ABSTRACT
Vomiting and diarrhoea of acute onset, lasting 24—48 hours, without fever, are not diseases, but symptoms indicating that the body is expelling toxic or infected material from the intestine, and clearing the intestine of the substrate on which bacteria feed. 'Constipation' is one of the vaguest symptoms, and needs careful history-taking to explore what the patient is actually experiencing. Anti-emetics like prochlorperazine can give short-term relief of vomiting. It is one of several dopamine-receptor blockers that act on the chemoreceptor trigger zone of the brainstem, which is part of the vomiting control mechanism. A variety of chronic symptoms may present, including variable and varying abdominal pain, usually poorly localised, a sense of bloating, diarrhoea, constipation or a sense of incomplete defecation. A gastroenterologist might consider Irritable bowel syndrome as a diagnosis in the proven absence of structural, medical or neurological disease.
