Vomiting without fever and diarrhea in the baby

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

Epidemiology

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

Consider the epidemiology of the most common in the list of etiologic factors of vomiting diseases.

1. Regurgitation is a functional reflex, often not requiring treatment. Vomiting without fever and diarrhea in infants is a common phenomenon associated with the anatomical specificity of the baby's body. In the early period of infancy, the cardia of the stomach is practically not developed, the stomach has not yet "found" its position in the body, settling vertically. As the child grows, regurgitation decreases, but the vomiting reflex may persist and be accompanied by pallor of the skin, increased salivation. Also, vomiting without raising body temperature in young children is caused by an unformed nervous system, when, for example, neuromuscular fibers, structures in the digestive tract are not yet ripe, their functioning is imperfect. Thus, the passive eruption of company masses in a baby can be considered a transient phenomenon and in the epidemiological sense it is safe. Separate attention deserves pyloric stenosis as an inborn pathology of the sphincter of the stomach. Primarily diagnosed in new-born boys first-born - 4 times more likely than in babies. Thickening of the pyloric wall clinically manifests itself literally from the first days of birth in the form of vomiting after ingestion of breast milk or artificial mixtures. Frequent vomiting is typical for the first 4 weeks, then reflex rejection of food is reduced, but the process remains. Vomiting occurs actively, eruption - a strong stream. The body weight of the baby, as a rule, does not change, the only thing that parents notice is constipation and rare urination.
2. Gastrointestinal diseases of non-infectious etiology, for example, gastritis. Vomiting without fever and diarrhea in a child can be a consequence of a developing or long ago, slow indifferent nonspecific inflammation of the stomach. This is not a separate, isolated condition of atrophied tissue. The stomach is anatomically connected with nearby organs and systems, including the nervous or endocrine system. Therefore, the 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, gastritis ranks 5 place (all diseases of the gastrointestinal tract - 4 place).
   • Since 2005, the number of confirmed diagnoses - GERD (g astroesophageal reflux disease), CGD (chronic gastroduodenitis) in children has increased by 30%.
   • In a number of diseases associated with digestion in a child, gastroduodenitis is in the lead in chronic form.
   • Children often diagnosed with so-called secondary chronic gastritis, one of the symptoms of this disease is vomiting without temperature and diarrhea.
   • The onset of exacerbation of CHD (chronic gastroduodenitis) coincides with a sharp change in the regime of the day and nutrition, nervous tension, for example, the child's enrollment in school.
   • Most often gastritis affects girls until the end of the puberty period, then the rates between boys and girls equalize.
   • CHD in a child is rarely an isolated nosology, in 85% of it "accompany" duodenal diseases, dysfunction of the gallbladder, pancreas.
   • HG (chronic gastritis) in children, provoked by Helicobacter pylori, increases statistically with age - children under 10 years old - 20%, up to 15 years - 40-45%, children over 15 years - 55-60%.

This information is also available on the frequency and statistics of the occurrence of vomiting in children:

1. As the child grows up, attacks of vomiting and nausea decrease, neurological factors of vomiting are inherent in adolescents 12-14.
2. Girls are most prone to vomiting reflex.
3. Vomiting without fever and diarrhea in a child can be associated with motion sickness syndrome, more than 40% of children have such a syndrome. This is due to the high sensitivity, the vulnerability of the vestibular apparatus and the "fixing" of the vomiting reflex (reflex arc).
4. Most often, vomiting is noted in emotional, excitable children.
5. Children with a metabolic disorder, overweight 2 times more likely to suffer from vomiting.

Epidemiological studies of the factors causing vomiting are numerous, it is not possible to generalize them in the framework of this article. In general, note that the emetic functional reflex without other concomitant clinical symptoms is most typical for young children.

[1], [2]

Causes of the vomiting without fever and diarrhea in the baby

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

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

At once we will make a reservation that serious illnesses threatening a child's life accompanied by vomiting, as a rule, have standard clinical manifestations in the form of increased body temperature or diarrhea (diarrhea). A gag reflex without other symptoms rarely indicates a pathological state of a child's health, except that it can only be CTB (craniocerebral trauma), cardiac problems and diabetes.

The most common factors provoking a gag reflex is a rather large list of physiologically transient conditions, including the nervous and gastrointestinal system. The causes of vomiting without fever and diarrhea in a child are due to many signs, clinical manifestations. Often before vomiting in children there is a feeling of nausea as a harbinger of the actual vomiting reflex and subsequent symptoms.

Vomiting without fever and diarrhea in a child can be a reflex that originates both in the psychoemotional sphere, and in the systems, organs of the baby. The most common cause that does not belong to pathological conditions is a temporary, temporary irritation of the pharyngeal mucosa, in the second place is a rather large list of discomfort or pathological conditions of the gastrointestinal tract, it also happens that the causes of vomiting lie in the pain syndrome (the center of the reflex comes from special parts of the brain).

Clinically, the causes of vomiting without additional signs - temperature and diarrhea, can be divided into three broad categories:

1. Psychogenic vomiting, provoked by structural irritation or pathological lesion of the central nervous system (CNS)
2. Vomiting as a reflex in irritation or gastrointestinal illness (gastrointestinal tract)
3. A gag reflex caused by hemato-toxic causes (poisoning with drugs, poisonous substances)

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

Diseases, pathologies and transient conditions of the digestive tract	Neurological disorders, diseases of the central nervous system	Psychogenic causes of vomiting
Congenital abnormalities of the gastrointestinal tract (pyloric stenosis, diverticulum, obstruction of the esophagus)	Craniocerebral injury	Stress, fright, provoking a psychogenic emetic reflex
Maltractive syndrome	Labyrinthopathy or Ménière's disease	Associative, reactive vomiting (reaction to uncomfortable associations, for example, to the smell, to the appearance of the object)
Foreign body in the esophagus	Hemikrania (migraine)	Strong affective excitation (vomiting as a compensatory reaction)
Functional dyspepsia	Hypoxia	Anorexia
Reflux disease (GERD)	Meningitis, epilepsy	Vomiting as an early symptom of mental disturbance
Cardiospasm associated with esophageal dysfunction (motor impairment)	A sharp jump in intracranial pressure	Rumination - vomiting as a way to attract attention when there is insufficient attention of a close, caring for a child, a person

Once again, note that vomiting without fever and diarrhea in a child is almost never a symptom of an infectious intervention. Bacteria, parasites or viruses, as a rule, provoke a rise in body temperature, and diarrhea. An exception may be infectious diseases of the urinary, bronchopulmonary system in a chronic, neglected form, which proceed in a clinical sense sluggishly, without characteristic signs. Rarely, the causes of vomiting without fever and diarrhea can be caused by such pathologies:

• Cardiovascular diseases.
• Diabetes.
• Rotavirus infection in a slow form.
• Laktatatsidoz.
• SCR - a syndrome of cyclic vomiting in the background of migraine.

