Diagnosis and tests for vomiting

Most vomiting needs no tests at all - the story and a look at the patient suffice. Tests enter when vomiting is severe, persistent, bloody, or when the cause is not obvious.

When no tests are needed: a short episode after suspect food or a mild stomach bug, settling within a day, with good urine output - clinical assessment and home care are enough.

What the doctor checks first. Hydration status (mouth, skin turgor, pulse, blood pressure, urine output), the abdomen (tenderness, swelling, bowel sounds), and the story - what was eaten, who else is sick, medicines, pregnancy possibility, recent travel, head injury.

Blood tests when dehydration or a body-wide cause is suspected: electrolytes (sodium, potassium - vomiting depletes them), kidney function, blood counts, sugar, and infection markers. In women of childbearing age with unexplained vomiting, a pregnancy test is routine.

Urine tests for ketones (a marker of poor intake and dehydration) and for urinary infection, which commonly causes vomiting in children.

Imaging and scopes for specific suspicions: ultrasound or X-ray/CT for obstruction, appendicitis, gallbladder or abdominal pain causes; endoscopy for persistent vomiting, blood in vomit, or suspected ulcer; brain imaging (CT/MRI) when headache, injury or neurological signs point that way.

Special situations: infants with projectile vomiting get an ultrasound for pyloric stenosis; persistent vomiting in pregnancy gets electrolytes, ketones, thyroid and an ultrasound; suspected poisoning guides its own workup.

Ayurvedic view (interpretive): classical assessment of chardi relied on observation of the patient and the vomitus - consistent with the clinical emphasis above, within an interpretive framework of limited evidence. Modern tests resolve the dangerous causes quickly and should never be deferred for empirical treatment.

Remember: short, self-settling vomiting needs no tests. Blood, green bile, severe pain, head injury, dehydration signs, pregnancy with unrelenting vomiting, or any infant with projectile vomiting = get tested and treated, the same day.