Nausea and vomiting classification

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Differentiating Nausea and Vomiting from other Conditions

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Overview

Nausea and vomiting can be classified into acute or chronic

Acute nausea and vomiting

Acute vomiting which typically lasts from a few hours to few days is the most common presentation in the emergency department. Acute vomiting needs an extensive workup to exclude life-threatening conditions like bowel obstruction, mesenteric ischemia, acute pancreatitis, and possibly myocardial infarction.

Chronic nausea and vomiting

Chronic vomiting which lasts from weeks to months is initially evaluated in an outpatient setting. Cyclical vomiting syndrome is the most common cause of chronic nausea and vomiting.

Classification

Based on the duration of symptoms it can be classified as

Acute:

Acute nausea and vomiting can be caused by food allergies, viral gastroenteritis etc

It typically lasts from few hours to few days

Chronic:

Chronic nausea, vomiting can last from weeks to months. [1]

Chemotherapy is one of the most common cause of nausea and vomiting, and

Chemotherapy induced nausea and vomiting can be classified as

Acute:

Acute Chemotherapy induced nausea and vomiting (CINV) occur with in 24 hours of chemotherapy administration

Delayed:

Delayed CINV can occur at least 24 hours after chemotherapy and peaks between 48-72 hours [2]

Anticipatory:

Nausea and vomiting that is triggered by stimuli associated withchemotherapy and can be due to prior poor control of nausea and vomiting during chemotherapy [3] [4]

Refractory:

CINV that occurs despite maximum antiemetics

Breakthrough:

CINV that occurs within 5 days of chemotherapy despite of antiemetics. May require rescue therapy

References

  1. Lacy BE, Parkman HP, Camilleri M (May 2018). "Chronic nausea and vomiting: evaluation and treatment". Am J Gastroenterol. 113 (5): 647–659. doi:10.1038/s41395-018-0039-2. PMID 29545633.
  2. Navari RM (2003). "Pathogenesis-based treatment of chemotherapy-induced nausea and vomiting--two new agents". J Support Oncol. 1 (2): 89–103. PMID 15352652.
  3. . doi:10.1002/j.1875-9114.1990.tb02560.x. Missing or empty |title= (help)
  4. Jordan K, Kasper C, Schmoll HJ (January 2005). "Chemotherapy-induced nausea and vomiting: current and new standards in the antiemetic prophylaxis and treatment". Eur J Cancer. 41 (2): 199–205. doi:10.1016/j.ejca.2004.09.026. PMID 15661543.

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