Vomiting without temperature and diarrhea is conventionally divided into age categories. For example, a gag reflex of a psychogenic nature is more common in adolescents or children older than 6-7 years. In the pubertal period, vomiting on nervous soil is observed in adolescents 12-14 years old, as it grows up this condition passes. Just like the psychogenic vomiting reflex disappears by age and the motion sickness syndrome is kinetosis.

In infancy, vomiting without fever and diarrhea is common in infants of the first month of life. The so-called regurgitation is a kind of reduction of the gastrointestinal tract, when the cardiac sphincter is open. Vomiting in infants has functional causes and is most often due to either ingestion of the air, or a violation of the feeding regimen. Such vomiting stops in 6-7 months.

Particular attention should be paid to acetonemic vomiting. The condition has the following characteristic features:

• Vomiting is preceded by nausea.
• From the mouth of the child there is a specific smell of acetone.
• The baby is listless, weak, complaining of a headache.
• The child quickly becomes dehydrated.
• Vomiting increases and becomes indomitable, plentiful.

Acetonemia is diagnosed at any age, but according to statistics, it is most common in children up to 9-10 years old. At the first clinical signs, and more often it is a characteristic smell, you need to turn to the treating pediatrician, with severe vomiting - to call an ambulance.

[3], [4], [5]

Risk factors

Vomiting without fever and diarrhea in the child in most cases has a functional cause. However, risk factors should be considered and pay attention to the following symptoms:

• Vomiting in a child is accompanied by weakness, drowsiness
• The gag reflex repeats more than 3 times a day
• In addition to vomiting, the baby has a stomach ache
• repeated vomiting subsequently ends with an increase in temperature
• the child's urination decreases
• vomiting occurs after a bruise, a fall, especially it is dangerous if the blow fell on the head
• the kid flatly refuses to drink
• The gag reflex arises without apparent objective reasons

For any of the above signs, the child needs qualified medical care.

Risk factors that need to be addressed if vomiting without fever and diarrhea in a child does not stop within 1-2 hours:

Symptoms	Probable cause, which the doctor will confirm or exclude	What parents should do
Vomiting in a child acquires a specific color shade - greenish or with an admixture of blood, a baby may have stomach ache	An acute form of the intestinal tract, for example, intestinal obstruction	Immediately call an ambulance
Vomiting without temperature and diarrhea is triggered by a child's fall. The gag reflex is accompanied by weakness, drowsiness	Traumatic brain injury Brain concussion	It is necessary to call an ambulance team
Vomiting is accompanied by severe headache, drowsiness. Child annoyed by daylight, sounds	Disease associated with the central nervous system. Meningitis	Urgent hospitalization is necessary
In addition to vomiting, the child has a sharp pain in the back, in the groin. Pain radiates, moves	Possible renal colic in the background of pyelonephritis	Call a doctor, with acute pain and indomitable vomiting - call an ambulance

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

1. Repeated, intensifying vomiting is a serious symptom requiring medical attention.
2. After one or two episodes of vomiting, the child's body temperature rises.
3. Vomiting has a specific smell - putrefactive or the smell of acetone.
4. After the vomiting stops, the baby begins diarrhea.
5. Vomiting is accompanied by involuntary muscle contractions, seizures.
6. If a child is given a drink, vomiting is worse.

In general, the risk factors for a gag reflex are two states:

• Dehydration
• The risk of vomiting into the respiratory system

The most vulnerable at this point are babies up to one year old.

[6], [7], [8], [9], [10], [11], [12]

Pathogenesis

Pathogenesis or a description of how the condition begins and develops, the disease in relation to the vomiting reflex is an explanation of the physiological processes that trigger vomiting. Vomitus (vomiting) is a specific reflex, which is provoked by spasm of the sphincter between the stomach itself and the bulb of the duodenum. The gatekeeper or sphincter shrinks constantly, controlling the progress of food along 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, increased separation of saliva.
• Vomiting begins with a deep, heavy breath that seeks to compensate for the spasm of the sphincter.
• During the inhalation, the epiglottis closes, isolating the respiratory system from the possible eruption of the masses.
• The gatekeeper spasms, and at the same time there is a relaxation of the muscular tissue of the bottom of the stomach. This is how vomit masses can move up.
• The lower sphincter of the esophagus opens, the abdominal muscles tense, the diaphragm is greatly contracted - thus, intra-abdominal pressure increases.
• Vomit masses move upward to the oral cavity and are ejected through the mouth, less often through the nose.
• Vomiting is always accompanied by strong salivation due to the fact that glandulae salivariae (salivary glands), facial and pharyngeal nerves are located very close to the center, which starts the gag reflex (in the medulla oblongata).

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

1. Descending zone of the reticular formation.
2. The chemoreceptor zone that triggers the process. It is located in fossa rhomboidea (a rhomboid fossa on the bottom of the IV ventricle).

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

1. The stimuli to the vomiting reflex come from the nerve endings of the gastrointestinal tract or the bile duct, and the impulse can also come from the vestibular apparatus (cortical centers) or from the hypothalamus, thalamus dorsalis.
2. It starts vomiting as a chemoreceptor zone trigger (HTZ or CTZ), from there the impulse goes directly to the vomiting center (VC). The cause of the stimulation may be a lack of oxygen (hypoxia), the taking of certain medicines, diabetic violation of carbohydrate metabolism (ketoacidosis).

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

[13], [14], [15]

Symptoms of the vomiting without fever and diarrhea in the baby

Symptoms of vomiting and nausea can be varied. Vomiting without fever and diarrhea in the child is a kind of protective reflex, helping to remove from the body what prevents normal life. Irritating the vomiting center, provoking factors, as a rule, have such symptoms:

• Blanching of the skin.
• Intensifying salivation.
• Lethargy, weakness.
• Nausea, sometimes very long.
• Involuntary swallowing movements.
• Heart palpitations may increase.
• Breath intermittent or, conversely, deep, slow.
• Sweating is increasing.

