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The vomiting is often described as non-bile stained ("non bilious") and "projectile vomiting", because it is more forceful than the usual spitting up (gastroesophageal reflux) seen at this age. Some infants present with poor feeding and weight loss but others demonstrate normal weight gain.
Newborns present with bilious or non-bilous vomiting (depending on where in the duodenum the obstruction is) within the first 24 to 48 hours after birth, typically after their first oral feeding. Radiography shows a distended stomach and distended duodenum, which are separated by the pyloric valve, a finding described as the double-bubble sign.
Vomiting (also known as emesis, puking and throwing up) [a] is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. [ 1 ]
Fecal vomiting or copremesis is a kind of vomiting wherein the material vomited is of fecal origin. It is a common symptom of gastrojejunocolic fistula and intestinal obstruction in the ileum . [ 1 ] [ 2 ] Fecal vomiting is often accompanied by gastrointestinal symptoms, including abdominal pain , abdominal distension , dehydration , and diarrhea .
Emesis that is of a bilious nature (greenish in color) localizes the obstruction to a point past the stomach. Emesis of undigested food points to an obstruction prior to the gastric outlet, such as achalasia or Zenker's diverticulum. If patient experiences reduced abdominal pain after vomiting, then obstruction is a likely etiology.
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Unlike typical vomiting, regurgitation is typically described as effortless and unforced. [2] There is seldom nausea preceding the expulsion, and the undigested food lacks the bitter taste and odour of stomach acid and bile. [2] Symptoms can begin to manifest at any point from the ingestion of the meal to two hours thereafter. [3]
Vomiting (the expulsion of gastric contents) is usually preceded by retching, but retching and vomiting can occur separately [6] and involve different sets of muscles. [7] During a retch, thoracic pressure is decreased and abdominal pressure is increased , which may serve to position gastric contents and overcome esophageal resistance. [ 6 ]