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The American Journal of Gastroenterology May 2018Nausea is an uneasy feeling in the stomach while vomiting refers to the forceful expulsion of gastric contents. Chronic nausea and vomiting represent a diverse array of... (Review)
Review
Nausea is an uneasy feeling in the stomach while vomiting refers to the forceful expulsion of gastric contents. Chronic nausea and vomiting represent a diverse array of disorders defined by 4 weeks or more of symptoms. Chronic nausea and vomiting result from a variety of pathophysiological processes, involving gastrointestinal and non-gastrointestinal causes. The prevalence of chronic nausea and vomiting is unclear, although the epidemiology of specific conditions, such as gastroparesis and cyclic vomiting syndrome, is better understood. The economic impact of chronic nausea and vomiting and effects on quality of life are substantial. The initial diagnostic evaluation involves distinguishing gastrointestinal causes of chronic nausea and vomiting (e.g., gastroparesis, cyclic vomiting syndrome) from non-gastrointestinal causes (e.g., medications, vestibular, and neurologic disorders). After excluding anatomic, mechanical and biochemical causes of chronic nausea and vomiting, gastrointestinal causes can be grouped into two broad categories based on the finding of delayed, or normal, gastric emptying. Non-gastrointestinal disorders can also cause chronic nausea and vomiting. As a validated treatment algorithm for chronic nausea and vomiting does not exist, treatment should be based on a thoughtful discussion of benefits, side effects, and costs. The objective of this monograph is to review the evaluation and treatment of patients with chronic nausea and vomiting, emphasizing common gastrointestinal causes.
Topics: Chronic Disease; Cost of Illness; Humans; Nausea; Prevalence; Quality of Life; Vomiting
PubMed: 29545633
DOI: 10.1038/s41395-018-0039-2 -
Australian Family Physician Sep 2007Most people experience nausea and vomiting at some stage, but when these symptoms recur frequently they can significantly reduce quality of life. In most cases, a... (Review)
Review
BACKGROUND
Most people experience nausea and vomiting at some stage, but when these symptoms recur frequently they can significantly reduce quality of life. In most cases, a thorough history, examination and simple investigations can yield a diagnosis. Chronic nausea is a more challenging problem with its many potential causes and with a significant number of patients remaining undiagnosed despite extensive investigation.
OBJECTIVE
This article discusses the assessment and management of acute and chronic nausea and vomiting in adults.
DISCUSSION
Gastrointestinal infections and food poisoning are the most common causes of acute nausea and vomiting. Medication side effects and pregnancy should always be suspected. Hospitalisation may be required for severe metabolic abnormalities, dehydration or surgical causes. There are many potential causes of chronic nausea and vomiting and a comprehensive history and examination is required. Symptoms are poor predictors of functional versus pathological illness. Type and extent of investigation must be tailored to the individual patient.
Topics: Acute Disease; Adult; Chronic Disease; Diagnosis, Differential; Family Practice; Foodborne Diseases; Gastroenteritis; Humans; Nausea; Risk Factors; Vomiting
PubMed: 17885699
DOI: No ID Found -
Clinical Journal of Oncology Nursing Oct 2021Pain and nausea affect a significant number of patients with cancer. Applying foot reflexology to this population has had some positive effects, but more studies are... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Pain and nausea affect a significant number of patients with cancer. Applying foot reflexology to this population has had some positive effects, but more studies are needed to confirm its efficacy.
OBJECTIVES
The purpose of this study was to conduct a randomized controlled trial to evaluate the effects of foot reflexology on pain and nausea among inpatients with cancer as compared to traditional nursing care alone.
METHODS
A pilot study was conducted with adult patients with cancer hospitalized on a 24-bed inpatient oncology unit. Using convenience sampling, 40 patients provided consent and were randomized into either the intervention or control group. Each group had a treatment session of 20-25 minutes in which pre- and postsession surveys were completed, with reflexology performed in the intervention group only.
FINDINGS
Results show that foot reflexology significantly decreases pain for inpatients with cancer as compared to traditional nursing care alone. Although the effects on nausea are not statistically significant, they may be clinically relevant; the mean changes in pre- and postsession nausea ratings indicate at least some decreased nausea among patients in the intervention group.
Topics: Adult; Humans; Inpatients; Massage; Musculoskeletal Manipulations; Nausea; Neoplasms; Pain; Pilot Projects
PubMed: 34533507
DOI: 10.1188/21.CJON.539-545 -
Revista Espanola de Anestesiologia Y... Apr 2017Recognising the importance of the prevention and early treatment of postoperative nausea and vomiting (PONV) is essential to avoid postoperative complications, improve... (Review)
Review
Recognising the importance of the prevention and early treatment of postoperative nausea and vomiting (PONV) is essential to avoid postoperative complications, improve patient satisfaction and enable the development of major outpatient surgery and fast-track surgery. The topic of PONV might seem to have become stagnant, but we are moving forward. New concepts and problems like post-discharge nausea and vomiting, new risk factors and new drugs are appearing. However, there continue to be mistaken notions about PONV, such as the association between PONV and post-anaesthesia care unit stays, or assuming that it is a risk factore characteristic of the patient, anaesthesia or surgery when it is not. Perhaps, now is the moment to tackle PONV in a different manner, implementing guidelines and going for more aggressive prophylaxis in some groups of patients. We present an extensive review of this topic.