The most typical vomiting without fever and diarrhea for babies, this process is called regurgitation. Symptoms:

• Vomiting occurs without prior nausea.
• The kid's tummy tenses quickly, becomes firm.
• The skin of the face can change color in the direction of blanching.
• The general condition of the infant 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 complexion of the baby becomes bluish.
• The child becomes restless, often crying without objective reason.
• The body temperature of the baby falls, legs and hands feel cold.
• Regurgitation is more like a multiple vomiting, threatening dehydration of the body.

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

1. Functional vomiting, regurgitation. Erupt mass is allocated without obvious stress, without effort and changes in the state of health of the baby.
2. A vomitive reflex caused by diseases, pathological states of the brain (the central origin of the provoking factor). Vomiting occurs without nausea, but is accompanied by a headache. After the eruption of the vomiting, the condition of the child 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 pain symptom in the abdomen. So-called gastric emesis rarely begins right after eating, it "starts" 40-60 minutes after eating, when digestion as the process reaches its peak. After vomiting, the child's condition improves significantly.

Particular attention deserves the symptoms of dehydration (dehydration), as a consequence of profuse vomiting:

• The child is very thirsty.
• Mucous membranes of the mouth are dry, lips often dry out, cracks appear.
• Urination is meager.
• The skin is pale.
• The general condition of the child is characterized as weak, exhausted.
• Any attempt to water a child ends with a new bout of vomiting.

Symptoms that require immediate medical attention:

1. Vomiting begins after a head injury, after falling and hitting other parts of the body.
2. Vomiting does not stop within 4-6 hours.
3. The gag reflex is accompanied by severe pain in the abdomen.
4. Vomit has a specific kind and smell, except for food, they have an admixture of blood, feces, bile.
5. Vomiting is combined with increased urination or on the contrary - urine is practically not excreted.
6. The gag reflex leads to a change in cognitive functions. The child begins to confuse words, to perform unusual actions for him.

Summarizing the clinical manifestations of vomiting without fever and diarrhea in a child, it can be noted that reflex symptoms are important diagnostic information. Therefore, attentive parents should pay attention to the beginning of the process, that is, 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 poor health. Involuntary, sudden vomiting is rare, so you should not be afraid of serious complications.

The first signs of starting vomiting in a child:

• The baby loses its activity, becomes unusually sluggish, quiet.
• The child may have a burp, which is repeated many times.
• Often children complain of nausea, which precedes vomiting.
• The child has no appetite, he eats poorly or very little during the day.
• The child may complain of dizziness.
• The face of the baby acquires an unusual shade, turns pale.
• The child can sweat much, it increases salivation.
• Painful sensations are concentrated in the epigastric zone, the child clearly indicates the localization of pain.

Vomiting is not a separate, independent disease, therefore the first signs are the clinical manifestations of the root cause of the vomiting reflex. On them, and should pay attention in order to subsequently give full information to the doctor for the specification of the diagnosis and adequate treatment recommendations.

What should I look for, what are the first signs of serious illness accompanied by vomiting?

1. Diseases of the central nervous system. With 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, as a rule, is accompanied by fever and convulsive syndrome, but in the first hours of these manifestations may not be. Therefore, it is better to be reinsured, if the child has vomiting, headache for 3-4 hours, you need to call a doctor.
2. Inflammation of the appendix. Usually begins with nausea, prolonged and persistent, then there may be vomiting without fever and diarrhea. Specific signs - pain in the right side of the abdomen, closer to the hypochondrium, or pain symptom in the navel.
3. Vomiting in acetone has a peculiarity - a smell. At the first symptoms, you should consult a doctor.
4. Children can "fall" a special zone in the place where the cranial bones - fontanel.
5. After the fall, a head injury in the child, an uncontrollable vomiting can be opened up to loss of consciousness. This condition requires urgent hospitalization.

Also, the first symptoms of vomiting can be manifested and for reasons not related to disease. For example, the kid was too active, running and overworked. His nervous system is not so perfect, any bright impression can affect so much that the child will react with an emetic reflex. In addition, the motor activity of the child requires constant replenishment of the fluid. If the baby does not get enough water, vomiting can be caused by an elementary violation of the water-salt balance.

A child over three or four years old can complain of poor health, the first signs of vomiting without fever and diarrhea will be voiced within the age-specific speech characteristics. It is more difficult for young children who can not describe their problems, so all the more unusual, uncharacteristic manifestations in the behavior of the baby, in its appearance, food preferences, in the mode of urination and allocation of feces should be observed by attentive parents.

[16], [17]

Complications and consequences

Consequences and complications are a consequence of serious pathologies, diseases, provoking vomiting. But, considering that we are considering vomiting without the temperature and diarrhea in a child, it's probably not necessary to talk about the consequences and risks. This is due to 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 are manifested either by diarrhea or by persistent constipation.

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

• Regurgitation in infants. Consequences and complications are not observed.
• Single vomiting as a protective physiological mechanism on an exogenous or endogenous stimulus. Complications are recorded very rarely.
• Psychogenic vomiting. The consequences can be in the form of fixing the reflex to a certain trigger. For example, a single vomiting that occurs when you see any image, frightening or exciting child, can be fixed and repeated in the future.
• Acetonemic vomiting. Complication is dehydration, dehydration.
• Frequent vomiting due to headache is complicated by deterioration in the general condition of the child. The kid can lose weight.
• Consequences and complications can have a craniocerebral injury, in which vomiting is almost inevitable. An exact diagnosis, localization of the lesion and treatment is prescribed by the doctor. The minimization of risks and complications depends on how timely this is done.
• Hypoxia can provoke vomiting, which is then fraught with metabolic acidosis. Acidosis is also characteristic of diabetes mellitus. As a complication it is necessary to describe the actual acidosis, and not vomiting, detailed information on the condition - ketoacidosis, metabolic acidosis, you can find on our website.
• The complication of vomiting can be aspiration - ingestion of vomit into the respiratory system, up to aspiration pneumonia.
• Vomiting without fever and diarrhea in a child can lead to hyperkalemia, especially if vomit is erupted abundantly and often, and reflex accompanied by increased sweating.

[18], [19], [20], [21]

Diagnostics of the vomiting without fever and diarrhea in the baby

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

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

In addition, the pediatrician examines the vomit, or ask parents about them. According to certain signs - odor, density, presence of impurities, amount of content, it is possible to exclude, or confirm preliminary diagnostic assumptions.

