Green vomit in an adult with cancer

Vomiting is a natural defense mechanism, the purpose of which is mainly to remove toxins from the body or to protect some part of the gastrointestinal tract from excessive distension. Vomiting should not be related to digestion at all. It occurs during pregnancy, motion sickness, sometimes due to throat irritation or symptoms of a urinary tract infection. But this is no reason to panic. If vomiting is very severe or recurrent, you should of course seek specialized help, regardless of the cause. Especially when the question concerns a child and the color of the vomit is unusual. Green, coffee-ground vomit mixed with red blood—this type of vomit requires emergency treatment.

Probably everyone knows what “normal” vomiting looks like. This is usually a liquid characterized by a pungent, unpleasant odor. It’s enough to eat something bad, catch an acute virus, or have a little too much at a party - and you’re done. Most often, vomiting follows unpleasant nausea and abdominal pain, and brings relief and improved well-being.

Symptoms of black vomit

Black vomiting is a characteristic symptom observed in gastrointestinal oncology. It usually occurs in the early stages of the disease with a tendency to increase the frequency and duration of attacks. In most cases, an attack of coffee-ground-colored vomiting is preceded by a general deterioration in the patient's condition. The following symptoms are observed:

pain in the stomach;
tachycardia;
a sharp decrease in blood pressure;
hypotensive crisis;
fainting, loss of consciousness;
fever;
discharge of dark feces.

After some time, the attack itself begins, which is an eruption of black vomit, in which brown bloody clots can often be found.

Causes of vomiting in cancer patients

In people suffering from cancer, black vomiting can occur not only as a result of pathological processes in the body, but also as a side effect of treatment. The fact is that almost all chemotherapy drugs have a specific emetogenic effect on the patient’s brain, liver, stomach and intestines. Thus, according to experts, nausea and vomiting in cancer patients can be provoked by the following factors:

chemotherapy;
tumor intoxication;
radiation therapy;
inoperable stomach tumors;
side effect of gastric resection;
complicated tumors of the gastrointestinal tract;
the presence of concomitant infectious and inflammatory diseases;
intestinal obstruction;
dehydration of the body;
development of so-called electrolyte disorders;
a sharp decrease in body weight;
aspiration pneumonia;
reducing the dosage of medications;
refusal of treatment.

Another common cause of this condition may be irritation of advanced receptors located in the brain or gastrointestinal tract, which is often observed in cancer patients.
The appearance of metastases in the later stages of cancer development can also trigger nausea and bouts of dark vomiting. The black color of the vomit is due to the presence of altered blood impurities in it. What does vomiting blood mean in cancer and what does its color indicate? Thus, vomiting with dark, almost black blood in most cases indicates gastric bleeding. Vomiting with a dark brown color, reminiscent of coffee grounds, is a clear sign of bleeding in the intestinal area. Especially if the patient has black, tarry stools.

Causes of vomiting in different types of cancer

The vomiting reaction is always formed “in the head,” specifically in two zones of the medulla oblongata. One of the zones is called the vomiting center; a response is formed there to the transmitted impulses in the form of a command to contract muscles in some organs or relax in others. The second area, the chemoreceptor trigger zone (CHZ), also collects “nauseous” impulses from the underlying sections and sends them to the vomiting center for response.

When impulses to the medulla oblongata come from special sensitive cells of the intestinal mucosa, this mechanism is designated as peripheral. Signals coming from the cerebral cortex or from biologically active or toxic substances circulating in the blood directly to the chemoreceptor zone form the central mechanism of nausea and vomiting. In a cancer patient, both mechanisms are activated separately or together.

The central mechanism is believed to occur in the following clinical situations:

increased intracranial pressure due to tumor or metastatic lesions of the brain is complicated by visual and neurological disturbances, as well as a gag reaction when turning the head, and in severe cases even with synchronous opening of the eyes;
high concentration of calcium in the blood - hypercalcemia when bone tissue is destroyed by multiple metastases or when the parathyroid glands are involved in a conglomerate of thyroid cancer;
tumor intoxication , when toxic waste products of a cancer tumor and decay products of a tumor node are constantly released into the blood and poorly eliminated;
psychogenic vomiting reaction due to fluctuations in psycho-emotional state or from fear of imminent nausea and uncontrollable vomiting during chemotherapy.

