Health Matters

Throw up

This is a column about throw up.

“Why,” you may ask, “would anyone write about throw up?” I ran out of subjects. Throw up is all that’s left, but that’s okay because throw up is a lot more interesting than you might imagine. It is far more than the sum of what you ate 15 minutes ago. The list of ingredients is amazing; enzymes, bile, intrinsic factor, hydrochloric acid, salts, water, proteins, antibodies, bicarbonate, and hormones, plus everything you ate or drank. Isn’t that amazing? I know you want to hear more!

Beyond the mere chemistry are the vast aesthetics of throw up. Who better to demonstrate this than Austin, our paranormal bulldog. Austin throws up at least twice a day. It’s unclear if this is due to some quirk in his anatomy, or if he just likes it. In any case Austin produces an incredible cornucopia of barf. Yard debris, street trash, pieces of his heating pad and blanket, items from the local archeological site, car parts, other dogs’ throw up, virtually anything inedible or unattended is there. The appearances range from that of a Picasso collage to something that looks like an oyster covered in pancake batter, all of which are faithfully deposited on our front door mat twice daily. Please do not wipe your feet before coming in.

The act of throwing up is quite complex. Normally the esophagus, stomach and intestines work to move food from the mouth all the way out the other end slowly, with coordinated contractions called peristalsis. This process has to be circumvented in order to throw up. It all starts in the “Vomiting Center,” not to be found in even the largest of malls, rather it is a specific area in the brain, located right next to the “Flatulence Center” and the “Social Faux Pax Center.” The vomiting center can be triggered by the vagus nerve (back of the throat, gag), the vestibular nerve (inner ear, vertigo, motion sickness), and a whole slew of other causes, some trivial and some serious.

Once activated, the vomiting center increases saliva production, opens the valve at the top of the stomach, and makes the abdominal muscles contract violently to send everything rapidly northwards. Throwing up has a useful purpose. It is the body’s way of expelling potential toxins and disease, but it can go awry. For example if you were to discover blood in your throw up, which can either appear red or look like coffee grounds, it may indicate a tear in the esophagus or a bleeding ulcer of the stomach. If you are really athletic, you can bring up bile from the duodenum (first part of the intestine), which will appear green and/or produce projectile vomiting, which, among my patients, seems to be a point of tremendous pride. Throwing up, along with diarrhea, can dehydrate a person very quickly. Often these folks need medical help, as they are unable to re-hydrate themselves. Throwing up can also be a sign of something more ominous, including being a paranormal bulldog, blockage of the bowel, trauma to the head, brain tumors, psychiatric problems, infection of internal organs (e.g. appendicitis), drugs and toxins (e.g. alcohol), pregnancy, or some combination of problems such as being a pregnant, paranormal bulldog.

The first line of treatment is re-hydration. This is very important with kids. They shrivel fast. Small, frequent sips of broth or water are better than big gulps. The best gauge of success is the frequency and color of urination. It should be hourly and pale. If not and the victim begins to appear shriveled, i.e. like a bulldog, then its time for medical help.