Parameters, characteristics, information, which the doctor will necessarily turn when diagnosing vomiting without fever and diarrhea in the child:

• Age of the child.
• Body weight.
• Skin condition (rash, degree of dehydration), examination of the oral cavity.
• Evaluation of the neurological status of the baby (for the subject of convulsive syndrome).
• Checking the condition of the muscle tone of the abdominal cavity.
• Accompanying illnesses.
• Predisposition to diseases caused by genetics (eg, allergy, diabetes, metabolic disorders).
• Vomiting symptoms (headache, abdominal pain, tinnitus, palpitations).
• Characteristics of the frequency of episodes of vomiting (before meals, the time of day, how many times, how long).
• Characteristics of the vomiting contents - impurities, odor, volume, the presence of mucus, bile, foreign bodies, what remains of food in the vomit.

Let us note separately how important is the diagnosis of vomiting without fever and diarrhea in a child under the age of one year. 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 period?

• Atresia of the esophagus (esophagus) - lack of proper lumen, congenital etiology, leads to obstruction of the esophagus.
• Pylorosthenosis of newborns (significant narrowing of the sphincter / pylorus). According to statistics, it is more often diagnosed in males.
• Diaphragmatic hernia - displacement of the abdominal organs higher, to the zone of the thorax.
• Atresia of the intestine.
• Congenital dysfunction of the adrenal cortex (adrenogenital syndrome).
• Intestinal obstruction due to stenosis.
• Cystic fibrosis of congenital etiology.
• Intestinal obstruction due to filling the ileum / ileum lumen with meconium.
• Aachalasia of cardia (cardiospasm).

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

[22], [23], [24], [25], [26]

Analyzes

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

Typically, the doctor is sufficient to collect information (history), examination and evaluation of the characteristics of the vomiting content. Analyzes are given only in extreme cases, if there is any doubt in the preliminary diagnosis for normal, physiological vomiting.

For example, vomiting without fever and diarrhea in a child can initially be single, without specific odors and impurities. Home methods of replenishment of lost fluid (fractional soldering) does not have an effect and after a time the baby opens a second vomiting episode, vomiting becomes stubborn. In such cases, the child is shown hospitalization and a comprehensive examination, which necessarily includes tests. They can be:

1. When a virus is suspected of rotavirus infection, stool analysis is used to detect a specific antigen of the viral group A VP6. Analyzes of the vomiting contents or blood for the detection of the virus are not so revealing, 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, manifested clinically only by vomiting.
2. If a child's history has information that suggests that diabetes is an etiological factor that provokes vomiting, blood tests are prescribed. Quite often, type II diabetes, however, like the first one, can develop gradually, slowly and almost unnoticeably. Vomiting without fever and diarrhea in a child can serve as the first clinical signal and an occasion for operative diagnosis of the disease. The blood sample is taken fractionally, determining the level of sugar. Diabetes (insulin-dependent) is also confirmed by the presence of antibodies to the insulin in the blood, to the cells of the intrasector department of the pancreas / islets of Langerans. Very indicative for confirming the diagnosis of urinalysis on the level of sugar, on the presence of ketone bodies (acetone). For a complete and detailed analytical picture, you need a biochemical blood test for an indicator of the average sugar level for a certain period (usually from 1 to 3 months) - glycated hemoglobin.
3. Acetonemia is characterized not only by an emetic reflex, but also by the smell of vomit. However, for differentiation from ketogenic hypoglycemia, the TAC (biochemical blood test) is appointed. In acetonemia, leukocytosis (neutrophilic), a significant excess of uric acid, a strong increase or decrease in the level of sodium and potassium, and an increased rate of erythrocyte sedimentation (ESR) are detected there. In the urine, ketonuria is clearly expressed, which is indicated, depending on the degree of severity - one or more of the pluses.
4. Congenital disorders of metabolism, metabolism, which clinically signal themselves vomiting without concomitant symptoms, require additional laboratory tests. In the urine can be found amino acids, organic acids, acetone. In addition, as with suspicion of diabetes mellitis, it will be necessary to pass the OAK, a biochemical blood test, to carry out GTT (Glucose-Tolerant Test).
5. If the child, in addition to vomiting, has symptoms of achalasia cardiac, the doctor recommends that such tests be performed:
   • UAC (general blood test) to clarify the level of reticulocytes.
   • Blood tests for coagulation (coagulogram).
   • Determination of serum albumin level.
   • Clarification of serum creatinine levels.
   • OAM (general urinalysis).

6. Analyzes are also needed for fermentopathy (nonferrotic hemolytic anemia). They give - a biochemical blood test for bilirubin level, for detection of specific Heinz-Ehrlich bodies in erythrocytes, evaluate the level of activity of amylase, lipase, phosphatase and other enzymes, reveal the deficiency of the gamma-globulin protein.

In general, tests for vomiting without fever and diarrhea, the child - this is the necessary information base, which excludes various serious pathologies.

[27], [28], [29], [30], [31]

Instrumental diagnostics

Instrumental diagnosis is necessary if vomiting without fever and diarrhea in a child is not defined as a clear symptom of a particular disease or condition.

It happens that the disease develops secretly, proceeds in a languid form and does not manifest itself as a characteristic clinical feature. Vomiting is not a pathology, but one of the many signals about the dysfunction of an organ or system.

What precedes the instrumental diagnosis?

• Analysis of collected anamnestic data.
• Inspection.
• Specification of the characteristics of the emetic reflex.
• Data on the diet of the child.
• Preliminary assessment of the psychoneurological status.
• Palpation of the abdominal cavity.
• Palpation of lymph nodes.
• Oral cavity examination.
• Evaluation of the skin condition.

If the primary collection of information does not provide a specific vector for diagnostic assumptions, or conversely, there are all signs of a serious disease requiring clarification, instrumental diagnostics is assigned.

What methods can the child's condition be examined?

1. Organs of the abdominal cavity - ultrasound (size, condition, location).
2. Digestive system, digestive tract - FGDS (fibrogastroduodenoscopy).
3. Contrast fluoroscopy for detection of defective areas in the digestive tract (gastrointestinal tract).
4. Electrocardiogram.
5. Examination of GM (brain) - computed tomography, neurosonography, magnetic resonance imaging.