The peripheral mechanism is involved in the following cases:

complications of the use of chemotherapy drugs that are toxic to nerve tissue, causing a significant decrease in intestinal motor activity until contractions stop—intestinal paresis;
intestinal obstruction or stenosis - narrowing of the outlet of the stomach by a malignant neoplasm;
tumor damage to the liver with a significant decrease in functionality.

The interaction of both signaling pathways to the vomiting center provides radiation and chemotherapy, in which toxic metabolites circulate in the blood and irritate the sensitive cells of the intestinal mucosa. When using high doses of narcotic analgesics, the effect of metabolites is complemented by a decrease in gastrointestinal motility, but gagging is less of a concern than almost constant nausea.

What does black vomit mean?

The eruption of brown vomit with foamy impurities may indicate pulmonary hemorrhage, characteristic of oncological diseases of the respiratory system. The appearance of profuse, continuous black vomiting is a serious phenomenon that poses a potential threat to the life and health of the patient. Black vomiting is especially dangerous, accompanied by the following symptoms:

increased body temperature;
signs of intoxication of the body;
sharp pain in the abdominal area, with a tendency to increase;
vomiting in masses that have been in the gastric cavity for several days.

If at least several of the above alarming signs are present, it is necessary to urgently call an ambulance, and before the doctors arrive, provide the patient with all possible first aid. In addition, black vomit may be a sign of intestinal obstruction or acute internal bleeding, which, if not promptly taken, can cause death.

Characteristics of vomiting

Vomiting without blood

Vomit without blood for cancer of any organ and stage does not require urgent medical intervention. However, if the ongoing process is not stopped, the consequences can be negative and even cause death. If the patient vomits for more than three days in a row, then the further prognosis will be extremely unfavorable.

The following complications are possible:

excessive dehydration;
general weakness and loss of immunity;
disruption of the cardiovascular system;
the occurrence of vascular blockage.

Vomiting with the absence of blood is a consequence of rotting processes in the affected organ. The amount of vomit is small. A characteristic feature is a sour odor specific to tissue decay.

Types of vomiting without blood:

Mucous vomiting that occurs in the morning or during the day without eating. The cause is stomach cancer or stage 4 cancer of any organ with multiple metastases. Insufficient production of digestive enzymes produced by the stomach, liver and pancreas contributes to the deterioration of the general condition. Vomit consists of a slimy liquid called cancer water.
Vomiting in the absence of gastric juice is typical for patients at the last stage and occurs immediately after eating. Nausea in stage 4 cancer is a constant companion to vomiting.
Vomiting of bile in oncology as a result of reflux from the duodenum into the stomach is a common phenomenon in cancer of these organs with multiple metastases. A characteristic feature is frequent urges and a green tint.

Different organs of the gastrointestinal tract produce different enzymes that participate in the digestion process and break down proteins, fats and carbohydrates. Based on the residual content of these elements in the vomit, one can draw a conclusion about the involvement of a particular organ in the pathological process and the depth of oncological changes.

Vomiting blood

If a cancer patient begins to vomit blood, then medical attention is needed urgently. This is a consequence of an advanced process, indicating damage to blood vessels. Blood occurs when a tumor that has many vessels for growth is damaged. With serious bleeding, the stomach quickly fills with blood, which gives it a burgundy or scarlet color in the vomit.

Black vomit

Black vomiting during oncological processes indicates hidden internal bleeding.

Requires urgent medical intervention and is a consequence of damage to the following organs:

Stomach cancer. Vomit with the color of “coffee grounds” is a consequence of the oxidation of iron in hemoglobin with hydrochloric acid, caused by bleeding from a stomach tumor. As the bleeding increases, it turns black.
Bowel cancer. Black vomiting is caused by intestinal obstruction, which is accompanied by black stool.
Respiratory tract cancer. Brown and black vomit with foamy impurities indicates pulmonary hemorrhage.
Stage 4 cancer of any organ. The eruption of brown-black vomit indicates an overdose of drugs, incorrectly selected chemotherapy, resulting in complete intoxication of the body.

