomen. So-called gastric vomiting rarely begins immediately after eating, it "starts" 40-60 minutes after eating, when digestion as a process reaches its peak. After vomiting, the child's condition improves significantly.

Symptoms of dehydration as a consequence of profuse vomiting deserve special attention:

• The child is very thirsty.
• The mucous membranes of the oral cavity are dry, lips often dry out, and cracks appear.
• Urination is scanty.
• The skin is pale.
• The child's general condition is characterized as weak and exhausted.
• Any attempt to give the child something to drink ends with another bout of vomiting.

Symptoms that require immediate medical attention:

1. Vomiting begins after a blow to the head, after a fall and impact with other parts of the body.
2. Vomiting does not stop within 4-6 hours.
3. The gag reflex is accompanied by severe abdominal pain.
4. Vomit has a specific appearance and smell; in addition to food, it contains an admixture of blood, feces, and bile.
5. Vomiting is combined with increased urination or, on the contrary, almost no urine is excreted.
6. The gag reflex leads to changes in cognitive functions. The child begins to confuse words and perform actions that are unusual for him.

Summarizing the clinical manifestations of vomiting without fever and diarrhea in a child, it can be noted that the symptoms of the reflex are important diagnostic information. Therefore, attentive parents should pay attention to the beginning of the process, that is, to the first signs of vomiting in their child.

First signs

The first signs of nausea, vomiting without fever and diarrhea in a child are his complaints of feeling unwell. Involuntary, sudden vomiting is quite rare, so there is no need to fear serious complications.

The first signs of vomiting in a child:

• The baby loses activity, becomes unusually lethargic and quiet.
• The child may experience belching, which occurs repeatedly.
• Children often complain of nausea preceding vomiting.
• The child has no appetite and eats poorly or very little during the day.
• The child may complain of dizziness.
• The baby's face takes on an unusual hue and turns pale.
• The child may sweat heavily and salivate more.
• The pain is concentrated in the epigastric region; the child clearly indicates the location of the pain.

Vomiting is not a separate, independent disease, so the first signs are clinical manifestations of the underlying cause of the gag reflex. They should be paid attention to in order to subsequently provide complete information to the doctor to specify the diagnosis and adequate recommendations for treatment.

What should you pay attention to, what are the first signs of serious diseases accompanied by vomiting?

1. Diseases of the central nervous system. In meningitis, vomiting is one of the classic symptoms of the disease. Specific signs may include irritability, lethargy, drowsiness, severe headaches, fear of bright light. Meningitis is usually accompanied by fever and convulsive syndrome, but these symptoms may not be present in the first hours. Therefore, it is better to be on the safe side, if a child vomits, has a headache for 3-4 hours, you need to call a doctor.
2. Inflammation of the appendix. Usually begins with nausea, long-lasting and persistent, then there may be vomiting without fever and diarrhea. Specific signs are pain in the right side of the abdomen, closer to the hypochondrium, or a pain symptom in the navel area.
3. Vomiting with acetonemia has a peculiarity - smell. At the first symptoms you should consult a doctor.
4. In babies, a special area where the cranial bones meet, the fontanelle, can “sink in”.
5. After a fall or a head injury, a child may experience uncontrollable vomiting, even to the point of losing consciousness. This condition requires immediate hospitalization.

Also, the first symptoms of vomiting can appear for reasons not related to illnesses. For example, the baby played too actively, ran and got overtired. His nervous system is not yet so perfect, any bright impression can affect so much that the child will react with a gag reflex. In addition, the child's motor activity requires constant replenishment of fluid. If the baby does not receive enough water, vomiting can be caused by an elementary violation of the water-salt balance.

A child over three or four years old is able to complain of feeling unwell, the first signs of vomiting without fever and diarrhea will be voiced within the age-appropriate speech characteristics. It is more difficult with small children who cannot describe their problems, therefore, everything is more unusual, atypical manifestations in the child's behavior, in his appearance, food preferences, in the mode of urination and excretion of feces should be observed by attentive parents.

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Complications and consequences

Consequences and complications are the result of serious pathologies, diseases that provoke vomiting. But, given that we are considering vomiting without fever and diarrhea in a child, it is most likely not necessary to talk about consequences and risks. This is explained by the fact that health-threatening conditions, as a rule, do not occur without hyperthermia (elevated body temperature), especially in children. In addition, complications are typical for diseases of infectious etiology, which in turn manifest themselves either as diarrhea or persistent constipation.

Let's discuss the most typical types of vomiting without fever and diarrhea:

• Regurgitation in infants. Consequences and complications are not observed.
• A single vomiting as a protective physiological mechanism to an exogenous or endogenous irritant. Complications are extremely rare.
• Psychogenic vomiting. The consequences may be in the form of fixing the reflex to a certain trigger. For example, a single vomiting that occurs when seeing an image that frightens or excites the child may become fixed and repeat in the future.
• Acetonemic vomiting. Complication – dehydration.
• Frequent vomiting caused by headaches is complicated by the deterioration of the child's general condition. The baby may lose weight.
• Consequences and complications may be caused by a craniocerebral injury, in which vomiting is almost inevitable. The doctor prescribes an accurate diagnosis, localization of the lesion and treatment. The minimization of risks and complications depends on how timely this is done.
• Hypoxia can provoke vomiting, which is subsequently fraught with metabolic acidosis. Acidosis is also typical for diabetes mellitus. As a complication, acidosis itself should be described, not vomiting, detailed information about the condition - ketoacidosis, metabolic acidosis you can find on our website.
• A complication of vomiting may be aspiration – the entry of vomit into the respiratory system, leading to aspiration pneumonia.
• Vomiting without fever and diarrhea in a child can lead to hyperkalemia, especially if the vomit is profuse and frequent, and the reflex is accompanied by increased sweating.