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

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

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

Etiology	Anamnesis Symptoms	Methods of instrumental diagnostics
Vomiting of cerebral (cerebral) etiology	Difficult childbirth, 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 digestive tract, Ultrasound of the stomach according to indications
Cardiac dysfunction of the stomach	The first month of life - flaccid reflexes, then anemia, vomiting with blood impurities	Radiography of the stomach Esophagogastroscopy. Manometry for determining the motor function of the pharynx
Pylorosthenosis	"Fountain" abundant vomiting, usually after eating, after feeding. Preservation of good appetite, constipation, neurologic manifestations	Survey radiography of the stomach, esophagus, Ultrasound

To perform instrumental diagnostics, hospital conditions are needed. Therefore, vomiting without fever and diarrhea in the child, requiring clarification, especially if episodes of vomiting are repeated often, is not diagnosed at home. Procedures are fast, as a rule, if the child's condition is normal, after 3-5 days he is discharged home.

Differential diagnosis

Differential diagnosis of a symptom such as vomiting without fever and diarrhea in a child is a way to exclude serious illnesses, including those that threaten the baby's life.

There are such areas of analytical tactics in the diagnosis of vomiting:

• Presence or absence of diseases of the digestive tract.
• Infection.
• Food or chemical intoxication.
• Metabolic disorders in acute form.
• Cerebral disorders, including complicated ones.
• Psychogeny.

How does differential diagnosis work if there are complaints of vomiting without hyperthermia and diarrhea?

1. Collection of epidemiological history.
2. Examination and palpation of the abdominal cavity.
3. Assessment of the body weight of the child, changes in the direction of decrease or weight gain.
4. Premorbid background in infants of the first year of life (account for a neurologist, congenital pathology).
5. A food regime, an estimation of quality and volume of a feed of the child.
6. Psychoemotional status of the child and the surrounding family environment.

In the differentiation of etiological factors, it is important to evaluate the characteristics of the emetic reflex by such parameters:

• Is there nausea before vomiting.
• How long does vomiting last?
• Is there a feeling of relief after an episode of vomiting.
• Activity of a vomiting reflex (to exclude "fountain" vomiting).
• Differentiation of regurgitation from vomiting.
• Establish a connection between the vomiting reflex and eating.
• Track the dynamics of vomiting (decreases, is activated).
• Analyze the volume of emetic contents.
• Assess the smell, color and consistency of vomiting.
• Establish the presence or absence of impurities in the vomit.

Clinical diagnostic differentiation:

1. Identify the symptoms of a possible inflammatory process.
2. Check body temperature.
3. Assess the condition of the oral cavity.
4. Check the operation of the respiratory system.
5. Assess the skin condition for moisture, turgor, rash.
6. Check the condition of the fontanel in infants.
7. Evaluate the work of peripheral circulation, measure the pulse.
8. Check muscle activity, tone.
9. Evaluate the function of the gastrointestinal tract and participation in the respiratory system (abdominal distention or bloating, NSC - abdominal wall tension syndrome).
10. Eliminate the symptoms of meningitis.
11. Assess the condition of the central nervous system if the child is older than 2-3 years - to assess the level of cognitive abilities, excluding the violation of consciousness.
12. Check the reflexes.
13. If it is possible to evaluate the characteristics of urine and feces on site.

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

• A greenish or brownish hue indicates that the food was in the stomach for a long time.
• Virtually undigested food in vomiting is a signal about the atony of the digestive system.
• Vomiting without smell = a sign that the food did not get into the stomach and was not processed there.
• The characteristic smell of stool in vomiting is a clear sign of a serious pathology - an intestinal obstruction.
• The smell of ammonia indicates uremia.
• Slime in the contents of vomiting - a symptom of either advanced bronchitis, or gastritis.
• Bile in the vomit - a signal about the narrowing of the duodenum, may indicate stenosis.
• Vomiting in the form of a foam is a sign of intoxication with a chemical substance.
• The smell of acetone - should exclude diabetic ketoacidosis.
• Bloody vomiting - hemorrhagic disease or false melena (the baby swallowed blood clots either during breastfeeding, if the mother has a cracked nipple, or during the first hours of birth, while passing through the birth canal). Also the blood in the contents of vomiting. Can be a sign of an ulcerative process in the digestive tract. A serious threat is bleeding in the stomach, as evidenced by vomiting in the form of "coffee grounds".

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

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

[32], [33], [34]

Treatment of the vomiting without fever and diarrhea in the baby

How is vomiting treated without fever and diarrhea? The child, as a rule, has such a reflex single, one-time. If vomiting occurred only once, there is no need to take any specific measures, the only thing that is necessary is to observe the condition of the baby during the day. If vomiting happens repeatedly and repeatedly, it is better not to risk it and call a doctor.

Who can join the treatment after the diagnosis?

1. A pediatrician is a doctor who performs a primary examination, collects information about a child's health and makes a preliminary or final diagnosis. If necessary, narrow specialists may be involved, who will prescribe the treatment of vomiting without temperature and diarrhea already according to their specialization.
2. The gastroenterologist can take care of the child if vomiting is a clinical manifestation of the gastrointestinal tract. Usually the baby takes treatment at home.
3. The surgeon is needed for acute, urgent conditions. Pylorostenosis, trauma of the stomach or intestines, intestinal obstruction, appendicitis and other acute illnesses are treated in a hospital.
4. The neurologist prescribes additional examinations if the vomiting for the primary diagnostic option is associated with pathologies, CNS diseases.
5. Psychogenic emetic reflexes suggest treatment with a psychotherapist, a child psychologist.

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

• Be sure to call for emergency medical attention.
• Ensure a proper supply of fresh air in the room.
• Before the medical help will be rendered, it is necessary to be with the child literally every minute. The child needs to release tight clothes, can be put on his side, so that the head is turned (to avoid vomiting in the respiratory tract). Infants should be kept in their arms in an upright position, and also monitor the release of vomiting to prevent aspiration (vomiting into the respiratory system).
• Babies after the vomiting act need to clean the mouth, older children can rinse their mouths themselves.
• You can not force a child to eat, except for babies.
• It is obligatory to give a child, in small fractions, in small portions, literally half a teaspoon, but very often (after 5-7 minutes). So you can avoid dehydration (dehydration) of the body.

