Nausea and Vomiting

What are nausea and vomiting?

Nausea is when you feel sick to your stomach, as if you are going to throw up. Vomiting is when you throw up.

Nausea and vomiting can be symptoms of many different conditions, including:

• Morning sickness during pregnancy
• Gastroenteritis (infection of your intestines) and other infections
• Migraines
• Motion sickness
• Food poisoning
• Medicines, including those for cancer chemotherapy
• GERD (reflux) and ulcers
• Intestinal obstruction

Nausea and vomiting are common. They are usually not serious. However, you should contact your health care provider immediately if you have:

• A reason to think that your vomiting is from poisoning
• Vomited for longer than 24 hours
• Blood in the vomit
• Severe abdominal pain
• Severe headache and stiff neck
• Signs of dehydration, such as dry mouth, infrequent urination or dark urine

Your health care provider will take your medical history, ask about your symptoms and do a physical exam. The provider will look for signs of dehydration. You may have some tests, including blood and urine tests. Women may also have a pregnancy test.

Treatments for nausea and vomiting depend on the cause. You may get treatment for the underlying problem. There are some medicines that can treatment nausea and vomiting. For severe cases of vomiting, you may need extra fluids through an IV (intravenous).

There are things that you can do to feel better:

• Get enough fluids, to avoid dehydration. If you are having trouble keeping liquids down, drink small amounts of clear liquids often.
• Eat bland foods; stay away from spicy, fatty, or salty foods
• Eat smaller meals more often
• Avoid strong smells, since they can sometimes trigger nausea and vomiting
• If you are pregnant and have morning sickness, eat crackers before you get out of bed in the morning

Neural Tube Defects

Neural tube defects are birth defects of the brain, spine, or spinal cord. They happen in the first month of pregnancy, often before a woman even knows that she is pregnant. The two most common neural tube defects are spina bifida and anencephaly. In spina bifida, the fetal spinal column doesn't close completely. There is usually nerve damage that causes at least some paralysis of the legs. In anencephaly, most of the brain and skull do not develop. Babies with anencephaly are usually either stillborn or die shortly after birth. Another type of defect, Chiari malformation, causes the brain tissue to extend into the spinal canal.

The exact causes of neural tube defects aren't known. You're at greater risk of having an infant with a neural tube defect if you:

• Have obesity
• Have poorly controlled diabetes
• Take certain antiseizure medicines

Getting enough folic acid, a type of B vitamin, before and during pregnancy prevents most neural tube defects.

Neural tube defects are usually diagnosed before the infant is born, through lab or imaging tests. There is no cure for neural tube defects. The nerve damage and loss of function that are present at birth are usually permanent. However, a variety of treatments can sometimes prevent further damage and help with complications.

NIH: National Institute of Child Health and Human Development

Nutrition for Older Adults

What is nutrition and why is it important for older adults?

Nutrition is about eating a healthy and balanced diet so your body gets the nutrients that it needs. Nutrients are substances in foods that our bodies need so they can function and grow. They include carbohydrates, fats, proteins, vitamins, minerals, and water.

Good nutrition is important, no matter what your age. It gives you energy and can help you control your weight. It may also help prevent some diseases, such as osteoporosis, high blood pressure, heart disease, type 2 diabetes, and certain cancers.

But as you age, your body and life change, and so does what you need to stay healthy. For example, you may need fewer calories, but you still need to get enough nutrients. Some older adults need more protein.