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Diagnostics vomiting without fever and diarrhea in a child

Diagnosis of vomiting without fever and diarrhea in a child is not difficult in most cases. It begins with collecting information and examining the baby. Anamnesis - data on the child's health from the moment of birth, the presence or absence of concomitant diseases, including chronic ones, genetic predisposition and other information help the doctor to more accurately determine the causes of vomiting. It is also important for the doctor to clarify some parameters of vomiting, for example, the release of stomach contents in the morning, on an empty stomach may indicate increased intracranial pressure, CNS diseases, psychogenic factors of the reflex. Vomiting during or after eating is one of the clinical signs of dysfunction of the digestive system, gastrointestinal tract.

No less important is information about other symptoms accompanying vomiting - dizziness, pain, pulse.

In addition, the pediatrician examines the vomit or asks the parents about it. Based on certain signs - smell, thickness, presence of impurities, amount of contents, preliminary diagnostic assumptions can be excluded or confirmed.

Parameters, characteristics, information that a doctor will definitely pay attention to when diagnosing vomiting without fever and diarrhea in a child:

• Age of the child.
• Body weight.
• Skin condition (rash, degree of dehydration), examination of the oral cavity.
• Assessment of the baby's neurological status (for seizures).
• Checking the tone of the abdominal muscles.
• Associated diseases.
• Predisposition to disease caused by genetics (eg allergies, diabetes, metabolic disorders).
• Symptoms accompanying vomiting (headache, abdominal pain, tinnitus, palpitations).
• Characteristics of the frequency of vomiting episodes (before meals, time of day, how many times, how long).
• Characteristics of vomit contents - impurities, smell, volume, presence of mucus, bile, foreign bodies, what food residues are in the vomit.

Let us note separately how important it is to diagnose vomiting without fever and diarrhea in a child under one year of age. A persistent gag reflex in newborns is one of the symptoms of congenital pathologies, most often in the digestive tract. What diseases can be accompanied by vomiting in the neonatal and subsequent periods?

• Atresia of the esophagus (esophagus) - the absence of a proper lumen, congenital etiology, leads to obstruction of the esophagus.
• Pyloric stenosis of newborns (significant narrowing of the sphincter/pylorus). According to statistics, it is more often diagnosed in male infants.
• Diaphragmatic hernia is the displacement of abdominal organs higher, towards the chest area.
• Intestinal atresia.
• Congenital dysfunction of the adrenal cortex (adrenogenital syndrome).
• Intestinal obstruction due to stenosis.
• Cystic fibrosis of congenital etiology.
• Intestinal obstruction due to filling of the lumen of the ileum/ileum with meconium.
• Aachalasia cardia (cardiospasm).

Diagnosis of vomiting without fever and diarrhea in a child is generally not difficult, since the absence of hyperthermia and diarrhea allows you to immediately exclude many pathologies. However, sometimes the search for the root cause of vomiting may require additional tests, including instrumental diagnostics.

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Tests

Tests for vomiting without fever and diarrhea in a child are prescribed as additional information to confirm or exclude the diagnosis.

As a rule, it is enough for the doctor to collect information (anamnesis), examine and evaluate the characteristics of the vomit contents. Tests are taken only in extreme cases, if there are doubts about the preliminary diagnosis of normal, physiological vomiting.

For example, vomiting without fever and diarrhea in a child may initially be a single episode, without specific odors and impurities. Home methods of replenishing lost fluid (fractional drinking) do not have an effect and after a while the baby has a repeated vomiting episode, vomiting becomes persistent. In such cases, the child is recommended hospitalization and a comprehensive examination, which necessarily includes tests. They can be as follows:

1. If rotavirus infection is suspected, a stool test is prescribed to detect the specific antigen of the A virus group VP6. Vomit or blood tests to detect the virus are not so indicative, since rotavirus is the so-called "disease of unwashed hands". It can occur in an acute form with hyperthermia and diarrhea, but it happens that it develops sluggishly, clinically manifesting itself only by vomiting.
2. If the child's medical history suggests diabetes as an etiologic factor that provokes vomiting, blood tests are prescribed. Quite often, type II diabetes, as well as type I, can develop gradually, slowly and almost unnoticed. Vomiting without fever and diarrhea in a child can serve as the first clinical signal and a reason for prompt diagnosis of the disease. Blood is taken fractionally, determining the sugar level. Diabetes (insulin-dependent) is also confirmed by the presence of antibodies to insulin in the blood, to the cells of the intrasectoral part of the pancreas / islets of Langerhans. Urine tests for sugar levels and the presence of ketone bodies (acetone) are very indicative for confirming the diagnosis. For a complete and detailed analytical picture, a biochemical blood test is also needed for the average sugar level over a certain period (usually from 1 to 3 months) - glycated hemoglobin.
3. Acetonemia is characterized not only by a gag reflex, but also by the smell of vomit. However, to differentiate from ketogenic hypoglycemia, a BAC (biochemical blood test) is prescribed. In case of acetonemia, it reveals leukocytosis (neutrophilic), a significant excess of uric acid, a strong increase or decrease in the level of sodium and potassium, an increased erythrocyte sedimentation rate (ESR). Ketonuria is clearly expressed in the urine, which is designated, depending on the degree of expression, by one or more pluses.
4. Congenital metabolic disorders, metabolism, which clinically signal themselves by vomiting without accompanying symptoms, require additional laboratory tests. Amino acids, organic acids, acetone can be detected in urine. In addition, as with suspected diabetes mellitus, it will be necessary to take a complete blood count, a biochemical blood test, and conduct a GTT (glucose tolerance test).
5. If a child, in addition to vomiting, has symptoms of achalasia cardiac, the doctor recommends taking the following tests:
   • Complete blood count (CBC) to determine reticulocyte levels.
   • Blood tests for coagulation (coagulogram).
   • Determination of serum albumin levels.
   • Clarification of serum creatinine levels.
   • OAM (general urine analysis).

