Emesis is the forceful ejection of the stomach contents through the mouth. Regurgitation is the effortless bringing up of a small amount of food without discomfort or distress. For a layperson, these can be hard to separate. The differential diagnosis is very extensive and the most common problems vary with the age of the child. Congenital anomalies and inborn metabolic errors along with feeding difficulties are more common in infancy with infectious and systemic disease become more common in childhood.
Adolescence adds the problems such as eating disorders, drug use and pregnancy.
Potentially, any of the problems listed may be seen at any time. Attention should be paid to the timing of the emesis in association with eating, any associated pain or discomfort, changes in eating and elimination patterns, whether eating or eliminating improves or worsens the emesis, characteristics of the stool and urine, any trauma or systemic problems such as changes in mentation or weight loss, and fever. The physical examination should emphasize the abdominal examination, but other areas such as the respiratory, and genitourinary systems should be closely examined. Additionally, other systemic signs should be looked for including skin changes and an erythematous pharynx. A careful history and physical examination guides all laboratory and radiographic evaluations.