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Vomiting Blood During Pregnancy
A common yet relatively unknown problem that many women experience in their pregnancy is vomiting blood. Although vomiting blood in the early stages of pregnancy is normal, it could be a sign of an underlying condition. Experiencing morning sickness or vomiting for a long period of time could cause vomiting of blood during pregnancy. If you are pregnant and vomit severely, it could rupture your oesophagus lining, and the blood may spew out. There is no reason to panic as it could be treated. However, there are some serious conditions which could lead to vomiting of blood during pregnancy. These conditions could be a sign of worry and must be diagnosed and treated appropriately.
What Is Hematemesis (Vomiting Blood)?
Vomiting blood during pregnancy is known as hematemesis and it may happen because of various medical reasons ranging from a small nosebleed or serious bleeding of the intestine. Hematemesis is not characterized by the presence of streaks of blood in the bile. In this condition, the blood looks black or dark brown in colour similar to ground coffee. Vomiting blood in the first trimester of pregnancy is common, as morning sickness is at its worst then. The bleeding occurs due to a tear in the oesophagus and the bleeding in the upper gastrointestinal tract is primarily caused by the force of the previous vomiting.
Facts About Hematemesis
Here's what may happen when you vomit blood during pregnancy.
Bleeding in the upper gastrointestinal tract is one of the main causes of hematemesis during pregnancy.
Vomiting continuously can increase the risk of melaena - a condition which leads to black and tarry stools with the presence of blood.
Haematin acid is the main cause of the presence of blood in vomit.
When some large blood vessels bleed heavily, fresh blood appears in the vomit.
Vomiting of blood causes dizziness and slight abdominal pain.
Vomiting blood could lead to a drop in blood pressure levels.
Vomiting forcefully leads to a sudden mucosal tear in the oesophagus (called the Mallory-Weiss tear), which can also lead to hematemesis.
Causes of Hematemesis During Pregnancy
Vomiting blood during pregnancy has several factors associated with it. Some of the common causes of vomiting of blood during pregnancy are as follows:
Gastritis: An inflammation of the stomach causes harmful bacteria, Helicobacter pylori, to infect the inner lining of the stomach, which leads to gastritis. Acute gastritis leads to minor inflammation whereas chronic gastritis causes chronic inflammation. This disorder may eventually lead to excessive vomiting of blood, which is often red in colour. It may also be accompanied by abdominal pain and weakness.
Dehydration: One of the main reasons why you may vomit blood during pregnancy is dehydration. When the body runs out of fluid, it exerts excess pressure causing the vomit to spew bile pigments and blood. Lack of fluids causes nausea and lead to vomiting.
Starvation: It is a known fact that an expectant woman needs to have smaller meals at regular intervals to satisfy her hunger. If you starve yourself during pregnancy, your empty stomach could make you feel sick and you might vomit blood. It may sound strange, but if you don’t eat enough during pregnancy, your body may rebel by vomiting.
Rupture of the Oesophagus: It is very common to feel nauseous and vomit repeatedly during pregnancy. But constant episodes of vomiting, especially forceful ones could cause a rupture in the oesophagus. This injury could result in stains of blood in the vomit.
Unhealthy Diet: A lack of a well-balanced diet during pregnancy can also lead to vomiting of blood. It is not uncommon if you feel like throwing up after meals or early in the morning if you are not following the diet chart. The body has its own way to fight back against things that it cannot accept.
Hypertension: Pregnancy usually leads to hypotension but if the woman has hypertension, then it may lead to vomiting of the blood, but this happens rarely. Portal hypertension can also lead to hematemesis. Doctors always suggest pregnant women to take ample rest and stay in a peaceful and happy environment. Stress can lead to an upset stomach, eventually leading to vomiting of blood.
Food Poisoning: Food poisoning is a gastrointestinal problem. Eating stale or toxic food can put you at an added risk during pregnancy. Ensure that you are cautious about hygiene and wash your fruits and vegetables well before eating them. Stay away from foods that could trigger allergies and complications.
Medications: Taking over-the-counter medicines for pain like aspirin and Ibuprofen can lead to irritation and bleeding. Taking these medicines reduce the production of mucus and irritate the lining of the stomach. Aspirin is known to clot the blood and interfere with the function of blood platelets. Prenatal vitamins are also known to cause nausea and vomiting.