6. Tests are also needed for enzymopathies (non-spherocytic hemolytic anemia). They take a biochemical blood test for bilirubin levels, to detect specific Heinz-Ehrlich bodies in erythrocytes, to assess the level of amylase, lipase, phosphatase and other enzyme activity, to detect gamma globulin protein deficiency.

In general, tests for vomiting without fever and diarrhea in a child are a necessary information base that excludes various serious pathologies.

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Instrumental diagnostics

Instrumental diagnostics are necessary if vomiting without fever and diarrhea in a child is not determined as a clear symptom of a specific disease or condition.

It happens that the disease develops covertly, proceeds in a sluggish form and does not manifest itself with characteristic clinical signs. Vomiting is not a pathology, but one of the many signals about the dysfunction of one or another organ or system.

What precedes instrumental diagnostics?

• Analysis of collected anamnestic data.
• Inspection.
• Clarification of the characteristics of the gag reflex.
• Data on the child's diet.
• Preliminary assessment of psychoneurological status.
• Palpation of the abdominal cavity.
• Palpation of the lymph nodes.
• Examination of the oral cavity.
• Skin condition assessment.

If the initial collection of information does not provide a specific vector for diagnostic assumptions, or, on the contrary, there are all the signs of a serious disease that requires clarification, instrumental diagnostics are prescribed.

What methods can be used to examine a child’s condition?

1. Abdominal organs - ultrasound (size, condition, location).
2. Digestive system, digestive tract – FGDS (fibrogastroduodenoscopy).
3. Contrast fluoroscopy to detect defective areas in the gastrointestinal tract.
4. Electrocardiogram.
5. Examination of the GM (brain) – computed tomography, neurosonography, magnetic resonance imaging.

Vomiting without fever and diarrhea in a child usually does not require a long and detailed examination, but there is a small percentage of diseases that need to be excluded.

This is especially important for newborns and children under 1 year of age.

Instrumental diagnostics and its connection with the etiological causes of vomiting:

Etiology	Anamnesis Symptoms	Instrumental diagnostic methods
Vomiting of cerebral etiology	Difficult birth, congenital pathologies, obvious neurological symptoms	CT, MRI
Congenital malformations of the digestive tract	Polyhydramnios in the mother during pregnancy, poor digestion of food, frequent regurgitation, increased salivation and vomiting with belching	X-ray of the gastrointestinal tract, Ultrasound of the stomach according to indications
Dysfunction of the cardiac sector of the stomach	The first month of life - weak reflexes, then anemia, vomiting with blood impurities	X-ray of the stomach Esophagogastroscopy. Manometry for determining the motor function of the pharynx
Pyloric stenosis	"Gushing" profuse vomiting, usually after eating, after feeding. Maintaining a good appetite, constipation, neurological manifestations	Survey radiography of the stomach, esophagus, Ultrasound

Inpatient conditions are required to perform instrumental diagnostics. Therefore, vomiting without fever and diarrhea in a child, which requires clarification, especially if episodes of vomiting are repeated frequently, is not diagnosed at home. The procedures are quick, as a rule, if the child's condition normalizes, he is discharged home in 3-5 days.

Differential diagnosis

Differential diagnostics of such a symptom as vomiting without fever and diarrhea in a child is a way to exclude serious diseases, including those that threaten the life of the child.

There are the following directions of analytical tactics when making a diagnosis of vomiting:

• The presence or absence of gastrointestinal diseases.
• Infectious disease.
• Food or chemical poisoning.
• Acute metabolic disorders.
• Cerebral disorders, including complicated ones.
• Psychogenia.

How is differential diagnosis carried out if there are complaints of vomiting without hyperthermia and diarrhea?

1. Collection of epidemiological anamnesis.
2. Inspection and palpation of the abdominal cavity.
3. Assessment of the child's body weight, changes towards weight loss or weight gain.
4. Premorbid background in infants in the first year of life (registration with a neurologist, congenital pathologies).
5. Dietary regimen, assessment of the quality and volume of the child's nutrition.
6. Psycho-emotional status of the child and his family environment.

In differentiating etiological factors, it is important to evaluate the characteristics of the gag reflex according to the following parameters:

• Is there nausea before vomiting?
• How long does vomiting last?
• Is there a feeling of relief after an episode of vomiting?
• Activity of the gag reflex (exclude “fountain” vomiting).
• Differentiation of regurgitation from vomiting.
• Establish a connection between the gag reflex and food intake.
• Monitor the dynamics of vomiting (decreases, increases).
• Analyze the volume of vomit contents.
• Assess the odor, color, and consistency of the vomit.
• To determine the presence or absence of impurities in vomit.