Treatment at home involves a special diet. The rule is one - all products that are included in the menu should be carefully selected so that the diet meets the standards of gentle nutrition. Anyway, when vomiting, the mucous membrane of the gastrointestinal tract is subjected to a traumatic process, therefore, the food should not aggravate either mechanical discomfort or inflammatory process, which is also possible. It is important to consider the cause of vomiting. If it is of a psychogenic nature, in no case should you force a child to be forcibly.

Very useful and drinking regime in the format of oral rehydration. The child needs to drink water-salt liquid, best of all, purchase special powders in the pharmacy and dilute them according to the scheme indicated on them. For example, rehydron diluted at the rate of 1 packet per 0, 5 liters of boiled water. Fractional, frequent drinking is calculated depending on the age and body weight of the baby. Children under the age of 1 year - 150ml for each kilogram of body weight (per day). Children older than 1 year do not require this amount, calculation - 120 ml per 1 kg of weight. The amount of drinking should also be divided into an hour of time and water the child every 3-15 (depending on the age) minutes from the teaspoon.

The scheme of drinking regime for children:

• Infants under 1 year - every 3-5 minutes for 1 teaspoon.
• Children from 1 to 3 years - every 3-5 minutes for 2-4 teaspoons.
• A child older than three or more years is shown - 1.5-2 tablespoons every 5 minutes.

Abundant drink with a vomitive reflex is not shown, it will only strengthen it and injure the gastric mucosa.

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

Medications

Medicines for vomiting without fever and diarrhea are usually not required. Acute, urgent conditions that manifest as vomiting without fever and diarrhea are, fortunately, rare in a child. All that is required of the parents is to monitor the baby's condition and give him enough fluids in the form of a fractional drink. Any medicine that is used alone, without the advice of a doctor, can increase the gag reflex and greatly complicate the diagnosis of the underlying cause.

If a doctor's visit ends with a prescription for treatment, then parents can safely start conservative therapy at home. What can be prescribed by a pediatrician for vomiting?

1. Regridron is a preparation of rehydration oral therapy. It is needed to restore the water-salt balance, neutralize acidosis and reduce the risk of dehydration. Regidron is produced 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 - a combination of sodium chloride and potassium restore the normal level of salt balance, which in turn positively affects cardiovascular activity.

Mode of application:

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

Before starting the reception, you should calculate the drinking regimen depending on the body weight, taking into account the volume of fluid from other sources (breastfeeding, feeding liquid food to older children). Usually, this dosage is recommended - for 1 hour you need to take 10 milliliters per 1 kilogram of weight.

How to calculate the medicine?

• The first 4-8 hours with a single, profuse vomiting without other complications and menacing symptoms - 100 milliliters per 1 kg of body weight for children over 1 year of age (drink fractional), then gradually the dosage is reduced to 10 ml per 1 kg of body weight.
• Children older than 3 years - the first 5-6 hours after heavy vomiting to avoid dehydration should be given up to one liter during this period, then reduce the dose to 200 ml within 2 hours (fractional).
• A more precise scheme can be prescribed by a doctor depending on the vomiting factor, the age and condition of the child.

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

Regiodron has its own contraindications, it is not safe. Contraindications:

• Kidney pathologies, including congenital.
• Diabetes.
• Obstruction of the esophagus, intestine.
• Hyperkalemia.

2. Dramina is a drug shown primarily if vomiting without fever and diarrhea in a child is provoked by dysfunction of the central nervous system.

The drug gently acts on the central nervous system, the basic basic substance dimenhydrinate inhibits it. Dramine is used as a remedy against vomiting, as a sedative, and as an antihistamine drug in certain forms of allergy.

The action of a drama can last up to 5-6 hours.

Indication - kinetosis, motion sickness syndrome, dizziness, vestibular disorders.

How to take a drama?

• Children from 3 to 5-6 years. For ¼ tablets before meals for 30 minutes, twice a day with the potential for prolonged travel and motion sickness. If drama solves the problem as a one-time anti-emetic, you need to give ½ tablets and observe the child's condition.
• Children older than 6 years - up to 10-12 years. ½ tablets twice a day or 1 tablet once for a single case of vomiting.

Contraindications:

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

3. Humaine electrolyte as a medicine for dehydration (dehydration). This is a good hypo-osmolar, which corrects the water-electrolyte balance, restores the energy potential of the child's body.

Produced in the form of powder in bags, divorced - 1 packet in a glass of warm boiled water.

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

The structure includes such components:

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

Scheme of admission for a prolonged, prolonged vomiting:

0-2,5-3 months of life	4-5,5 months	6-12 months	1-3 years
200-500ml for 7-8 times a day	300-600ml for 5-8 times a day	400-1000ml for 5-8 times a day	100 - 150ml 6-8 times

One-time vomiting does not require such a drug, it is enough to give such quantity:

• A child under 1 year - half a teaspoon every 5 minutes for 1-2 hours.
• Children older than a year - a teaspoon every 5-7 minutes for 1-2 hours.
• Children older than 3 years - on a tablespoon every 5-10 minutes for an hour.

Vitamins

Vitamins are not a basis for treatment, rather it is an additional stage in therapy that allows to strengthen the immune system, to fill the deficiency of necessary substances, trace elements. Self-medication, especially when vomiting without fever and diarrhea in a child, is unacceptable. For what reasons does the company reflex not be treated with vitamins?

• If a child has vomiting, you can not force him to eat, the only thing you need in the first few hours after the episode of a vomiting reflex is drinking, often in small portions. Vitamins can provoke a new attack of vomiting.
• Vitamins are prescribed after a few days if vomiting without temperature and diarrhea does not lead to a worsening of the condition. Vitamin complexes, monopreparations can fix a positive result, but they should be prescribed by a doctor.
• Vitamins are unsafe, an overdose of any kind of vitamins threatens serious complications for both adults and babies. Pay attention to hypervitaminosis D, which often provokes vomiting without hyperthermia and diarrhea.
• It often happens that vomiting is just a signal about an overdose of vitamins. In addition to a vomiting reflex, a child may have a headache, a small puffiness.

Vitamins, however, are shown to children, mainly after a course of therapy

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

• Complex preparations containing a number of vitamins and microelements.
• Vitamins of group B, vitamin C and A for normalization of metabolism, strengthening of immune defense.
• Calcium in a bioavailable form.
• Vitamin K, which is considered an antihemorrhagic substance, contributing to the normal process of blood clotting.
• Acetonemic vomiting shows B vitamins.