Topics: Humans; Postoperative Nausea and Vomiting; Prognosis; Risk Factors
PubMed: 28041609
DOI: 10.1016/j.redar.2016.10.001 -
Autonomic Neuroscience : Basic &... Jan 2017Nausea and vomiting of pregnancy (NVP) is one of the most common disorders of pregnancy. The symptoms occur predominantly during the first trimester, although in a... (Review)
Review
Nausea and vomiting of pregnancy (NVP) is one of the most common disorders of pregnancy. The symptoms occur predominantly during the first trimester, although in a subgroup of patients they can continue throughout the entire pregnancy and can affect the woman's quality of life. A small percentage of women develop a severe form of NVP called hyperemesis gravidarum (HG) that if left untreated may lead to significant maternal morbidity and adverse birth outcomes. Overall, the morbidity in pregnant women with NVP is significant, although it tends to be underestimated. The pathogenesis of NVP remains unclear, but there is consensus that the disorder is multifactorial and that various genetic, endocrine and infectious factors may be involved. The treatment of NVP can be challenging as the optimal targets for therapy are not known. Currently, the therapy used depends on the severity of the disorder and it is focused on improving the symptoms while minimizing risks to mother and fetus. Therapies range from dietary changes, pharmacologic treatment or hospitalization with intravenous fluid replacement and nutrition therapy. The aims of this review are 1) to provide an overview of NVP, 2) to present possible links between the most important factors associated with the pathogenesis of NVP and 3) to discuss the effectiveness and safety of the pharmacologic and non-pharmacologic options available to treat this disorder.
Topics: Female; Humans; Nausea; Pregnancy; Pregnancy Complications; Vomiting
PubMed: 27209471
DOI: 10.1016/j.autneu.2016.05.002 -
The American Journal of Managed Care Sep 2017Among patients with cancer, chemotherapy-induced nausea and vomiting (CINV) is a common adverse effect that not only impacts quality of life, but also treatment... (Review)
Review
Among patients with cancer, chemotherapy-induced nausea and vomiting (CINV) is a common adverse effect that not only impacts quality of life, but also treatment outcomes. It is important to address these issues from both prevention and treatment standpoints so that patients remain adherent to their regimens. With CINV being classified into 5 different types, the primary medication options for prevention and treatment include 5-HT3 receptor antagonists, NK1 receptor antagonists, and corticosteroids. Other medications used, but to a lesser extent, include dopamine antagonists, benzodiazepines, cannabinoids, and olanzapine. In addition, those patients who express interest in alternative or nonpharmacologic therapies may have options as well. With the array of medications available for patients with cancer, pharmacists play an integral role in optimizing patient outcomes. Therefore, it is important that pharmacists stay up-to-date on the most current guidelines available for CINV treatment.
Topics: Antiemetics; Antineoplastic Agents; Humans; Nausea; Neoplasms; Risk Factors; Vomiting
PubMed: 28978206
DOI: No ID Found -
European Journal of Pharmacology Jan 2014Clinical research shows that postoperative nausea and vomiting (PONV) is caused primarily by the use of inhalational anesthesia and opioid analgesics. PONV is also... (Review)
Review
Clinical research shows that postoperative nausea and vomiting (PONV) is caused primarily by the use of inhalational anesthesia and opioid analgesics. PONV is also increased by several risk predictors, including a young age, female sex, lack of smoking, and a history of motion sickness. Genetic studies are beginning to shed light on the variability in patient experiences of PONV by assessing polymorphisms of gene targets known to play roles in emesis (serotonin type 3, 5-HT3; opioid; muscarinic; and dopamine type 2, D2, receptors) and the metabolism of antiemetic drugs (e.g., ondansetron). Significant numbers of clinical trials have produced valuable information on pharmacological targets important for controlling PONV (e.g., 5-HT3 and D2), leading to the current multi-modal approach to inhibit multiple sites in this complex neural system. Despite these significant advances, there is still a lack of fundamental knowledge of the mechanisms that drive the hindbrain central pattern generator (emesis) and forebrain pathways (nausea) that produce PONV, particularly the responses to inhalational anesthesia. This gap in knowledge has limited the development of novel effective therapies of PONV. The current review presents the state of knowledge on the biological mechanisms responsible for PONV, summarizing both preclinical and clinical evidence. Finally, potential ways to advance the research of PONV and more recent developments on the study of postdischarge nausea and vomiting (PDNV) are discussed.