Clinical diagnostic differentiation:

1. Identify symptoms of a possible inflammatory process.
2. Check body temperature.
3. Assess the condition of the oral cavity.
4. Check the functioning of the respiratory system.
5. Assess the condition of the skin for moisture, turgor, and the presence of a rash.
6. Check the condition of the fontanelle in infants.
7. Assess the functioning of the peripheral circulation, measure the pulse.
8. Check muscle activity and tone.
9. Assess the function of the gastrointestinal tract and its involvement in the respiratory system (abdominal retraction or bloating, SNBS – abdominal wall tension syndrome).
10. Rule out symptoms of meningitis.
11. Assess the state of the central nervous system; if the child is older than 2-3 years, assess the level of cognitive abilities, excluding impaired consciousness.
12. Check your reflexes.
13. If it is possible to assess the characteristics of urine and feces on site.

It is especially important to pay attention to the characteristics of the vomit contents:

• A greenish or brown tint indicates that the food has been in the stomach for a long time.
• Almost undigested food in vomit is a signal of atony of the digestive system.
• Odorless vomit = a sign that food did not reach the stomach and was not processed there.
• The characteristic smell of feces in vomit is a clear sign of a serious pathology - intestinal obstruction.
• The smell of ammonia indicates uremia.
• Mucus in the contents of vomit is a symptom of either advanced bronchitis or gastritis.
• Bile in vomit is a signal of narrowing of the duodenum and may indicate stenosis.
• Vomiting foam is a sign of chemical intoxication.
• Acetone smell - diabetic ketoacidosis should be ruled out.
• Bloody vomiting is a hemorrhagic disease or false melena (the baby swallowed blood clots either during breastfeeding, if the mother has cracked nipples, or in the first hours of birth, when passing through the birth canal). Also, blood in the contents of vomit can be a sign of an ulcerative process in the gastrointestinal tract. Bleeding in the stomach poses a serious threat, which can be indicated by vomiting in the form of "coffee grounds".

In addition, there are types of vomiting that the pediatrician knows about and is guided by this knowledge when differentiating the diagnosis:

• Cardiac vomiting.
• Psychogenic vomiting.
• Abdominal gag reflex.
• Bloody vomiting.
• Vomiting of cerebral etiology (cerebral vomiting).

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Treatment vomiting without fever and diarrhea in a child

How is vomiting without fever and diarrhea treated? As a rule, such a reflex in a child is isolated and one-time. If vomiting occurs only once, no specific measures need to be taken, the only thing that needs to be done is to observe the baby's condition during the day. If vomiting occurs repeatedly, it is better not to take risks and call a doctor.

Who can join the treatment after diagnosis?

1. A pediatrician is a doctor who conducts an initial examination, collects information about the child's health and makes a preliminary or final diagnosis. If necessary, narrow specialists can be involved who will prescribe treatment for vomiting without fever and diarrhea according to their specialization.
2. A gastroenterologist can treat a child if vomiting is a clinical manifestation of a gastrointestinal disease. Usually, the child is treated at home.
3. A surgeon is needed in acute, emergency conditions. Pyloric stenosis, stomach or intestinal trauma, intestinal obstruction, appendicitis and other acute diseases are treated in a hospital setting.
4. A neurologist prescribes additional examinations if vomiting, according to the primary diagnostic option, is associated with pathologies or diseases of the central nervous system.
5. Psychogenic gag reflexes require treatment by a psychotherapist or child psychologist.

What can parents do if vomiting without fever and diarrhea in a child continues more than once and the child’s condition worsens?

• It is imperative to call emergency medical assistance.
• Ensure adequate supply of fresh air in the room.
• Until medical assistance is provided, you need to be with the child literally every minute. The child needs to be freed from tight clothing, you can put him on his side, so that the head is turned (to prevent vomit from entering the respiratory tract). Babies should be held in an upright position, and also monitor the release of vomit to prevent aspiration (vomit entering the respiratory system).
• Babies need to have their mouths cleaned after vomiting, older children can rinse their mouths themselves.
• You can't force a child to eat, with the exception of infants.
• It is essential to give the child water, fractionally, in small portions, literally half a teaspoon, but very often (every 5-7 minutes). This will help avoid dehydration of the body.

Treatment at home also involves a special diet. There is only one rule - all products included in the menu should be carefully selected so that the diet meets the standards of gentle nutrition. One way or another, when vomiting, the gastrointestinal mucosa is subject to a traumatic process, therefore, food should not aggravate either mechanical discomfort or the inflammatory process, which is also possible. It is important to consider the cause of vomiting. If it is psychogenic, in no case should you force the child to eat.

A drinking regimen in the form of oral rehydration is also very useful. The child needs to drink a water-salt liquid, it is best to buy special powders in a pharmacy and dilute them according to the scheme indicated on them. For example, rehydron is diluted at the rate of 1 sachet per 0.5 liters of boiled water. Fractional, frequent drinking is calculated depending on the age and body weight of the baby. Children under 1 year old - 150 ml per kilogram of body weight (per day). Children over 1 year old do not require such an amount, the calculation is 120 ml per 1 kilogram of weight. The volume of drinking should also be distributed over an hour of time and the child should be given water every 3-15 (depending on age) minutes from a teaspoon.

