From the Guidelines
Vomiting in infants is most commonly caused by gastroesophageal reflux (GER), which is usually benign and resolves with age. The causes of vomiting can be categorized into nonbilious and bilious vomiting, with the latter suggesting a more serious underlying condition, such as an obstruction in the gastrointestinal tract 1. Nonbilious vomiting is often due to regurgitation, which is a normal occurrence in infants, especially in the first weeks of life, and is usually related to overfeeding or decreased lower esophageal sphincter pressures 1.
Some of the key causes of vomiting in infants include:
- Gastroesophageal reflux (GER)
- Infectious etiologies, such as viral gastroenteritis
- Neurologic diseases, such as increased intracranial pressure
- Mechanical causes, such as intestinal obstruction or malrotation
- Metabolic causes, such as phenylketonuria or hyperammonemia 1
- Other conditions, such as hypertrophic pyloric stenosis (HPS), pylorospasm, formula intolerance, and gastroenteritis
A thorough clinical evaluation, including history and physical examination, is essential in determining the underlying cause of vomiting in infants. This evaluation can help identify signs of dehydration, abdominal tenderness, or other symptoms that may indicate a more serious condition 1. In some cases, diagnostic imaging or laboratory tests may be necessary to confirm the diagnosis and guide treatment. It is crucial to note that while most cases of vomiting in infants are benign, some conditions can be life-threatening, and prompt medical attention is necessary if symptoms persist or worsen 1.
From the FDA Drug Label
In humans, urinary 5-hydroxyindoleacetic acid (5-HIAA) excretion increases after cisplatin administration in parallel with the onset of emesis The released serotonin may stimulate the vagal afferents through the 5-HT 3receptors and initiate the vomiting reflex.
The causes of vomiting can be related to the release of serotonin from the enterochromaffin cells of the small intestine, which may stimulate the vagal afferents through the 5-HT3 receptors and initiate the vomiting reflex 2.
- Chemotherapy (e.g., cisplatin) can induce vomiting by increasing the release of serotonin.
- Serotonin syndrome can also cause vomiting, as reported in pediatric cases after inadvertent oral overdoses of ondansetron.
- Postoperative nausea and vomiting can occur after surgery, especially in patients receiving general anesthesia.
From the Research
Causes of Vomiting
- Vomiting can be a symptom of various conditions, including gastrointestinal disorders and migraine headaches 3
- Cyclic vomiting syndrome (CVS) is a condition characterized by recurrent episodes of nausea and vomiting, and is often comorbid with migraine 3
- Gastroparesis and functional dyspepsia are also associated with delayed gastric emptying and vomiting, and are common comorbidities in patients with migraine 3
- Vestibular migraine is a condition that can cause vertigo, dizziness, and vomiting, and is often underdiagnosed 4, 5, 6
- Patients with vestibular migraine may experience a range of symptoms, including headache, photophobia, phonophobia, and osmophobia, in addition to vestibular symptoms like vertigo and dizziness 6
- Anxiety and depression are common comorbidities in patients with vestibular migraine, and can have a significant impact on quality of life 7