Rupture of the Gastrointestinal Tract: Vomiting puts pressure on the chest, oesophagus, and abdomen. The sudden increase in pressure causes a rupture in the intestinal tract. This results in vomiting causing chest inflammation. You might experience chest pain, sweating, and shortness of breath if there is a rupture in the gastrointestinal tract.
Cirrhosis: Drinking alcohol excessively or autoimmune diseases like hemochromatosis (absorption of the excess amount of iron in the blood) leads to cirrhosis. Cirrhosis leads to the dilation of blood vessels, which start rupturing and affect the oesophagus too. Cirrhosis is a serious condition affecting the health of the liver, and people affected with this disease tend to vomit large quantities of bright red blood.
What Is the Colour of the Blood in the Vomit?
Here's how the blood may appear if you vomit during pregnancy.
If the bleeding is caused by an injury to the stomach or duodenum (first part of the small intestine), then the blood in the vomit may appear maroon or dark brown.
If bleeding is caused by a tear in the oesophagus, the blood will appear red and fresh.
Signs and Symptoms of Hematemesis in Pregnancy
The colour and consistency of the blood vomited differs as per the cause of bleeding. Apart from bleeding, pregnant women also experience other symptoms which need to be given attention. Some of the common symptoms associated with vomiting of blood during pregnancy are:
Nausea
Abdominal pain and discomfort
Enlargement of pupils
Blurred vision
Dizziness or lightheadedness
How Is the Diagnosis Done?
For diagnosis, the doctor may ask you questions about the colour of the blood discharged or any injuries that you may have had in the past or present. To diagnose any internal causes, the doctor may need to conduct imaging tests to look deeper. Scans determine the injury and the extent of the damage caused to suggest appropriate treatment. Common imaging tests used by gynaecologists include:
Ultrasound tests
X-ray
MRI (Magnetic Resonance Imaging)
Nuclear medicine scan
Endoscopy
Blood tests
Complications Associated With Hematemesis While Pregnant
A few complications that arise because of vomiting blood during pregnancy are mentioned below.
Choking: You may often find yourself struggling to swallow food after an episode of vomiting or if you vomit continuously.
Anaemia: Due to the loss of blood, your body may become deficient in healthy red blood cells. You may suffer from loss of energy or anaemia. It is advisable to intake healthy and nutritious food to restore blood loss.
Stress or Depression: Vomiting blood during pregnancy can make you feel stressed or depressed. Stress may lead to further complications like pale skin, rapid breathing, dizziness, and low urine discharge.
Prolonged episodes of choking, stress or low levels of anaemia must not be ignored. It is best to consult a doctor to avoid any complication.
Treatment
The treatment begins after ascertaining the cause of bleeding and administering the appropriate line of treatment.
After vomiting, there is a deficiency in optimum fluid levels. A pregnant woman will need to stay hydrated.
If severe dehydration occurs, the patient would need to be admitted to a hospital to ensure she gets body fluids and supplements through intravenous saline.
A healthy and nutritious diet will be suggested to ensure that the right amount of nutrients and minerals are being supplied to the mother and the baby.
If there is a huge amount of blood loss caused by vomiting, a doctor may prescribe the following treatments:
Blood transfusions
Administering oxygen
Endoscopic treatment to determine any rupture and treat it accordingly
Extraction of fluids through veins
A surgical procedure in case of several internal haemorrhage or ulcer
Prevention
Prevention is better than cure, and it certainly stands true in case of vomiting of blood during pregnancy. A few steps that could help prevent vomiting of blood are:
Avoid intake of alcohol as it causes inflammation of the stomach.
Quit smoking.
Avoid eating spicy food as it causes irritation of the stomach and acid reflux during pregnancy.
Limit your intake of medicines especially painkillers, aspirin, etc.
Home Remedies
If you vomit blood and notice blood clots, you must consult a doctor. Loss of blood can make you feel weak. Vomiting blood may also leave an unpleasant taste in your mouth. Apart from medical advice, there are a few tips that you can follow to treat nausea and vomiting while pregnant.