Drinking regimen for children:

• Infants under 1 year old – 1 teaspoon every 3-5 minutes.
• Children from 1 to 3 years old – 2-4 teaspoons every 3-5 minutes.
• For a child over three years of age the recommended dose is 1.5-2 tablespoons every 5 minutes.

Drinking a lot of fluids when you have a gag reflex is not recommended; it will only intensify it and injure the gastric mucosa.

Conservative or surgical treatment of vomiting without fever and diarrhea in a child is required only according to indications, after a thorough and accurate diagnosis.

Medicines

Medicines for vomiting without fever and diarrhea are usually not required. Acute, urgent conditions that manifest as vomiting without fever and diarrhea in a child are, fortunately, rare. All that is required from parents is to monitor the baby's condition and give him a sufficient amount of liquid in the form of fractional drinking. Any medicine that is used independently, without a doctor's recommendation, can increase the gag reflex and significantly complicate the diagnosis of the underlying cause.

If the doctor's visit ends with a prescription for treatment, then parents can safely begin conservative therapy at home. What can a pediatrician prescribe for vomiting?

1. Regidron is a drug for oral rehydration therapy. It is needed to restore water-salt balance, neutralize acidosis and reduce the risk of dehydration. Regidron is available in powder form and contains:
   • Sodium chloride.
   • Potassium chloride.
   • Sodium citrate.
   • Glucose.

The drug is well absorbed, its ingredients have a high degree of bioavailability - the combination of sodium chloride and potassium restores the normal level of salt balance, which in turn has a positive effect on cardiovascular activity.

Directions for use:

1 sachet of rehydron is diluted in 1 liter of warm purified or boiled water. The solution should be cooled, rehydron in liquid form should be used within 24 hours. Unused preparation is disposed of and a new solution is prepared as needed.

Before starting to take rehydron, you should calculate the drinking regimen depending on your body weight, taking into account the volume of liquid from other sources (breastfeeding, liquid food for older children). The following dosage is usually recommended - 10 milliliters per 1 kilogram of weight should be taken in 1 hour.

How to calculate the medicine?

• The first 4-8 hours in case of a single episode of profuse vomiting without other complications and threatening symptoms - 100 milliliters per 1 kg of body weight for children over 1 year old (drink in small portions), then gradually reduce the dosage to 10 ml per 1 kg of weight.
• For children over 3 years old - the first 5-6 hours after profuse vomiting, to avoid dehydration, it is necessary to give up to one liter during the specified period, then reduce the dose to 200 ml over 2 hours (fractionally).
• A more precise regimen may be prescribed by a doctor depending on the factor causing vomiting, the age and condition of the child.

The course of therapy with rehydron should not exceed 2-3 days.

Regidron also has its contraindications, it is not safe. Contraindications:

• Renal pathologies, including congenital ones.
• Diabetes.
• Obstruction of the esophagus, intestines.
• Hyperkalemia.

2. Dramamine is a drug indicated primarily if vomiting without fever and diarrhea in a child is caused by dysfunction of the central nervous system.

The drug has a mild effect on the central nervous system, the main basic substance dimenhydrinate inhibits it. Dramina is used as an anti-emetic, as a sedative, and also as an antihistamine for certain forms of allergy.

The effects of Dramamine can last up to 5-6 hours.

Indications: motion sickness, motion sickness syndrome, dizziness, vestibular disorders.

How to take Dramamine?

• Children from 3 to 5-6 years. ¼ tablet before meals 30 minutes before, twice a day in case of potential long-term travel and motion sickness. If Dramamine solves the problem as a one-time antiemetic, you need to give ½ tablet and observe the child's condition.
• Children over 6 years old - up to 10-12 years old. ½ tablet twice a day or 1 tablet once in a single case of vomiting.

Contraindications:

Age up to 1 year and some kidney diseases, dermatosis, bronchial asthma.

3. Humana electrolyte as a medicine for dehydration. It is a good hypoosmolar agent that corrects the water-electrolyte balance, restores the energy potential of the child's body.

It is produced in the form of powder in sachets, diluted - 1 sachet in a glass of warm boiled water.

Humana electrolyte works effectively even in the treatment of children from the first days of life, and not only normalizes the fluid balance, but also replenishes the baby's body weight deficit lost during vomiting.

The composition includes the following components:

• Sodium chloride.
• Potassium citrate.
• Glucose.
• Maltodextrin.
• Natural aromatic flavors (cumin or banana).

Treatment regimen for profuse, prolonged vomiting:

0-2.5-3 months of life	4-5.5 months	6-12 months	1-3 years
200-500 ml 7-8 times a day	300-600 ml 5-8 times a day	400-1000 ml 5-8 times a day	100-150 ml 6-8 times

A single vomiting does not require such use of the medicine, it is quite enough to give the following amount:

• Child under 1 year old - half a teaspoon every 5 minutes for 1-2 hours.
• Children over one year old - one teaspoon every 5-7 minutes for 1-2 hours.
• Children over 3 years old - one tablespoon every 5-10 minutes for an hour.

Vitamins

Vitamins are not the basis for treatment, rather they are an additional stage in therapy that allows you to strengthen the immune system, replenish the deficiency of necessary substances, microelements. Self-medication, especially with vomiting without fever and diarrhea in a child, is unacceptable. For what reasons is the mouth reflex not treated with vitamins?