The appearance of profuse, continuous black vomiting entails a risk of death. Before providing emergency medical care, it is important to make it easier for a cancer patient to vomit and relatively stabilize his condition.

The patient must be laid down, reassured and supported morally, since panic can aggravate an already deplorable condition.

After that:

to avoid vomit getting into the respiratory tract, the patient should be placed in a lateral position;
if gastrointestinal bleeding is suspected, ice should be placed in the abdominal area;
if pulmonary hemorrhage is suspected, an ice compress should be placed in the chest area;
to prevent dehydration, give the patient a warm herbal decoction;
give medications that maintain the level of electrolytes in the body.

The above procedures will bring temporary relief, improve the general condition and stop the bleeding process.

Why is this phenomenon dangerous?

Nausea and frequent bouts of vomiting observed in cancer patients not only significantly worsen the patient’s quality of life, but are also a potentially dangerous pathological phenomenon, fraught with numerous adverse consequences and disruption of the functioning of all body systems. The most common complications resulting from frequent and prolonged vomiting attacks include:

dehydration of the body;
development of diseases of the cardiovascular system;
damage to the mucous membranes of the gastrointestinal tract;
high risk of thrombosis associated with blood clotting disorders characteristic of cancer patients.

How to provide first aid?

With profuse, continuous black vomiting, it is very important to provide the patient with the correct first aid. First of all, the patient should be put to bed and ensure absolute rest. Directly during a vomiting attack, the patient should be carefully turned on his side and his head slightly tilted down to prevent vomit from entering the respiratory tract. Next, apply a cold compress or a heating pad with ice to the patient's abdomen. This will reduce the pain somewhat and also help stop possible bleeding.

Treatment methods for different types of vomiting in cancer, first aid

Oncology has achieved considerable success in the treatment of chemotherapy vomiting, despite an incomplete understanding of the mechanism of action of antiemetics. Not only standard prevention and treatment regimens have been developed, but also basic principles for taking antiemetic drugs:

early prediction of the intensity of complications and individual selection of a combination of antiemetics;
start taking it not when a complication develops, but ahead of time and strictly on an hourly basis;
the advantage of intravenous and rectal forms over those taken orally - orally;
adding tranquilizers for nervousness;
introduction of PPI drugs into the regimen that protect the mucous membrane;
adequate levels of microelements in the blood and a sufficient volume of circulating plasma are maintained by intravenous drips.

When vomiting, the likelihood of gastric contents refluxing into the respiratory tract in a conscious patient is minimal. If the patient is unconscious, which is possible in the terminal stage of cancer, especially with metastases to the brain or liver, the head is turned to the side, trying to tilt it lower.

It is impossible to interrupt the urge to vomit; interference with the process will worsen its course and irritate the patient. After vomiting, it is advisable to rinse your mouth and replenish lost fluid throughout the day by drinking cool water with electrolytes - rehydron - and only in small sips.

How to stop black vomit?

You can ease vomiting with the help of a small amount of herbal infusions (the most effective in this case are herbs such as chamomile, nettle, and peppermint). In addition, the following medications that have an antiemetic effect will help stop the attack:

Regidron;
Glucosolan;
Oralin;
Tseruk;
Ethylperazine;
Haloperidol;
Lorazepam;
Raglan;
Dexamethasone;
Marinol;
Methylprednisolone;
Dronabinol;
Procloperazine.

To stop the vomiting process, patients suffering from cancer are prescribed special drugs - serotonin receptor antagonists, which have an anti-emetogenic effect. The following medications are most often used for these purposes:

The action of all of the above drugs is based on blocking the so-called trigger zone of the vomiting center.

The selection of the drug and determination of the dosage is carried out by the attending physician on an individual basis.

