Just a few thoughts.......

Throughout the day the blood flow concentrates in different parts of body because we are unable to carry enough blood to service the brain, muscles and organs simultaneously. Blood flows maximumly through the Liver between the hours of 11pm to 1am, and the gallbladder between 1am to 3pm.

When we sleep and about 4 hours after we last eat the body enters a housekeeping mode called the interdigestive migrating myoelectric complex or the migrating motor complex MMC.

There are four main phases of the MMC as follows:

Phase 1. A period of smooth muscle inactivity lasting 45 to 60 minutes, during which there are only rare action extensions and contractions.
Phase 2. A period of roughly 30 minutes in which peristaltic contractions occur and progressively increase in frequency. Peristalsis originates in the stomach and propagates through the small intestine.
Phase 3. The phase lasting 5 to 15 minutes in which rapid, evenly spaced peristaltic contractions occur. In contrast to the digestive period, the pylorus remains open during these peristaltic contractions, allowing many indigestible materials to pass into the small intestine.
Phase 4. A short period of transition.

The lower esophageal sphincter pressure is significantly higher during migrating motor complex phase 3 than phase 1; differences are approximately twofold. Some research has shown that the threshold to vomit is considerable lower during phase 2 of the MMC.

Failure of the MMC to complete properly can be cause by a number of different things and can only be diagnosed by analysing all the signs present in you fiend; for example, whether the vomit from the stomach or duodenum. Here are a few ideas:

The stomach doesn't empty properly because of an imbalance in hormones, autonomous nervous system misfunction, pyloric valve dysfunction. Also antidepressant drugs like amitriptyline a common tricyclic prescribed for a number of conditions including pain threshold.

In some people, delayed gastric emptying is the primary process which initiates nausea and vomiting by stimulating the vomiting centre in the brainstem through the gastric 'afferent' nerves. The intestines are design to transport liquids and the peristaltic waves of the stomach break up the solid food particles and forcing it though a small (about MM) valve called the pyloric sphincter. Large particles of food remain in the stomach until the MMC when the pyloric sphincter dilates. If particles still don't pass through vomiting is initiated. In most cases even large item like those swallowed by children pass through.

The Pyloric antrum is the initial portion of the pyloric part of the stomach. It is near the bottom of the stomach on the left side of the pyloric sphincter, which separates the stomach and the duodenum. It may temporarily become partially or completely shut off from the remainder of the stomach during digestion by peristaltic contraction of the prepyloric sphincter.

In diabetic people episodes of pyloric spasm or intense disorganised antral contractions lead to nausea and vomiting. The lack of a normal antral migratory motor complex, may contribute to abnormal emptying especially of dietary fibre, debris and bacteria which in turn renders the patient susceptible to bacterial overgrowth in the stomach and the upper intestine.

Upper intestinal fungal growth is also reported as casing delayed stomach emptying and vomiting.

There is a VERY rare condition where a large gallstone expelled into the duodenum where it becomes lodge and can interfere with the emptying of the stomach.

The MMC is stimulated by motilin and suppressed by somatostatin. The high levels of
somatostatin seen in insulin deficiency may also contribute to the inhibition of the MMC.

Treatment includes restoration of optimal metabolic control as well as correction of associated fluid and electrolyte abnormalities. The drug commonly used is metoclopramide, a dopamine known to increase gastric emptying.