Mr. Zhang complained, “After eating for a long time, I ended up vomiting slowly, even when lying down. May I ask what’s going on?” The doctor explained, “Your condition, in medical terms, is called ‘vomiting’. Vomiting is often accompanied by nausea, and nausea and vomiting are common clinical symptoms. Nausea is a feeling of discomfort in the upper abdomen, urgency to vomit, and is accompanied by signs of vagal excitement, such as pale skin, sweating, salivation, lowered blood pressure and bradycardia, often as a prelude to vomiting, and vomiting follows after nausea. Vomiting is a phenomenon in which the contents of the stomach or part of the small intestine are expelled from the body through the esophagus and mouth.” There are many causes of vomiting, which can be broadly classified as central vomiting, peripheral vomiting and functional vomiting. Central vomiting is commonly caused by intracranial infection or tumor, cranial injury, cerebrovascular accident, etc. It is often accompanied by headache, dizziness, neck discomfort and mental changes, and vomiting is mostly jet-like. Peripheral vomiting refers to vomiting caused by lesions outside the central nervous system, mainly caused by digestive system diseases, such as esophageal cardia, esophageal cancer, acute gastritis, gastric sinus cancer, pyloric obstruction, duodenal obstruction, etc. External organ lesions of the digestive system (such as tumors, etc.) compression or metabolic products affecting the patency of the digestive tract and some drugs can cause vomiting, which is often accompanied by related This vomiting is often accompanied by pathological manifestations of related organs. Functional vomiting includes chronic idiopathic vomiting, functional vomiting, and cyclic vomiting, which has no abnormal findings on gastroscopy or no organic disease that could explain the vomiting, often without eating disorders, and is often accompanied by depression or anxiety. The mechanism of vomiting is a complex reflex action that can be artificially divided into three phases: nausea, dry heaving and vomiting. The vomiting center is located in the medulla oblongata of the brain and has two functionally distinct structures: the neuroreflex center (i.e., the vomiting center) and the chemoreceptor trigger zone. The former receives afferent impulses from the GI tract, cerebral cortex, inner ear vestibule, coronary arteries, and chemoreceptor trigger zone and directly governs the vomiting action. The latter cannot directly govern the actual action of vomiting, but can receive stimuli from various foreign chemicals or drugs and metabolites in the body, and thus send nerve impulses to the vomiting center to cause vomiting. Mr. Zhang asked with confusion, “Why do you end up slowly vomiting things that you have eaten for a long time and vomit even when lying flat?” The doctor explained after asking some questions and examination: “Under normal circumstances, food from the mouth, esophagus can quickly enter the stomach, solid food from the stomach completely into the small intestine, often takes 3-5 hours ranging from liquid food can be faster, you eat into a long time things still vomit, indicating that there is a problem with the discharge of food, resulting in food retention in the stomach or duodenum, to a certain amount, stimulating Vomiting center, it will cause vomiting, lying down is easier to vomit, but vomiting is best not to lie down, the best position for the side or turn the head to the side to prevent vomit accidentally inhaled trachea caused by asphyxiation, life-threatening.” Mr. Zhang asked anxiously, “How should I treat my condition? What should I pay attention to in my diet?” The doctor suggested that in terms of diet, instead of eating solid food, you should eat a liquid diet, such as thin rice or thin rice water, and eat small and frequent meals, and do not eat raw, cold or stimulating food. If you eat liquid food and still have vomiting, you should fast temporarily, the length of time varies depending on the condition, but if vomiting is more frequent when fasting, intravenous rehydration should be carried out to prevent the loss of too much body fluid and electrolytes, which can endanger life. In case of short-term mild vomiting, on the basis of the above treatment, gastrointestinal prokinetic drugs can be applied for treatment, mainly including three major categories. The first generation of gastrointestinal prokinetic drugs: such as Gastrofluan, a dopamine receptor blocker, which promotes the release of acetylcholine from the intermuscular plexus, acts on chemoreceptors and stops vomiting, stimulates the contraction of the gastric sinus, improves the coordinated movement of the stomach and duodenum, and promotes gastric emptying. Intramuscular injection: each dose is 10mg. Second generation gastrointestinal prokinetic drugs: such as morpholine is also a dopamine receptor blocker, which mainly acts peripherally and has poor ability to cross the blood-brain barrier, so its adverse effects are less than those of gastrofacial. The oral dose is 10 mg, 3 times a day, half an hour before meals. Third-generation gastrointestinal stimulants: Moxapride, for example, is a 5-hydroxytryptamine (HTR)4 agonist, and the oral dose is 5 mg three times a day, half an hour before meals. Zemaco is a 5-HTR4 partial agonist at an oral dose of 6 mg twice a day, half an hour before meals. These drugs are total GI prokinetics. In addition, in recent years, a new gastrointestinal tract power regulator has been introduced: Trimebutin (trade name: Shuriken) is a potassium and calcium channel inhibitor, which has a bidirectional regulation effect on abnormal gastrointestinal tract power; and can promote the release of gastrin, intestinal vasoactive peptide, gastrin and glucagon by activating peripheral opioid receptors, thus increasing the rate of gastric emptying and regulating the movement of esophagus, small intestine and colon. motility. The oral dose is 100mg 3 times a day. If vomiting persists after the above treatment, further tests are needed to clarify the diagnosis. Blood sampling for electrolytes, pH, blood glucose, ketone bodies, amylase and liver and kidney functions to understand the extent of vomiting and the presence of metabolic and other organic diseases, standing and lying abdominal radiography to understand whether there is intestinal obstruction, and gastroscopy to understand the lesions of esophagus, stomach and duodenum. Further treatment will be done for the cause after clear diagnosis. Mr. Zhang asked, “Some people want to vomit when they see certain things, such as blood or dirty things, why is that?” The doctor explained, “This condition is called ‘conditioned vomiting’ and belongs to the category of functional vomiting, which is more common in women and autonomic instability, where the excitation threshold of the vomiting center may be lower, and thus vomiting is more likely to occur when subjected to the action of adverse stimuli. “