To choose and appoint the necessary vitamin complex, or vitamin as a mono drug can the doctor, guided by information on the characteristics of vomiting, the dynamics of the process and, first of all, relying on the diagnosis.

Physiotherapeutic treatment

Physiotherapy with a phenomenon such as vomiting without fever and diarrhea in a child is considered a method of choice. If there is a possibility to do without medicines, then physiotherapy is a wonderful and effective variant of stabilizing the state of the baby's health.

What is physiotherapy?

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

In pediatrics, physiotherapy procedures are very popular, as they act as activators of the child's own health resources. Wellness, relative safety, accessibility - this makes physiotherapy one of the leading directions in the treatment of children, including with vomitive reflexes.

What kinds of physiotherapy are shown at a desperate age?

• Electromagnetic therapy and its variants.
• Ultrasonic therapy.
• Magnetotherapy.
• Phototherapy.
• Thermal therapy.
• Phototherapy.
• Aerotherapy.
• Balneotherapy.
• LFK - exercise therapy.
• Water procedures.
• Wellness and therapeutic massage.

Physiotherapy, with all its positive characteristics, has features 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 according to age.
• Dosing of physical factors of procedures (water, heat, light) is also calculated according to age norms.
• Practically all physiotherapeutic procedures are appointed in the morning.
• The procedures are prescribed either 2-3 hours after a meal, or an hour before a meal.
• The duration of the course depends on the aetiological factors of vomiting without temperature and diarrhea in the child, age, other features of the baby.

When you can not use physiotherapy methods?

• Persistent, frequent vomiting.
• Abundant vomiting.
• Vomiting with impurities - blood, remnants of food, mucus, bile.
• With any manifestations of viral diseases.
• If there is an indication in the medical history of a potential risk of a convulsive syndrome.
• With head injuries, bruises.

How can physiotherapy help in vomiting in a child?

• Infrared laser radiation. It activates the metabolism, removes puffiness, activates the lymph flow. It is shown as a restorative procedure after passing the medication course of treatment, as well as after an operative intervention concerning the obstruction of the intestine, esophagus.
• Electrophoresis. Zonal administration of medicinal products with the help of a certain frequency of electric current. This method allows to use the necessary preparation in a gentle way, reducing the dose while maintaining the therapeutic effect.
• UV - 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 temperature and diarrhea.
• Magnetotherapy. Point effect of the magnetic field on certain parts of the body of the baby well treats digestive tract diseases, neurotic manifestations, including those that lead to vomiting reflex.
• Therapeutic course of health-improving physical training is an excellent method to restore the tone of the body, improve the work of the respiratory and nervous system, regulate the work of the vestibular apparatus and reduce the risk of motion sickness on the road (motion sickness is accompanied by vomiting).
• Massage. This is the most popular variant of physiotherapy, which can be done at home. If vomiting is a signal of overwork, a stressful reaction, a relaxing massage is shown, which can be done even for infants from 2-3 months. There are different types of massage and a conditional division into categories - restorative and curative. Precisely choose the physiotherapy in these categories will be the attending physician.

Alternative treatment

Alternative treatment with a symptom such as vomiting without fever and diarrhea in a child is a recommendation that parents get from anywhere, but not from the mouth of a doctor. Councils of relatives, acquaintances, articles in popular magazines and newspapers, certainly promise an instant recovery of the baby. However, everything that concerns the child's health requires caution and a reasonable approach. Therefore, alternative treatment is only an option that should be discussed with the attending physician.

What can be advised from safe alternatives to vomiting treatment?

• There are special products that help to reduce nausea, hence, help to avoid vomiting. For example, quince in a baked form. A child can be given it after successfully passing the process of fractional evaporation. Quince has an astringent property, but in the liver form it is considered almost a dietary product, rich in trace elements and vitamins.
• Freshly squeezed black currant juice due to the content of vitamin C and sour taste helps the child cope with nausea and vomiting. Juice can be given to children from the age of three, after a single vomiting, not associated with a serious disease.
• Gentle food after persistent vomiting can be bread crumbs, better white. Dry croissants do not burden the stomach and at the same time give a certain energy reserve to the body. One day of dietary nutrition, including croutons, herbal decoctions, and your baby will be completely healthy.
• The child after vomiting should drink chilled to room temperature boiled water with the addition of lemon and honey. This replenishes the body with potassium, magnesium and vitamin C. Recipe: for 1 glass of water - a teaspoon of honey and a half teaspoon of lemon juice. Drink in small sips, every 5-7 minutes.
• Mildly brewed green tea makes it easier to feel after vomiting, and can also neutralize nausea.
• Psychogenic vomiting without fever and diarrhea in a child is well removed by tea with the addition of chamomile and mint.
• If the baby is rocking on the way, you can give him a lollipop with lemon or mint flavor. This advice is only for children from 3 years old.

[35], [36], [37], [38], [39], [40]

Herbal Treatment

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

Usually well-acting as anti-emetics such infusions, decoctions:

• Mint tea or mint broth. The recipe is simple - a teaspoon of dried mint grass is poured with 1, 5 glasses of boiling water. Insists about 40 minutes, filtered. The child is put fractional soldering, so mint broth should be given on a teaspoon every 10-15 minutes. Of course, this type of tea is not recommended for infants, but for babies, starting from one and a half years, it is already possible to give it. Peppermint has an antispasmodic effect, soothes the stomach, relieves the condition after a vomiting eruption, replenishes fluid loss.
• Dill broth. Seeds of dill 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 a glass of water, let it boil and immediately remove from heat. Cool the broth to a warm state, strain and give the baby a half teaspoon every 5-7 minutes. You can even give infants to drink dill with a decoction. The volume of drinking is calculated based on body weight.
• Children older than 5 years can boil grass melissa. Treatment with herbs is effective if the parents know in advance the useful properties of the plant and have a "strategic" reserve for unforeseen cases. Melissa is brewed similarly to other phyto-drugs. A teaspoon of 250 ml of boiling water, if the child is older than 10 years, you can take a tablespoon of dry grass for the same amount of water. Boil the drink should not be, it is covered, allowed to stand for 30 minutes, cool to a warm state. The infused infusion should be drunk in a teaspoonful after 5-10 minutes. Melissa soothes the spasms of the esophagus, stomach, it affects the nervous system.
• Children over the age of 7 can drink ginger tea. A small piece of ginger should be grinded (grate), take literally a piece, at the tip of the knife, and put in 500 ml of boiling water. Insist 30 minutes, drain. The broth is obtained with a specific, tonic flavor and taste. A child can drink on a tablespoon of ginger infusion for an hour, every 10 minutes.

