医学部生の自習室

医学部生の自習室/Med student's study room

医学生の学びを世界へ / From Japan to the World: Daily Stories of a Medical Student

問診と身体診察を極めよう、OSCEにむけて:嘔気・嘔吐、腹部膨満感 / Unleash your Mastery - The art of history taking and physical examination: Nausea/Vomiting, Abdominal distension

Hey there! 

If you've ever felt queasy, thrown up, or dealt with a swollen belly, you know how unpleasant it can be.

 

みなさん、こんにちは〜!

今までに吐き気や嘔吐、腹部膨満感を感じたことはありますか?

今日はこれらの不快感に対してどうやって診察していくかを勉強してきました

 

Today, 

we’re diving into nausea, vomiting, and abdominal distention, breaking down what they are, why they happen, and how to deal with them. 

Let’s get started!

吐き気、嘔吐、お腹の膨張について、その正体や原因、対処法について詳しくまとめました

それでは始めましょう!

------------------------------------------------------------------------------------------------

The Basics: Nausea and Vomiting

基本事項:吐き気と嘔吐

What's Going On?

Nausea is that awful feeling where you think you might throw up.

何が起こっているのか?

まず吐き気とは、もどしそうになるあの嫌な感覚のことです。

 

Vomiting (or barfing, puking, hurling—you get the idea) is when your body forcefully expels what's in your stomach.

そして嘔吐は、吐き気の有無に関わらず

体が胃の中のものを力強く吐き出すことです。

 

It can be a one-time thing or happen over and over.

一度きりのこともあれば、何度も繰り返すこともありますよね

 

Why Does It Happen?

ではなぜ起こるのでしょうか

  • Acute/Sudden: Could be food poisoning, stomach flu, or even motion sickness.
  • Chronic/Ongoing: Might be GERD, pregnancy, or a reaction to medications.

 

What to Ask (Or Think About):問診

  1. Onset: 
    • When did it start? Is this a one-time thing or does it keep coming back?
    • Example: "How long have you been feeling like this? Is it the first time?"
  2. Quality: 
    • What's the vomit like? (Gross, I know, but important!)
    • Blood in vomit could mean a serious issue like an ulcer. Bile-stained (yellow/green) might point to a blockage.
  3. Severity: 
    • Are there other symptoms? Weight loss, headaches, or severe pain can signal bigger problems.
  4. Timing:
    • When does it happen? Morning sickness is common in pregnancy, while evening nausea might be due to alcohol or certain medications.

Swollen Belly Blues: Abdominal Distention

腹部膨満感:腹部膨張

What’s the Deal?

Abdominal distention is when your belly feels full or looks swollen.

さて次は、腹部膨満感に参りましょう

何が問題なのでしょうか?

腹部膨満感とは、お腹が満腹感を感じたり、膨らんで見える状態のことを指します

 

It can be gas, fluid, or even a tumor.

原因としてはガス、液体、または腫瘍などが挙げられます

もう少し詳しく見ていきましょう

 

Why Does It Happen?

  • Gas: Often from eating too quickly, carbonated drinks, or certain foods.
  • Fluid (Ascites): Could be from liver disease or heart failure.
  • Tumors: Sometimes, a mass or growth in the abdomen can cause distention.

How to Check It Out:身体診察

  1. Look and Listen:
    • Check for visible swelling, skin changes, or unusual bowel sounds.
  2. Feel and Tap:
    • Percussion and palpation can help figure out if the distention is due to fluid, gas, or a solid mass.

Meds to the Rescue: Anti-Nausea and Vomiting Treatments

薬物治療について

When it comes to stopping nausea and vomiting, 

there are several go-to medications:

吐き気や嘔吐に対しては、様々な薬を組み合わせて治療していきます

  • Antiemetics(制吐薬)
    • Serotonin Blockers: Like ondansetron (Zofran), they block the chemical that makes you feel sick.
    • Dopamine Blockers: Such as metoclopramide (Reglan), they help calm the nausea signals in your brain.(プリンペラン
    • Antihistamines: Think Dramamine or meclizine, great for motion sickness.
    • Steroids: Sometimes used for chemotherapy-induced nausea.
    • Benzodiazepines: Can help with anxiety-related nausea.

Common Idioms and Slang

To lighten things up, here are some fun ways people talk about feeling nauseous or vomiting:

さて、

ここまでは医学的な内容ばかりで、すこし気分が悪くなってきそうなので

すこし気分を変えて、嘔吐や吐き気に関係する面白い表現を学んでいきましょう

  • Barfing/Puking/Hurling: Just different ways to say vomiting.
  • Tossing Your Cookies: A playful way to say you're throwing up.
  • Blowing Chunks: Another colorful term for vomiting.
  • Calling Ralph on the Big White Phone: Vomiting into the toilet.
  • Technicolor Yawn: Vomiting with a visual twist.
  • Losing Your Lunch: Self-explanatory and kind of funny.
  • Talking to the Porcelain God: Another term for being sick in the toilet.
  • Yacking: Simple and to the point.

などなど、英語にも頓智の効いた表現が色々ありますね

ぜひ気に入ったものがあれば使ってみてください

 

Dealing with It:対処法

Practical Tips:臨床で使えるパール

  • Stay Hydrated: Sip water or an electrolyte solution.
  • Eat Light: Stick to bland foods like crackers or toast.
  • Rest Up: Give your body time to recover.
  • Avoid Triggers: Keep away from strong smells or foods that make you feel worse.

 

Conclusion:まとめ

Nausea, vomiting, and abdominal distention can be really uncomfortable, 

but understanding what's going on and how to handle it can make a big difference.

お疲れ様でした

吐き気、嘔吐、腹部膨満感は患者さんにとっては非常に不快な症状であり

何が起こっているのかを理解し、それに対処する方法を知っておくことは臨床においてとても役立つことでしょう

 

Keep these tips in mind, 

and you'll be better prepared to tackle these symptoms head-on. 

Stay well!

今日皆さんと共有してきたことを頭に入れて、

臨床の現場に出れば、きっと自信をもって診察していけるはずです

これからも頑張っていきましょう!