• If a child vomits, he should not be forced to eat, the only thing needed in the first few hours after the episode of the gag reflex is to drink, often and in small portions. Vitamins can provoke a new attack of vomiting.
• Vitamins are prescribed after a few days if vomiting without fever and diarrhea does not lead to worsening of the condition. Vitamin complexes, monodrugs can consolidate the positive result, but they should be prescribed by a doctor.
• Vitamins are not safe, overdosing on any kind of vitamins can cause serious complications for both adults and children. Pay attention to hypervitaminosis D, which often causes vomiting without hyperthermia and diarrhea.
• It often happens that vomiting is a signal of vitamin overdose. In addition to the gag reflex, the child may experience headaches and slight swelling.

Vitamins, however, are indicated for children mainly after a course of therapy.

What vitamins can be recommended for vomiting without fever and diarrhea?

• Complex preparations containing a whole range of vitamins and microelements.
• B vitamins, vitamin C and A to normalize metabolism and strengthen the immune system.
• Calcium in bioavailable form.
• Vitamin K, which is considered an antihemorrhagic substance that promotes normal blood clotting.
• In case of acetonemic vomiting, B vitamins are indicated.

A doctor can select and prescribe the necessary vitamin complex, or a vitamin as a single drug, based on information about the characteristics of vomiting, the dynamics of the process and, above all, based on the diagnosis.

Physiotherapy treatment

Physiotherapy treatment for such a phenomenon as vomiting without fever and diarrhea in a child is considered the method of choice. If it is possible to do without medications, then physiotherapy is an excellent and effective option for stabilizing the baby's health.

What is physiotherapy?

This is the influence and impact on the organs and systems of the body using a variety of techniques - both natural (heat, light, water) and artificial - hardware methods of physiotherapy.

Physiotherapeutic procedures are very popular in pediatrics, as they act as activators of the child's own health resources. The healing effect, relative safety, and availability make physiotherapy one of the leading areas in treating children, including gag reflexes.

What types of physical therapy are indicated in childhood?

• Electromagnetic therapy and its variants.
• Ultrasound therapy.
• Magnetic therapy.
• Phototherapy.
• Heat therapy.
• Phototherapy.
• Aerotherapy.
• Balneotherapy.
• LFK - therapeutic physical training.
• Water treatments.
• Wellness and therapeutic massage.

Physiotherapy, with all its positive characteristics, has its own peculiarities and contraindications, especially if the child’s vomiting is repeated and is a symptom of a serious illness.

Specificity of physiotherapy procedures:

• All procedures are prescribed taking into account age.
• The dosage of physical factors of procedures (water, heat, light) is also calculated according to age norms.
• Almost all physiotherapy procedures are prescribed in the first half of the day.
• The procedures are prescribed either 2-3 hours after eating, or an hour before eating.
• The duration of the course depends on the etiological factors of vomiting without fever and diarrhea in a child, age, and other characteristics of the baby.

When should physiotherapy methods not be used?

• Persistent, frequent vomiting.
• Profuse vomiting.
• Vomiting with impurities - blood, food debris, mucus, bile.
• For any manifestations of viral diseases.
• If there is a history of potential risk of seizure syndrome.
• For head injuries, bruises.

How can physical therapy help with vomiting in a child?

• Infrared laser radiation. Activates metabolism, relieves swelling, activates lymph flow. It is indicated as a general strengthening procedure after a course of drug treatment, as well as after surgery for intestinal obstruction, esophagus.
• Electrophoresis. Zonal introduction of drugs using a certain frequency of electric current. This method allows using the necessary drug in a gentle version, reducing the dose while maintaining the therapeutic effect.
• UFO - ultraviolet irradiation. The procedure activates the protective properties of the immune system, relieves the severity of inflammatory processes, for example, with prolonged, chronic bronchitis, accompanied by vomiting without fever and diarrhea.
• Magnetotherapy. The pinpoint effect of a magnetic field on certain parts of the baby's body is good for treating gastrointestinal diseases, neurotic manifestations, including those that lead to a gag reflex.
• A course of therapeutic physical training is an excellent method to restore the body's tone, improve the functioning of the respiratory and nervous systems, regulate the functioning of the vestibular apparatus and reduce the risk of motion sickness (motion sickness is accompanied by vomiting).
• Massage. This is the most popular type of physiotherapy, which can be done at home. If vomiting is a signal of fatigue, a stress reaction, a relaxing massage is indicated, which can be done even for babies from 2-3 months. There are different types of massage and a conditional division into categories - general strengthening and therapeutic. The attending physician will be able to accurately select physiotherapy in these categories.

Folk remedies

Folk treatment for such a symptom as vomiting without fever and diarrhea in a child are recommendations that parents receive from anywhere, but not from the doctor. Advice from relatives, friends, articles in popular magazines and newspapers certainly promise an immediate recovery of the baby. However, everything that concerns the health of the child requires caution and a reasonable approach. Therefore, folk treatment is only an option that should be discussed with the attending physician.

What safe folk methods of treating vomiting can you recommend?