Topics: Animals; Antiemetics; Humans; Nausea; Neurochemistry; Postoperative Nausea and Vomiting; Risk Factors; Vomiting
PubMed: 24495419
DOI: 10.1016/j.ejphar.2013.10.037 -
Nutrients Nov 2022Nausea and vomiting are the most common side effects of chemotherapy. They must be managed because they can increase the risk of malnutrition in patients, which can... (Meta-Analysis)
Meta-Analysis Review
Nausea and vomiting are the most common side effects of chemotherapy. They must be managed because they can increase the risk of malnutrition in patients, which can adversely affect treatment. The objective of this study was to evaluate the effect of ginger supplementation as an adjuvant treatment for alleviating chemo We checked. therapy-induced nausea and vomiting (CINV). This study searched for randomized controlled trials (RCTs) related to ginger supplement intake for CINV in three electronic databases (i.e., Medline (PubMed), Embase, and Web of Science). The search period ranged from each database's first date of service to 5 November 2021. Two investigators independently performed abstract screenings, full-text screenings, data extraction, and risk of bias analyses (ROB). The Cochrane ROB tool was used for the assessment of ROB. This study systematically reviewed 23 RCTs. The effects of ginger supplementation were compared to those of placebo or antiemetic agents. This study conducted a meta-analysis after classifying the effects of ginger supplementation on acute and delayed CINV into subgroups due to the clinical heterogeneity between these RCTs. The results showed that the incidence of acute nausea ( = 0.53), the incidence of delayed nausea ( = 0.31), the incidence of acute vomiting ( = 0.09), and the incidence of delayed vomiting ( = 0.89) were not significantly different between the ginger supplement intake group and the control group. However, it was found that the ginger supplement intake group, which took not more than 1 g of ginger supplementation per day for above four days, had significantly less acute vomiting than the control group (OR 0.30; 95% CI 0.12 to 0.79; = 0.02; I2 = 36%). Ginger supplementation may reduce the incidence of acute chemotherapy-induced vomiting. However, this study could not confirm the effects of ginger supplementation on the incidence of chemotherapy-induced nausea and delayed vomiting. Therefore, it will be necessary to conduct additional studies with sufficient sample sizes using high-quality RCTs to evaluate the effects of ginger supplementations based on the results of this study.
Topics: Humans; Antineoplastic Agents; Zingiber officinale; Nausea; Randomized Controlled Trials as Topic; Vomiting
PubMed: 36501010
DOI: 10.3390/nu14234982 -
Presse Medicale (Paris, France : 1983) May 2019Nausea is a common feeling felt by the subject as a state likely to evolve into vomiting. However a lot of nausea is maintained without being followed by vomiting.... (Review)
Review
Nausea is a common feeling felt by the subject as a state likely to evolve into vomiting. However a lot of nausea is maintained without being followed by vomiting. Nausea can be isolated or accompanied by a clinical picture. Some situations are often accompanied by nausea like dizziness, migraines, transport sickness, pregnancy, acute or chronic digestive disorders or anxious state. Outside of a know pathological context, there must be an etiologic investigation. When they are accompanied by vomiting and general signs - especially a fever - nausea must first eliminate a potentially serious disease (intracranial hypertension, meningitis, occlusion…). Nausea resounds on the patient's quality of life, they can decrease concentration and professional activities. Many patients do not treat nausea and use rest and waiting for the resolution of symptoms. In the absence of signs of gravity taking a treatment without a medical prescription can be considered (recommendation ANSM 2008) especially for recurrent crisis whose cause can be precisely identified. They are many pharmacological substances with antinausea effects. If the etiological approach is essential and sometimes sufficient, symptomatic relief can be helped by some agents with less intense nausea and shorter duration especially by using of antihistaminics, anticholinergic agents and derivatives of phenothiazines.
Topics: Humans; Nausea
PubMed: 31113687
DOI: 10.1016/j.lpm.2019.04.004 -
Autonomic Neuroscience : Basic &... Oct 2006Nausea and vomiting are symptoms associated with a wide variety of diseases and particular life conditions, such as pregnancy. The symptoms may occur in acute form or... (Review)
Review
Nausea and vomiting are symptoms associated with a wide variety of diseases and particular life conditions, such as pregnancy. The symptoms may occur in acute form or chronically depending on the underlying pathogenesis. In some cases, nausea and vomiting are directly triggered by food, e.g. in patients suffering from food allergy or food intolerances. In other cases, food is not the primary cause but dietetic manipulations may still contribute to the management of the nausea and vomiting. Therefore, food plays an important pathophysiological and therapeutic role in nausea and vomiting. In the present article, we describe the most relevant nutrient triggers for nausea and vomiting, discuss food allergy and intolerance as cause of nausea and vomiting, propose a clinical classification of nausea and vomiting, and present in detail dietetic and other therapeutic strategies of relevance for the management of nausea and vomiting.
Topics: Female; Food; Food Hypersensitivity; Humans; Nausea; Nutritional Physiological Phenomena; Pregnancy; Vomiting
PubMed: 16935033
DOI: 10.1016/j.autneu.2006.07.011