Drink Fruit Juice: Regular intake of water and fruit juice can help you stay hydrated and recover from spells of dehydration. Electrolyte solutions are also a good alternative to combat dehydration. Keep yourself hydrated by drinking at least 2-3 litres of water in a day. Drinking water will help flush out the toxins from the body and also balance the production of urine in your body.
Follow a Balanced Diet: Unarguably, a diet which is well planned, balanced and proportionate in vital nutrients and minerals will go a long way in maintaining optimum energy levels and reducing nausea. So eat healthy foods and drink lots of water.
Opt for Small and Light Meals: Nausea is more common in the morning. Avoid having heavy meals at night and have a light breakfast to prevent nausea. Don’t overeat - stick to a fixed pattern of eating. For example, eat at a 3-4 hour interval to give yourself enough time to digest the food. Eating a lot at once might make you feel full and cause vomiting.
Avoid Oily Food: Curb your urge to gorge on fatty or spicy foods. Foods high in fat and spice can cause the stomach lining to swell and cause acidity. Stick to boiled foods which are low on spice.
Drink Ginger Juice: Drinking ginger juice is an age-old remedy for nausea and morning sickness. It is highly recommended to have ginger juice in the morning.
Prenatal Yoga: Prenatal yoga exercises or even light exercises have proven to be good for curing nausea.
Sleep Well: Get enough sleep at night and ensure that you do not feel suffocated or claustrophobic where you sleep. Ensure that you breathe well at night for a good night’s sleep.
Take Adequate Rest: Avoid stressing yourself - take ample rest and allow your body to relax and unwind to stay healthy during pregnancy.
Opt for natural remedies in case you suffer from nausea. If you find that your vomiting spells are not getting controlled by home remedies, then seek medical advice. If you do vomit blood, try and consult a doctor to rule out any issue in the beginning itself. Your doctor will guide you the best, so consult her if needed. Have a happy and healthy pregnancy!
Also Read: Everything You Need to Know About Vomiting in Pregnancy Read more
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Toe Walking in Children
Toe walking is a common practice for many kids when they just begin to walk. Most children grow out of it as they grow older and it is usually known to completely disappear after the age of three. However, in case your child continues to walk on his toes constantly, then you may need to consult a physician regarding this habit.
Video: Toe Walking in Children - Is It a Sign of Trouble?
https://www.youtube.com/watch?v=cCRRItNbPQg
What is Toe Walking?
Toe walking is the practice of walking on the tip of the toes. Kids walking on tiptoes tend to not touch the ground with their heel as they take their step. This is a habit that kids learn as they begin to cruise around holding onto furniture and is deemed normal in children up to the age of 2 or 3. However, if it goes on beyond this age, it may mean that your child has made a habit of it or has other underlying issues.
Causes of Toe Walking in Kids
Toe walking in kids is usually no reason for worry as it subsides after two or three years. However, if it does not, it can be associated with some underlying causes and conditions. Some of the causes of toe walking in kids are discussed below:
Short Achilles tendon:
Children who have short Achilles tendon will have difficulty in stretching it completely. This may encourage them to walk on their toes and even prevent them from standing flat on their feet.
2. Cerebral Palsy:
Several types of cerebral palsy are linked to difficulty in standing and walking. Spastic cerebral palsy is known to make the muscles around the feet very stiff, which can cause difficulties while walking. Some premature babies may also suffer from a brain haemorrhage that can cause cerebral palsy and lead to problems with walking, encouraging toe walking.
3. Periventricular Leukomalacia:
Premature babies, in some cases, may suffer from nerve damage which can lead to difficulty in walking. This may lead to toe walking and other walking issues
4. Spastic Hemiplegia:
Sometimes, due to cerebral palsy, the Achilles tendon in the kids can be pulled up very tight making it hard for them to place their feet flat on the ground. This can encourage toe walking.
5. Autism and language delays:
Autistic children and children with developmental delays can have prolonged toe walking paired with speech and social delays.
6. Idiopathic toe walking:
If your child has no underlying condition leading to toe walking and has normal movement in the ankle joint, but continues to walk on his toes, it can be idiopathic toe walking. This essentially means that there is no specific reason for it and his toe walking may have developed by habit.
