nausea%20-and-%20vomiting
NAUSEA & VOMITING
Nausea is the sensation felt immediately before vomiting.
Vomiting is a partially voluntary act of forceful expelling of stomach contents up to and out of the mouth that may or may not be preceded by nausea.
Retching or repetitive active contraction of the abdominal muscles occurs between nausea and vomiting.
Management includes correction of clinically relevant metabolic complications, pharmacological therapy and treatment of underlying cause.

Supportive Therapy

Rehydration

  • Patients with nausea and vomiting may become dehydrated and malnourished because of inadequate oral intake of fluid and nutrients, including electrolytes
  • Fluids and electrolytes, notably K+, are lost directly in the vomitus
  • Patients’ fluid and electrolyte status should be properly assessed to ensure adequate replacement
  • Normal saline solutions are commonly used, together with K+ supplementation as needed
  • In patients with gastric distension, a nasogastric tube may have to be inserted and tube output measured, so that appropriate replacement may be given
  • No study has compared the different fluid replacements for nausea and vomiting of pregnancy

Other Supportive Measures

  • Other measures to reduce nausea and vomiting may be useful, particularly in patients who have nausea and vomiting of pregnancy
  • Pregnant patients should be advised to increase their rest, because tiredness may make nausea worse
  • Advise patients to avoid sensory stimuli that trigger symptoms eg strong odors
  • Enlist support from patient’s family and friends
  • Acupressure, acupuncture and acustimulation may be beneficial in patients with PONV and in women with nausea and vomiting of pregnancy
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Gastroenterology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Stephen Padilla, 09 Feb 2018
A point-of-order test restriction algorithm for hospitalized adults with diarrhoea reduces bacterial stool cultures and ova and parasites testing, which results in substantial cost and time savings, according to a recent study.
2 days ago
Older women consuming high levels of dietary fibre in the long term appear to have a lower risk of developing faecal incontinence, a study reports.
05 Jun 2018
Active endoscopic surveillance in patients with Barrett’s oesophagus (BE) promotes detection of earlier-stage oesophageal adenocarcinoma (EAC) and may result in a small survival benefit, according to a recent meta-analysis.
Pank Jit Sin, 6 days ago
The common antimicrobial agent, triclosan, has been implicated in colonic inflammation and the disease development of colitis and colitis-associated colon cancer, reveals a study appearing in Science Translational Medicine. [doi:10.1126/scitranslmed.aan4116]