When black vomiting is caused by internal bleeding, doctors first determine its source. After which the necessary measures are taken to stop the bleeding. If the patient has significant blood loss, then measures are taken to replenish it, mainly consisting of blood transfusion. If black vomiting was caused by acute intestinal obstruction, which also accompanies a number of oncological diseases, then artificial stimulation of the intestines is performed, which is carried out by introducing a special drug - Proserin - under the patient’s skin. In especially severe cases, surgery cannot be avoided to eliminate this problem.

Black vomiting in oncology is a dangerous pathological phenomenon that poses a serious danger to the patient and requires immediate qualified medical care.

Vomiting is a common symptom of many diseases, including oncology. Vomiting in cancer appears at stage 4 of the disease. It can be used to determine the nature of the disease and the patient’s condition. Antiemetic medications are used as treatment. Additional remedies include traditional medicine and proper nutrition. If a problem is identified, you should immediately consult an oncologist.

Treatment of hematemesis

All patients with hematemesis are referred for urgent gastroscopy, during which they try to detect the source in the form of a gaping vessel and carry out conservative measures to stop the bleeding.

Many methods have been developed for local control of bleeding during endoscopy; often several methods are used in one patient. They resort to hypothermia with an ice solution, hemostatic agents and various methods of coagulation and vascular embolization. It is especially difficult with profuse leakage, when the blood seems to be oozing from the wall and not a single damaged vessel is visible.

The frequency of relapses after endoscopic control of blood loss is also significant, so the possibility of performing surgery on a cancer patient is mandatory. A radical measure is removal of the stomach, but emergency intervention immediately after the bleeding has stopped results in high postoperative mortality, therefore, if possible, the patient is actively prepared for a planned surgical intervention within several days.

Treatment of a bleeding stomach is a very difficult task, requiring only an individual therapeutic approach with the clinic being well equipped with modern operating and diagnostic equipment. To this, our clinic adds vast experience in endoscopic interventions in complex cancer patients.

Content

Vomiting in cancer is a consequence of the disease and its treatment. The reason is a terrible diagnosis that claims millions of lives. If it is impossible to fight the cause due to circumstances beyond people’s control, then to ease the last days, hours, minutes of a cancer patient, it is important to fight the effect.

The nature of vomiting provides information about the stage of the disease, the effectiveness of treatment, and individual drug intolerance. Analysis of the color, composition, and consistency of vomit indicates the processes occurring in the body and serves as a signal for the use of urgent measures for hospitalization in emergency mode.

Reasons for appearance

Nausea occurs due to the disintegration of the tumor, the spread of metastases and intoxication of the body.

Often, such a symptom of oncology indicates a deterioration in the patient’s condition. Vomiting in cancer patients occurs when certain centers in the brain are affected by impulses. They come from different centers. During the development of cancer, the body suffers from an overabundance of chemotherapy. Chemoreceptors react to them, which send a signal to the brain and cause nausea.

Other drugs also have a bad effect on the body's flora. Therefore, the causes of vomiting are disturbances in the functioning of the gastrointestinal tract (GIT) and liver. Another reason is the spread of metastases in the human body. When they affect the brain, intracranial pressure rises there. This affects the baroreceptors and causes nausea.

Nausea and vomiting in oncology often occurs while taking medications.

use of cancer drugs;
use of narcotic analgesics;
intoxication due to the development of metastases;
hypercalcemia;
overwork, constant stress.

Return to contents

The color and nature of vomiting determines the patient’s condition and the stage of development of oncology. Vomiting without blood is a common sign of pathology. It has an acidic smell and speaks of rotten processes in the body. Nausea due to cancer with blood is a reason to urgently consult an oncologist. Such masses appear due to disruption of the vascular network and indicate internal bleeding. If the vomit is dark black in color, then this also indicates hemorrhage. Black vomiting in oncology indicates that the problem is localized in the gastrointestinal tract. Such nausea is accompanied by stomach pain and tachycardia. A brown mass indicates a deterioration in the patient’s condition. Vomiting bile indicates that the ducts in the body are closed and liver function has deteriorated. Nausea has 4 stages of development, which are presented in the table.