• There are special products that help reduce nausea, therefore, help avoid vomiting. For example, baked quince. It can be given to a child after the process of fractional drinking has been successfully completed. Quince has an astringent property, but in baked form it is considered an almost dietary product, rich in microelements and vitamins.
• Freshly squeezed blackcurrant juice, due to its vitamin C content and sour taste, helps a child cope with nausea and vomiting. The juice can be given to children from three years old, after a single vomiting not associated with a serious illness.
• A gentle diet after persistent vomiting can be crackers from bread, preferably white. Crackers do not burden the stomach and at the same time give a certain energy reserve to the body. One day of dietary nutrition, including crackers, herbal decoctions, and your baby will be quite healthy.
• After vomiting, a child should drink boiled water cooled to room temperature with lemon and honey added. This will replenish the body with potassium, magnesium and vitamin C. Recipe: for 1 glass of water - a teaspoon of honey and half a teaspoon of lemon juice. Drink in small sips, every 5-7 minutes.
• Weakly brewed green tea can help relieve the feeling of vomiting and can also counteract nausea.
• Psychogenic vomiting without fever and diarrhea in a child is well relieved by tea with the addition of chamomile and mint.
• If your baby gets motion sick, you can give him a lemon or mint-flavored lollipop. This advice is only suitable for children over 3 years old.

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Herbal treatment

Herbal treatment will also be appropriate when vomiting without fever and diarrhea in a child is not accompanied by other symptoms.

Usually the following infusions and decoctions work well as antiemetics:

• Mint tea or mint decoction. The recipe is simple - pour 1.5 cups of boiling water over a teaspoon of dried mint. Leave for about 40 minutes, strain. The child is supposed to drink it in small portions, so the mint decoction should be given in a teaspoon every 10-15 minutes. Of course, this tea is not recommended for infants, but it can be given to babies starting from one and a half years old. Mint has an antispasmodic effect, soothes the stomach, alleviates the condition after vomiting, and replenishes fluid loss.
• Dill decoction. Dill seeds are popular not only as a way to prevent flatulence, but also as an option to reduce nausea and reduce the risk of vomiting. A teaspoon of seeds should be poured into a glass of water, brought to a boil and immediately removed from the heat. Cool the decoction to a warm state, strain and give the child half a teaspoon every 5-7 minutes. Even infants can drink dill decoction. The volume of drink is calculated based on body weight.
• Children over 5 years old can boil lemon balm. Herbal treatment is effective if parents know the beneficial properties of the plant in advance and have a "strategic" reserve for unforeseen cases. Melissa is brewed similarly to other herbal remedies. A teaspoon per 250 ml of boiling water, if the child is over 10 years old, you can take a tablespoon of dry grass for the same amount of water. The drink should not be boiled, it is covered, left to brew for 30 minutes, cooled to a warm state. The child should drink the strained infusion fractionally - a teaspoon every 5-10 minutes. Melissa soothes spasms of the esophagus, stomach, has a good effect on the state of the nervous system.
• Children over 7 years old can drink ginger tea. A small piece of ginger should be crushed (grated), take literally a piece, on the tip of a knife, and place in 500 ml of boiling water. Infuse for 30 minutes, strain. The decoction turns out with a specific, tonic aroma and taste. A child can drink a tablespoon of ginger infusion for an hour, every 10 minutes.

Herbal treatment is not a universal method, moreover, herbal medicine cannot be considered safe. All the above recipes can be considered only introductory information, and you need to clarify which herb can help with vomiting from your doctor or a herbalist.

Homeopathy

Homeopathy is a fairly popular method of treatment when vomiting without fever and diarrhea is diagnosed in a child. The remedies can be either complex or consist of one active substance.

What homeopathy is indicated for children with gag reflex?

• The most popular and complex drug is Nux Vomica, it is not for nothing that it is called a vomiting nut. The specificity of homeopathy is that each component of the drug corresponds to the rule - to treat like with like.

The composition includes Bryonia, Citulius colocynthsa, Licopodium, Strychnos nux vomsca and other components. The medicine is available in the form of drops, has a wide range of effects, and is recommended for use in children only from 2 years of age. Very rarely, a doctor can prescribe Nux Vomica to children from 1-1.5 years of age.

Dosage:

Children from 2 to 6 years old - 2-3 drops three times a day one hour after feeding. The drops should be dissolved in 10 ml of water.

Children over 6 years old – 10 drops of the preparation per 2 tablespoons, drink 2-3 times a day as indicated

Features of the reception:

Older children should be taught that the medicine should be held in the mouth for a while and then swallowed.

• Gastricumgel can also have a positive effect on vomiting without fever and diarrhea in a child. Especially if the reflex is provoked by overeating. The drug sedates, calms, relieves stomach spasms. The drug also works well for acetonemia, soothing vomiting and reducing intoxication. The drug is available in tablet form.

Gastricumgel has no contraindications, however it is not prescribed to children under 2.5-3 years old (small children are not able to dissolve a tablet under the tongue)

Directions for use:

Children from 5 to 12 years old – 1-1/2 tablets under the tongue, dissolve

Young children (3 to 5 years) - grind the tablet to a powder state, dissolve in 2 tablespoons of purified water. Drink 1-2 teaspoons 2-3 times a day.

• Vertigoheel is a drug that improves cerebral circulation, toning it up, reduces the symptoms of nausea and vomiting during motion sickness, dizziness, and fainting. It is good to give Vertigoheel to children who do not tolerate travel well.

Contraindications: Age up to 1 year

Directions for use:

Children from 1 to 3 years old – 2-3 drops in a tablespoon of water 20 minutes before meals.