Treatment with herbs is not a universal technique, moreover, we can not consider herbal medicine safe. All of the above recipes can be considered only as fact-finding information, and it is necessary to determine which herb can help with vomiting from a doctor or a specialist in phytotherapy.

Homeopathy

Homeopathy is a rather popular method of treatment, when vomiting without temperature and diarrhea is diagnosed in a child. Means can be either complex or consist of one active substance.

What kind of homeopathy is indicated to children with a vomiting reflex?

• The most popular and complex drug Nuks Vomica, it is not for nothing called an emetic. The specificity of homeopathy lies in the fact that each component of the medicine 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, it is recommended to use it for children only after 2 years. It is extremely rare for a doctor to prescribe Nux Vomica to babies from 1-1, 5 years old.

Dosage:

Toddlers from 2 to 6 years - 2-3 drops three times a day an hour after feeding. The drops must be dissolved in 10 ml of water

Children from 6 years - for 2 tablespoons 10 drops of the drug, drink 2-3 times a day according to the indications

Features of reception:

The older children need to explain that the medicine should be held in the mouth for a while, and then swallowed

• Gastricumgel in vomiting without fever and diarrhea in a child can also have a positive effect. Especially if the reflex is provoked by overeating. The drug sedates, soothes, relieves stomach cramps. Also the product works well with acetone, calming vomiting and reducing intoxication. The medicine is available in tablet form.

Contraindications gastricumgel does not have, but it is not prescribed to children until 2.5 -3 years old (small children are not able to dissolve the pill under the tongue)

Mode of application:

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

Children of younger age (from 3 to 5 years) - the tablet is ground to a powdered state, dissolved in 2 tablespoons of purified water. You should drink 1-2 teaspoons 2-3 times a day.

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

Contra-indications: Age under 1 year

Mode of application:

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

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

A child older than 6 years should drip 10 drops in 10 ml of water, ask to hold the solution in your mouth, and then swallow

• Regurgitation, which often looks like vomiting without fever and diarrhea, can be stopped with the help of Aethusa cynapium (canine parsley).

Dosage and reception should prompt the doctor-homeopath.

Homeopathy, although considered a safe method of treatment, nevertheless presupposes at a minimum an examination of the child, as a maximum - 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.

Surgery

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

Operative, surgical treatment is shown only in such situations, with diseases in acute form:

• Inflammation of the appendix.
• Cholecystitis (exacerbation).
• Diverticulitis.
• Acute intestinal obstruction, intussusception, intestinal intussusception.
• Exacerbation of gastric ulcer (in children it is extremely rare).
• It is extremely rare - atresia of bile ducts.
• Stenosis of the esophagus.
• Peritonitis.
• Pilorotomy with congenital pyloric stenosis.
• Perforation of duodenal ulcer.
• Traumatic injuries of the abdominal cavity.
• Traumatic injuries associated with a threat to the life of the baby.

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

Surgery is needed only with a typical picture of the "acute abdomen", when the baby has a strong tension of the peritoneal muscle tissue, high fever, pain, persistent constipation or diarrhea.

To exclude threats and risks, a specific diagnosis, the doctor collects an anamnesis, full information about the onset of the disease. The connection of vomiting with reception and a mode of reception of food is specified, vomitive masses for presence or absence of specific impurity, smells are investigated. Also, the child can be assigned additional examinations - tests, instrumental diagnostics (ultrasound, contrast X-ray, FGDS).

Prevention

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

The child needs a full-fledged diet, alternation of motor activity and adequate rest, a calm environment in the family, regular preventive medical examinations.

Prevention of an emetic reflex is a preventive measure that prevents etiologic factors provoking nausea and vomiting. Therefore, preventive actions should be aimed at strengthening immunity, the health of the baby.

Given that vomiting without fever and diarrhea in a child is usually associated with functional disorders or stressful causes, advice on prevention can be:

• The child needs adequate fluid intake into the body. 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. Duration of sleep - at least 8 hours a day. Infants sleep much more, they have their own, a specific regime.
• Stresses, psychotrauma, events that the child perceives as a personal "tragedy" can cause a vomitive reflex. The situation in the family, in the preschool institution, in the school largely affects the health of children. The psychoemotional state of a child is the care of adults. The more comfortable the environment in which the baby is, the stronger, flexible his nervous system, and the less the risk of vomiting as a consequence of the shock.
• The child needs constant replenishment with vitamins and beneficial microelements. They will help to choose the attending pediatrician.
• Eating is also important in the prevention of vomiting in a child. If the baby suffers from a chronic gastrointestinal disease, the food needs to be adjusted so that the portions are small, and their intake is fractional, frequent. Diet, limitations in the range of products recommended by a doctor in accordance with the established diagnosis and treatment strategy.
• The child needs to ensure a stay in the fresh air. Oxygen starvation, hypodynamia - a sure way to the development of many diseases, including those that are accompanied by vomiting.
• At the first alarm signals, which includes vomiting, you should at least consult a pediatrician. If the gag reflex was single, let it be a kind of safety net. If vomiting recurs, lasts more than 2-3 hours, you should immediately call a doctor. In time, the detected disease is successfully treated, and it is likely that vomiting without fever and diarrhea will not happen again.

[41]

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, it all depends on the care of parents and the provision of timely assistance.

An unfavorable prognosis is possible only when extremely rare diseases are detected, accompanied by an emetic reflex. These are congenital pathologies of the brain, gastrointestinal tract, CNS, rare genetic disorders, which are diagnosed in the first days of life, and often even during gestation. Also dangerous is meningitis, encephalitis, acute inflammation of the appendix, intestinal obstruction, pathological conditions of the pancreas and gallbladder, diabetes (precoma), renal failure, metabolic disorders in acute form (cyclic ketonomy)

In general, the prognosis of the condition - vomiting without temperature and diarrhea is 95% good. Remember that the vomiting reflex itself is not a disease, it is a clinical sign.

If you notice the smallest changes in the child's health in time, do not panic, act wisely and follow all the recommendations of the treating pediatrician, the baby's life will not be threatened. A nausea and vomiting protective mechanism as a functional condition will eventually pass, because according to statistics, the older the child, the less often he has vomiting.

[42], [43]