What affects the color of vomit, what determines the color of vomit?

By the color and nature of the masses annealed by the stomach, it is easier to determine the reason that provoked their appearance. It is also necessary to note whether the vomiting was preceded by pain in the stomach and what its nature is (after eating or independently of it, dull or acute, how sharp and intense), whether the use of any drugs was required for the onset of relief. It should be remembered that it is dangerous for health and life to attempt independent diagnosis and self-medication. If vomiting occurs, you should definitely consult a doctor who, if necessary, will prescribe tests and examinations to correctly determine the diagnosis and choose a treatment method.

Features of vomiting in oncology

Vomiting is dangerous for a cancer patient. Increases the risk of dehydration, which is a prerequisite for thrombosis. With an unremoved tumor or actively developing metastases, the blood clotting mechanism is disrupted. Eruption of contents occurs for the following reasons:

Chemotherapy or waiting for the procedure. It is almost impossible to predict the response to therapy; it is individual for everyone. Various factors influence the occurrence of nausea during chemotherapy.
Brain tumors in which blood pressure rises, causing nausea.
The spread of metastases in the liver causes an unpleasant condition. The patient experiences weakness, fever appears, and the skin becomes yellowish.
Diseases that have an inflammatory or infectious etiology.

Irritation of the receptors causes a gag reflex. When affected by intestinal or stomach cancer, the reflex appears at the slightest irritant. Such diseases are not treated only by nausea. Added to the unpleasant symptoms are indigestion, indigestion and bloating.

At what stage of cancer does nausea and vomiting develop?

Nausea appears at the fourth stage of oncology. It can occur after eating, when the food consumed has not yet begun to be digested.

If the condition is a rare occurrence and does not contain blood impurities, it is enough to take antiemetic drugs to ensure peace for the patient. In some cases, the body's rejection of vomit leads to death. Frequent urges cause complications:

dehydration of the body;
constant nausea contributes to the development of pathological conditions of the cardiovascular system;
internal bleeding;
the appearance of thrombosis.

Vomiting mainly occurs with stage 4 cancer. This is due to the following reasons:

with a brain tumor at the last stage, metastases completely affect the organ, due to which intracranial pressure increases;
complications after anticancer drugs;
taking painkillers based on narcotic substances;
intoxication that occurs when a malignant tumor enlarges or metastases are activated;
psychological reasons associated with a long struggle for life, stress and depression.

Complication of cancer - bleeding with vomiting

The first symptom of bleeding in cancer is most often sudden vomiting of characteristic contents. Bleeding is possible with a large or very small tumor located next to a large vessel. In almost 70% of patients with a complicated course of the disease, the size of the malignant lesion corresponds to stages 3 and 4 of cancer.

Initially, gastric bleeding in carcinoma is rarely pronounced; as a rule, the vessel corroded by the cancerous tumor periodically secretly sneaks in for some time, leading to anemia or aggravating existing anemia. With cancerous infiltration, the tissues become “hard” and the likelihood of vascular walls sticking together due to thrombosis is minimal, so seven out of ten asymptomatic bleeding patients eventually develop serious bleeding, and one in nine – up to shock due to rapid and severe blood loss. In every fifth patient, bleeding is combined with wall perforation or cancer growth into adjacent anatomical structures.

What happens and what does it mean?

The characteristics of vomit can say a lot about the extent of the disease. When examining the contents of vomit, attention is paid to color and consistency. Their nature may indicate certain disorders in the body:

