Retching - Causes, Symptoms, and Treatment

Introduction

Retching is also known as dry heaving. Retching is when a person feels uncomfortable due to the inability to vomit despite feeling nauseous. It can be triggered by awful odor, lousy food, morning sickness, bowel disease, digestive problems, indigestion, and sometimes stress. Generally, it is not a medical emergency and resolves independently with home remedies. However, in some cases, retching can indicate an underlying disease. Therefore, a person should consult a doctor to get treated in such cases.

What Is Retching?

Dry heaving or retching can be defined as the body's act of vomiting but not being able to produce any substance. Retching can be explained physiologically; it can be defined as the mechanism of reverse movement when the body tries to eject undesirable material by contracting the diaphragm (a muscle located below the lungs and heart that helps in breathing) and is unable to eject any substance. Awful odor, bad food, morning sickness, motion sickness, bowel disease, digestive problems, indigestion, and sometimes stress can result in a gag reflex. A person feels uncomfortable and experiences a sour taste in the mouth during the gag reflex.

What Causes Retching?

Retching can result from various causes. They are as follows:

Indigestion - Indigestion affects 30 % of the general population, leading to discomforts like heartburn and acid reflux. It is generally caused by the accumulation of gastric acid in the abdomen. Indigestion can occur due to excessive consumption of spicy or fast foods, overeating, carbonated beverages, and lactose intolerance.

Morning Sickness - Morning sickness is characterized by nausea and vomiting in the morning. It is most commonly seen in pregnancy.

Motion Sickness - Motion sickness, also called travel sickness, can occur with any mode of journey. It is characterized by nausea and vomiting during the journey.

Pregnancy - Pregnancy is a common phenomenon wherein a mother can feel nauseous and tends to vomit very often, but it is quite normal. Morning sickness associated with retching is a prevalent symptom of pregnancy.

Gastrointestinal Disorders - Most gastrointestinal diseases can cause retching. Retching is caused due to an obstruction in the food passage, which affects food intake. Examples of such diseases include the following:

1. Inflammatory bowel disease.

2. Dysphagia (difficulty in swallowing food).

3. Dyspepsia (a condition that is described by symptoms such as discomfort, bloating, and nausea).

4. Diarrhea (an illness in which the body's solid waste is more liquid than usual and comes out more often).

5. Crohn's disease.

6. Gastroesophageal reflux disease (GERD).

Acidity - The excessive accumulation of acid in the stomach causing a burning sensation in the chest is called acidity. It is characterized by a feeling of fullness and bloating after eating. Acid reflux can be due to overeating, eating spicy or fast foods, and is characterized by bloating, sore throat, etc. Acidity is a common feature in gastroesophageal reflux disease.

Gastritis - The inflammation of the stomach's wall due to acid accumulation in the abdomen is called gastritis. Gastritis can be due to Helicobacter pylori infections or underlying gastrointestinal disease.

Dyspepsia - Dyspepsia is described by discomfort, bloating, and nausea, which are thought to originate from the upper gastrointestinal tract. Dyspepsia and Helicobacter pylori infection are common digestion-related problems. The alarming features of dyspepsia are retching and vomiting. Therefore, retching can be associated with dyspepsia.

Infections - Viral or bacterial infection can cause retching. Infections, such as diarrhea, are when the body excretes its waste in a liquid form more than usual and frequently. Retching is a common symptom of diarrhea. In the case of Helicobacter pylori infection, retching is also noticed.

Medications - The side effects of some medicines can cause retching. Some of the common treatments are certain antibiotics, chemotherapeutic drugs, non-steroidal non-inflammatory drugs, and opioids. A person should stop medications that cause retching after consulting with the doctor.

Stress - Sometimes, stress can also cause retching. For many reasons, individuals suffering from stress or anxiety attacks can upset their stomachs. People should identify the cause that triggers anxiety attacks and try to resolve it by seeking medical help.

What Are the Symptoms of Retching?

Retching is not a disease but a medical condition resulting from various causes.

The following are the symptoms of retching:

• Abdominal pain.

• Nausea.

• Bloating after a meal.

• Pain or nausea may be felt on waking.

• Anxiety.

• Heartburn.

• Weight loss.

• Difficulty in swallowing (dysphagia).

• Melaena (dark and tarry stool)

• A person experiences a feeling of fullness without having a meal.

• Sour taste in the mouth.

• Irritation and itching in the throat.

• Dehydration.

• Diarrhea.

• Fever.

• Dizziness.

• Increased saliva in the mouth.

• Increased heart rate.

• Profuse sweating.

• Chest pain.

• In severe cases, vomiting blood or the presence of blood in the stool.

When to See a Doctor?

If a person suffers from retching and it is not resolved after taking over-the-counter drugs, they should consult a doctor. However, retching associated with acidity and allergies resolves once the causative agents are eliminated. Sometimes it may be severe and abdominal pain can radiate to the chest and cause serious complications. Therefore, a person should consult a doctor immediately if they elicit any of the following signs and symptoms:

• Vomiting blood.

• Black stool.

• Blood in the stool.

• Severe abdominal pain.

• Fever.

• Chest pain.

• Dehydration.

• A state of confusion and dizziness.

What Are the Treatment Options for Retching?

The most important aspect is identifying the cause of the retching. Possible psychological and emotional issues should be investigated and considered by a doctor. If stress or other emotional problems cause retching, then proper counseling of the patient is the treatment of choice. Apart from these, the following are the treatment options for retching:

• Treating the Underlying Causes - The symptoms of retching associated with underlying gastrointestinal disorders need to be treated. If retching is due to diarrhea, then replacement of fluid losses in diarrhea is crucial and may be life-saving.

• Changing Lifestyle - Lifestyle and restrictive diets are of little benefit but can prevent retching. Excessive consumption of oily, spicy, or fast foods can cause acidity and digestive problems. Therefore, avoiding such food is suggested. Herbal drinks are recommended to those patients having digestive issues. Patients must identify the food or beverage that triggers retching and avoid that particular food.

• Medication - Over-the-counter drugs such as antacids can be used, which are sometimes helpful in acidity. Prokinetic drugs such as Metoclopramide or Domperidone may be used when nausea and vomiting are noticed. Off note taking any medicine during pregnancy is prohibited without the doctor's consultation. Histamine type-2 receptor antagonist drugs (Ranitidine) can be used in case of heartburn. Low-dose tricyclic agents, such as Amitriptyline, can be used in case of anxiety.

• Counseling - The concept of psychological influences on gut function should be considered by a doctor. Some patients with major mental illnesses or emotional issues need behavioral therapy and proper counseling. Retching associated with an identifiable cause of stress should be resolved with appropriate counseling and intervention.

Conclusion

Poor lifestyle is the primary cause of retching. People can prevent retching by maintaining hygiene and avoiding spicy foods. Good daily habits include regular eating, avoiding missing meals, taking time to chew food correctly, reducing intake of resistant starch and insoluble fibers, avoiding food with artificial sweeteners and carbonated and caffeinated drinks, and reducing alcohol intake. Practicing a wholesome and stress-free lifestyle is the best way to stay healthy.