Pathophysiology

Vomiting is a complex, highly coordinated activity involving the gastrointestinal tract, the central nervous system (CNS), and the vestibular system. In 1952, Wang and Borison identified a medullary vomiting center.1 The proximity of the medullary vomiting center to other CNS nuclei allows for the coordinated activity of vomiting. 1 Three stages of vomiting have been described: nausea, retching, and emesis.2 With nausea come hypersalivation and tachycardia. Retching occurs when the pylorus contracts and the fundus relaxes, thereby moving food to the gastric cardia. Finally, emesis occurs when the powerful abdominal muscles contract simultaneously and thus eject food or gastric secretions from the stomach.

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