vomit without blood indicates that putrefactive processes have begun in the organ affected by the tumor. The contents have a sour smell, but the volumes are not large. At the last stage of the disease, reflex vomiting becomes more frequent;
vascular damage causes vomiting of blood. If the tumor has many vessels, if their integrity is violated, the masses become red;
vomiting black masses is a sign of bleeding. The appearance of clear mucus indicates a malfunction of the gastric function and has dangerous consequences;
frequent nausea of light masses with small admixtures of bile indicate the formation of metastases in the liver. Their reproduction clogs the ducts, preventing the organ from working productively;
Green vomiting in oncology is a sign of the presence of bile. Repeated symptoms increase the concentration of bile, the vomit turns green. This manifestation indicates a deterioration in the condition of the liver or the activation and proliferation of metastases;
Vomiting of feces in a cancer patient is caused by intestinal obstruction. When a blockage occurs in one of the sections of the gastrointestinal tract, fecal contents accumulate in this block, gradually expanding it. Mechanical enlargement of the intestines causes a gag reflex, as a result of which the patient loses electrolytes. A cancer patient cannot go to the toilet and have a bowel movement naturally. The abdominal area gives off heaviness and discomfort. If treatment with conservative therapy does not bring results, surgical intervention is resorted to.

Treatment

If vomiting occurs once, treatment can be carried out at home. If it is not accompanied by diarrhea and fever, it is most likely indigestion or a reaction to high blood pressure, injury or stress. The measures taken must take into account the possible causes of this condition. In case of indigestion, it is necessary to take adsorbents or enzymes, follow a diet and drinking regime. In other cases, specific treatment is required.

In more serious cases, when the patient vomits a lot of green liquid, has diarrhea, a fever and symptoms of intoxication, it is necessary to contact a medical facility. This is especially important for children, since they very quickly develop dehydration, leading to death. At the same time, drinking ordinary water does not improve the patient’s condition, since a large amount of electrolytes and minerals are lost.

Treatment for green vomiting should take into account the causes of this condition. In case of poisoning, gastric lavage and enterosorbents are taken, for example, Smecta or activated carbon. Sometimes additional antibacterial drugs are required if this condition is caused by an infection. It is necessary to eliminate the causes of vomiting - reduce blood pressure, remove intestinal obstruction, remove toxins, improve the functioning of the digestive organs.

But in many cases, such measures are not enough, so special therapy is also required to overcome the urge to vomit. These may be drugs Cerucal, Metoclopramide, Domperidone. Sometimes you also need centrally acting drugs: Diazepam or Haloperidol. Antacids also eliminate nausea - Rennie, Maalox, Phosphalugel. They not only reduce stomach acidity, but also prevent belching.

If the color and consistency of the stool has also changed, anti-diarrhea medications are needed. These could be Motilium, Smecta, Loperamide.

Sometimes traditional methods are also used:

you can chew green tea leaves or drink this drink;
An infusion of dill seeds helps a lot;
take 30 drops of lemon peel tincture;
drink in small quantities decoctions of yarrow, burdock root, milk thistle, immortelle;
A decoction of chicory or ginger relieves nausea well.

Treatment methods for the condition

Treatment methods for symptoms of cancer depend on the etiology of the process. There is definitely no universal remedy that is equally successful for different patients. Despite the huge list of various medications intended to relieve the gag reflex, doctors advise starting or combining drug therapy with physical procedures. Non-drug therapy includes:

A massage that allows the patient to relax.
Swimming in warm water in the absence of contraindications.
Walking in the fresh air without overworking the body.
Mint tea.
Light gymnastics.

Such treatments are useful as a calming factor - the process of fighting cancer is stressful. Patients become depressed and live with a constant feeling of fear and uncertainty.

It is necessary to treat nausea not only for reasons of comfort. Such pathological conditions cause negative consequences, such as exhaustion of the body, large loss of fluid and drug intoxication. Together with the vomit, the patient loses the strength the body needs in the fight against cancer. Doctors often advise sticking to a balanced diet and replenishing the water-salt balance.

To relieve nausea, the following is prescribed:

Antagonists. It affects the vomiting center, blocking the urge.
M-cholinergic receptor blockers affect the muscles of the stomach and pancreas. The drugs relax and slow down the reflux of contents.
Glucocorticosteroids have a wide range of effects and are good at blocking vomiting syndrome, preventing it in the future.
Prokinetics that block dopamine receptors.

The choice of antiemetic drugs is large, the range of actions lies in the restoring effect of water balance.