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Pathophysiology of Vomiting

Pathophysiology of Vomiting

Vomiting is a complex physiological response to expel harmful or irritating substances from the body. It's a defensive mechanism triggered by stimuli like poisons, microbial toxins, cytotoxic drugs, and mechanical abdominal distension. The process is centrally coordinated by the vomiting (or emetic) center located in the medulla of the brainstem. This area, rich in muscarinic M1, histamine H1, neurokinin 1 (NK1), and serotonin 5-HT3 receptors, coordinates the act of vomiting through interaction...

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Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
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In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...

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Prokinetic agents are specialized medications that stimulate gastrointestinal (GI) motility, promoting food movement through the GI tract. Dopamine, an inhibitory neurotransmitter, plays a significant role in this process, reducing GI motility and indirectly controlling the speed of digestion. Dopamine receptor antagonists, such as metoclopramide and domperidone, offer a unique advantage as prokinetic agents. By blocking the dopamine receptors, these drugs increase GI motility, improving food...

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Updated: Jul 15, 2026

Ear Plaster Therapy as a Safe and Effective Treatment for Gestational Vomiting

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Imipramine in persistent vomiting.

Journal of the Indian Medical Association

|April 21, 2007

Summary

Psychogenic vomiting in a young woman was successfully treated with imipramine. This antidepressant medication provided a favorable response for persistent vomiting when other investigations and treatments failed.

Area of Science:

Psychiatry
Gastroenterology

Background:

Persistent vomiting can significantly impact quality of life.
Identifying the underlying cause of chronic vomiting is crucial for effective management.

Observation:

A 21-year-old female experienced intractable vomiting for three years.
Extensive investigations, including gastroscopy, revealed no organic abnormalities.
Previous medical treatments from various facilities were ineffective.

Findings:

The vomiting was suspected to be psychogenic in origin.
Treatment with imipramine 25 mg thrice daily resulted in a favorable clinical response.

Implications:

Imipramine may be an effective treatment option for psychogenic vomiting.

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This case highlights the importance of considering psychogenic causes in unexplained chronic vomiting.

Further research into the efficacy of antidepressants for functional gastrointestinal disorders is warranted.