Children from 3 to 6 years old – 4-5 drops per tablespoon of liquid

For a child over 6 years old, you need to put 10 drops in 10 ml of water, ask him to hold the solution in his mouth, and then swallow it.

• Regurgitation, which often looks like vomiting without fever and diarrhea, can be stopped in a child with Aethusa cynapium (dog parsley).

The dosage and specifics of administration should be suggested by a homeopathic doctor.

Homeopathy, although considered a safe method of treatment, nevertheless requires at least an examination of the child, at most - a comprehensive examination. Self-medication is unacceptable, especially when it comes to the health of the child. The main thing in homeopathy, as in other methods of therapy, is the rule - do no harm.

Surgical treatment

Vomiting without fever and diarrhea in a child, as a rule, does not require surgical intervention. Surgical treatment is an extreme measure when the gag reflex is one of the symptoms of a life-threatening disease in a child. These may be abdominal diseases with clinical manifestations of severe abdominal pain, prolonged constipation or uncontrollable diarrhea. Usually, such pathologies are accompanied by elevated body temperature, other characteristic signs, which you can read about on our website.

Surgical treatment is indicated only in such situations, in acute forms of diseases:

• Inflammation of the appendix.
• Cholecystitis (exacerbation).
• Diverticulitis.
• Acute intestinal obstruction, intussusception, small intestinal intussusception.
• Exacerbation of gastric ulcer (extremely rare in children).
• Extremely rare - biliary atresia.
• Esophageal stenosis.
• Peritonitis.
• Pylorotomy for congenital pyloric stenosis.
• Perforation of the duodenal ulcer.
• Traumatic injuries of abdominal organs.
• Traumatic injuries associated with a threat to the baby's life.

In general, vomiting without fever and diarrhea in a child does not require surgical treatment.

Surgery is only necessary in the case of a typical “acute abdomen”, when the baby has severe tension in the abdominal muscles, high temperature, pain, persistent constipation or diarrhea.

To exclude threats and risks, a specific diagnosis, the doctor collects anamnesis, complete information about the onset of the disease. The connection of vomiting with food intake and regimen is clarified, vomit is examined for the presence or absence of specific impurities, odors. Also, the child may be prescribed additional examinations - tests, instrumental diagnostics (ultrasound, contrast X-ray, FGDS).

Prevention

Prevention of the symptom - vomiting without fever and diarrhea in a child - consists of simple, well-known recommendations.

The child needs adequate nutrition, alternating physical activity and adequate rest, a calm environment in the family, and regular preventive medical examinations.

Prevention of the gag reflex is a preventive measure that prevents etiological factors that provoke nausea and vomiting. Therefore, preventive actions should be aimed at strengthening the baby's immunity and health.

Considering that vomiting without fever and diarrhea in a child is usually associated with functional disorders or stress-related causes, prevention tips may be as follows:

• The child needs adequate fluid intake. Let the baby drink purified water, natural juices, herbal tea. The volume depends on the age and weight of the child.
• The child should get enough sleep. The duration of sleep is at least 8 hours per day. Infants sleep much more, they have their own specific regime.
• Stress, psychological trauma, events that a child perceives as a personal "tragedy" can cause a gag reflex. The environment in the family, in a preschool institution, school significantly affects the health of children. The psycho-emotional state of a child is the concern of adults. The more comfortable the environment in which the baby is, the stronger and more flexible his nervous system is, and the lower the risk of vomiting as a consequence of shock.
• The child's body needs constant replenishment of vitamins and useful microelements. The attending pediatrician will help you choose them.
• Eating is also important in preventing vomiting in a child. If the baby suffers from a chronic gastrointestinal disease, the diet should be adjusted so that the portions are small, and their intake is fractional and frequent. The diet, restrictions in the range of products are recommended by the doctor in accordance with the established diagnosis and treatment strategy.
• The child needs to be provided with fresh air. Oxygen starvation, hypodynamia - a sure path to the development of many diseases, including those that are accompanied by vomiting.
• At the first alarm signals, which include vomiting, you should at least consult a pediatrician. If the gag reflex was a one-time occurrence, let it be a kind of insurance. If vomiting is repeated, lasts more than 2-3 hours, you should immediately call a doctor. A disease detected in time can be successfully treated, and it is quite likely that vomiting without fever and diarrhea will not recur.

Forecast

The prognosis for such a symptom as vomiting without fever and diarrhea in a child is favorable in most cases. The risk of complications is minimal, everything depends on the attentiveness of the parents and the provision of timely assistance.

An unfavorable prognosis is possible only if extremely rare diseases accompanied by a gag reflex are detected. These are congenital pathologies of the brain, gastrointestinal tract, central nervous system, rare genetic disorders that are diagnosed in the first days of life, and often even during gestation. Also dangerous are meningitis, encephalitis, acute inflammation of the appendix, intestinal obstruction, pathological conditions of the pancreas and gall bladder, diabetes (precoma), renal failure, metabolic disorders in acute form (cyclic ketonemia)

In general, the prognosis for the condition is vomiting without fever and diarrhea in 95% of cases. Remember that the vomiting reflex itself is not a disease, it is a clinical sign.

If you notice the slightest changes in the child's health in time, do not panic, act wisely and follow all the recommendations of the attending pediatrician, the baby's life will not be in danger. And nausea and the vomiting defense mechanism as a functional condition will pass over time, because according to statistics, the older the child, the less often he vomits.