Risks and Complications of Toe Walking in a Child
While toe walking is common is many kids up to the age of three, the risk of developing idiopathic toe walking may be higher in families with a history of kids who had the problem.
Constant toe walking may cause damage to the joints and the muscles of the kids and even increase his risk of falling and stumbling. He may also be subject to ridicule by his peers as he grows, which can affect his confidence.
Diagnosis of Child Toe Walking
The diagnosis for toe walking is through a physical exam as it is easily observed. However, the doctor may also perform a gait analysis or EMG (electromyography) in some cases. A thin needle is inserted into the affected muscles or the nerve along with an electrode to measure the electrical activity during an EMG. If toe walking is a result of developmental delays, autism or cerebral palsy, the doctor may recommend a neurological exam or a developmental evaluation to identify the cause.
What is Idiopathic Toe Walking?
If your child walks on his toes even after he is three but is not diagnosed with any condition that may have caused it, he may have idiopathic toe walking. Children with idiopathic toe walking may walk on their toes constantly and keep their knees straight and locked as they walk. You may even notice that they walk on the tiptoes of both their feet and also stand flat on both feet sometimes. Idiopathic toe walking in children can sometimes also be attributed to a history of toe-walking with other children in the family.
Treating Toe Walking in a Child
If toe walking persists in your child beyond the age of three and you are concerned, you may want to get a diagnosis that can identify the cause of toe walking in your child. The right course of therapy and treatment can prevent the chance of damage to the joints and muscles. The doctor, based on the cause of the toe walking, may suggest the following treatment options for your child.
1. Physical therapy:
Stretching exercises and physical therapy can be used to treat children with a short Achilles tendon.
2. Ankle-foot orthosis:
Therapists may also ask your child to wear an ankle-foot orthosis. This is a plastic brace that holds the foot at a 90-degree angle and extends up to the back of the leg. This brace can be worn all day and in the night and can be taken out during exercises or bathing.
3. Serial casting:
An orthopaedist will apply a plaster or fibreglass cast in order to enable the tendons to stretch and provide your child with a better range of ankle movement. The cast will be changed every other week as the tendon stretches and will be taken out when the tendon is long enough. This cast cannot be removed when required.
4. Surgery:
If your child does not respond to other courses of treatments, the doctor may recommend surgery to stretch the tendon.
5. Neurological and development evaluation for autism and cerebral palsy:
If your child’s toe walking stems out of underlying conditions like cerebral palsy or autism, your doctor will perform a developmental evaluation.
Exercises to Help Children Who Walk on Tiptoes
Stretches and exercises can help your child overcome the habit of toe walking, especially in the case of idiopathic toe walking. Stretches help loosen stiff muscles in the calf and improve the range of movements in the ankles. Children with short Achilles tendon also benefit from regular exercises and stretches.
1.Calf stretch:
Your child needs to lay on his back with his knees straight. While he is in this position, bend his foot up so that it points towards his knees. Stretch the foot as much as your child can tolerate. Repeat this ten times on both feet.
2. Achilles tendon stretch:
Ask your child to lay on his back on a firm surface. You will need to bend his knee and carefully point his toe towards the knee and hold the position for 15 seconds or until your child can tolerate. Repeat this ten times.
3. Sit to stand:
Seat your child on a small chair so that his feet touch the ground. With both your hand hold his legs right below the knees and push it flat against the floor. As you do this, encourage your child to stand. You can engage your child in various activities like singing as you perform this exercise.
How to Prevent Your Child from Walking on Tiptoes?
Stretches:
Toddlers don’t have flexible muscles. Stretches can help loosen stiff muscles and provide them with a better range of movement in their ankles.
2. Ankle weights:
These can help lengthen your child’s tendon and help him walk with his feet flat on the ground. Always use the right sized weights and consult a therapist before doing so.
3. Shoes:
The right shoes with proper ankle support can prevent toe walking. You can encourage your child to wear shoes in the house often to help him walk on his feet.
4. Tactile training:
Provide your child with an opportunity to walk barefoot on different surfaces like grass, sand, a tray of rice, etc. This will give him an idea of what it feels like to walk with his whole feet pressed against the ground.