Some changes that can happen as you age can make it harder for you to eat healthy. These include changes in your:

• Home life, such as suddenly living alone or having trouble getting around
• Health, which can make it harder for you to cook or feed yourself
• Medicines, which can change how food tastes, make your mouth dry, or take away your appetite
• Income, which means that you may not have as much money for food
• Sense of smell and taste
• Problems chewing or swallowing your food

To stay healthy as you age, you should:

• Eat foods that give you lots of nutrients without a lot of extra calories, such as
  • Fruits and vegetables (choose different types with bright colors)
  • Whole grains, like oatmeal, whole-wheat bread, and brown rice
  • Fat-free or low-fat milk and cheese, or soy or rice milk that has added vitamin D and calcium
  • Seafood, lean meats, poultry, and eggs
  • Beans, nuts, and seeds
• Avoid empty calories. These are foods with lots of calories but few nutrients, such as chips, candy, baked goods, soda, and alcohol.
• Pick foods that are low in cholesterol and fat. You especially want to try to avoid saturated and trans fats. Saturated fats are usually fats that come from animals. Trans fats are processed fats in stick margarine and vegetable shortening. You may find them in some store-bought baked goods and fried foods at some fast-food restaurants.
• Drink enough liquids, so you don't get dehydrated. Some people lose their sense of thirst as they age. And certain medicines might make it even more important to have plenty of fluids.
• Be physically active. If you have started losing your appetite, exercising may help you to feel hungrier.

Sometimes health issues or other problems can make it hard to eat healthy. Here are some tips that might help:

• If you are tired of eating alone, try organizing some potluck meals or cooking with a friend. You can also look into having some meals at a nearby senior center, community center, or religious facility.
• If you are having trouble chewing, see your dentist to check for problems
• If you are having trouble swallowing, try drinking plenty of liquids with your meal. If that does not help, check with your health care provider. A health condition or medicine could be causing the problem.
• If you're having trouble smelling and tasting your food, try adding color and texture to make your food more interesting
• If you aren't eating enough, add some healthy snacks throughout the day to help you get more nutrients and calories
• If an illness is making it harder for you to cook or feed yourself, check with your health care provider. He or she may recommend an occupational therapist, who can help you find ways to make it easier.

NIH: National Institute on Aging

Pancreatic Cancer

The pancreas is a gland behind your stomach and in front of your spine. It produces the juices that help break down food and the hormones that help control blood sugar levels. Pancreatic cancer usually begins in the cells that produce the juices. Some risk factors for developing pancreatic cancer include:

• Smoking
• Long-term diabetes
• Chronic pancreatitis
• Certain hereditary disorders

Pancreatic cancer is hard to catch early. It doesn't cause symptoms right away. When you do get symptoms, they are often vague or you may not notice them. They include yellowing of the skin and eyes, pain in the abdomen and back, weight loss and fatigue. Also, because the pancreas is hidden behind other organs, health care providers cannot see or feel the tumors during routine exams. Doctors use a physical exam, blood tests, imaging tests, and a biopsy to diagnose it.

Because it is often found late and it spreads quickly, pancreatic cancer can be hard to treat. Possible treatments include surgery, radiation, chemotherapy, and targeted therapy. Targeted therapy uses drugs or other substances that attack specific cancer cells with less harm to normal cells.

NIH: National Cancer Institute

Pelvic Floor Disorders

The pelvic floor is a group of muscles and other tissues that form a sling or hammock across the pelvis. In women, it holds the uterus, bladder, bowel, and other pelvic organs in place so that they can work properly. The pelvic floor can become weak or be injured. The main causes are pregnancy and childbirth. Other causes include being overweight, radiation treatment, surgery, and getting older.

Common symptoms include:

• Feeling heaviness, fullness, pulling, or aching in the vagina. It gets worse by the end of the day or during a bowel movement.
• Seeing or feeling a "bulge" or "something coming out" of the vagina
• Having a hard time starting to urinate or emptying the bladder completely
• Having frequent urinary tract infections
• Leaking urine when you cough, laugh, or exercise
• Feeling an urgent or frequent need to urinate
• Feeling pain while urinating
• Leaking stool or having a hard time controlling gas
• Being constipated
• Having a hard time making it to the bathroom in time

Your health care provider diagnoses the problem with a physical exam, a pelvic exam, or special tests. Treatments include special pelvic muscle exercises called Kegel exercises. A mechanical support device called a pessary helps some women. Surgery and medicines are other treatments.

NIH: National Institute of Child Health and Human Development