When Should You Call the Doctor?
If you notice toe walking in your child, it may be wise to consult a doctor to get a proper diagnosis. You may also need to call your doctor if you notice that your child,
Constantly walks on his toes
Has stiff muscles
Lacks coordination
Stumbles very often
Has delayed motor skills
Has trouble bearing weight on his feet
Begins to lose the motor skills that he had
Tiptoeing in children is very common and in most cases, is no reason for worry. However, if you notice that it continues even after your child grows, you may want to consult a healthcare professional for to rule out any serious issues.
Also Read: Cerebral Palsy in Children Read more
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Dr Ghouse has added a new answer
Expecting Mom due in 9 months
1 hour ago
Q. i missed my periods on 5 but when I checked in the morning urine that is not showing positive but when I check now I can see faint line ... why this is happening
Dr Ghouse
Paediatrician
1 hour ago
A. please wait they can be simple delayed period. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
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Watermelon and Lemon Cooler Recipe
This cooler is ridiculously refreshing, absolutely easy and deliciously wholesome. Wondering why the use of such adjectives? Because that’s what the beverage is! You need less than 10 mins to prepare this cooler and we reckon that it will be an instant hit amongst the ones getting served. You just need to take a bow and revel in acknowledgement. When it comes to kids, add a dollop of their favourite ice cream and watch them scream with joy.
Serves
Preparation Time
Cooking Time
6 People
5-10 Minutes
10-15 Minutes
Ingredients
1 large watermelon, diced
4 tbsp sugar
2 tbsp lemon juice
2 cups crushed ice
500 ml soda
A few mint sprigs
1 lemon for garnishing
Method
Step 1
Dice the watermelon and blend in a mixer until you get a thick slush. Make sure that you don’t juice it out completely. Add sugar as per your taste while you blend watermelon.
Step 2
Remove from the blender, squeeze a medium lemon and stir it well.
Step 3
Take a stemmed mocktail glass, add crushed ice and pour the watermelon slush over it. Add club soda to add a little fizz.
Step 4
Garnish it with mint sprigs, or a cut lemon.
Nutritional Information
Calories
34 K cal
Proteins
0 gm
Fats
0 gm
Carbohydrates
9.0 gm
Cholesterol
0 mg
Sodium
25 mg
Potassium
2 mg
Tip:
1. Instead of lemon juice, you can add orange juice.
2. Use powdered sugar to ease the process of mixing.
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Q. #asktheexperts plz suggest me medicine for toothache
Dr Sameer awadhiya
Paediatrician
8 hours ago
A. A proper assessment is required here so regarding this it is vmore favourable to contact your local doctor and accordingly he will guide in a proper manner.
If any more queries you can tgake online consultation on the platform for a detailed discussion .
shilpi Bhandari has added a new answer
Mom of a 3 yr 5 m old child
8 hours ago
Q. 3.5 saal ki bacchi ko vomitab syrap kitni or kab den khane se phle ya khane ke bad??
shilpi Bhandari
Mom of 2 children
5 hours ago
A. hello dear u can give it before but if child is vomiting regularly then don't keep on giving medication like this u need to know the reason it might be infection so please consult with the doctor for that
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Expecting Mom due in 9 months
4 hours ago
Q. i missed my periods 3 days ago today I checked then this result come. but when I checked yesterday afternoon the result is the second attachment . why this is happening I am confused 😕
Dr Ghouse
Paediatrician
4 hours ago
A. you had to wait few days this can be delayed periods. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
Dr Ghouse has added a new answer
Expecting Mom due in 9 months
4 hours ago
Q. i missed my periods on 5 my result is attached but when I checked in the yesterday afternoon it was little bit dark why this is happening and what to do
Dr Ghouse
Paediatrician
4 hours ago
A. at present it is negative please wait few more days. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
Dr Ghouse has added a new answer
Guardian of 0 children
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Q. Hi, I am 35 weeks pregnant, and have AFI-24.3 and 2cm cervix length. What should I do to reduce AFI?
Dr Ghouse
Paediatrician
47 mins ago
A. AFI little bit more needs intervention medically. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
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